Apothecary measures in medicine

meanmaryjean, DNP, RN · Sep 18, 2015

I cannot think why teaching this system of measurement 'causes' med errors. Can you substantiate this? I mean, you used the word four times in your post, and yet provided none. (Please forgive me, but this seems like a posting from a student who failed an exam on the apothecary system to me.)

comocean · Sep 18, 2015

I cannot think why teaching this system of measurement 'causes' med errors. Can you substantiate this? I mean, you used the word four times in your post, and yet provided none. (Please forgive me, but this seems like a posting from a student who failed an exam on the apothecary system so me.)

Your reply, although greatly appreciated, shows EXACTLY why different systems should not be utilized in medicine. Your typing errors and failure to address the issue as requested with substantiated evidence shows the carelessness some healthcare professionals utilize. Opinions were not solicited, only substantiated evidence in support of the removal was requested. Again, thank you for your OPINION, however, it is not appropriate in this topic.

KatieMI, BSN, MSN, RN · Sep 18, 2015

I would like to solicit the assistance of anyone that could help substantiate the removal of the apothecary system of measurement from the curriculum at my nursing school. I presented the concept to the associate dean and substantiated my position. He agreed and is willing to take that suggestion to the curriculum committee for the removal. I simy hope to have rock solid substantiated evidence to sway that committee to immediately remove this archaic system that causes more medication errors than any other singular aspect as well as to show it should be used as a historical concept rather than that of modern medication practices. Any substantiated support on this topic would be greatly appreciated. Thanks.

Really?

http://www.medscape.org/viewarticle/556487

Here is the evidence that system that maybe, indeed, archaic, is not involved in the wast majority of medication errors. Nobody measures insulin and aspirin in tablespoons.

Otherwise, good luck to you explaining concepts of ml/day and mg/kg to someone who is not able to count to four and add 2 to 3 (and refuses, for whatever reason, to take pills). This people, and there are surprisingly lots of them, need clear, simple instruction of " pour up to THIS line, drink it all, morn, lunch and dinner time, every day".

chare · Sep 18, 2015

...Opinions were not solicited, only substantiated evidence in support of the removal was requested. Again, thank you for your OPINION, however, it is not appropriate in this topic.

Unfortunately for you, when you post on an anonymous internet forum, you don't have the option of dictating terms to those that respond.

However, in response to your original post. How do you see this as a causative factor in creating medication errors? Converting aspirin gr X to 650 mg isn't any more confusing, or likely to cause a medication error than calculating the volume of adenosine required for a 0.15 mg dose?

As the apothecary system highlights the importance of knowing conversion factors and how to properly set the equation, I am surprised that the associate dean agreed to this. I would be even more surprised if the curriculum committee agreed to remove it.

meanmaryjean, DNP, RN · Sep 18, 2015

Unfortunately for you, when you post on an anonymous internet forum, you don't have the option of dictating terms to those that respond.
However, in response to your original post. How do you see this as a causative factor in creating medication errors? Converting aspirin gr X to 650 mg isn't any more confusing, or likely to cause a medication error than calculating the volume of adenosine required for a 0.15 mg dose?
As the apothecary system highlights the importance of knowing conversion factors and how to properly set the equation, I am surprised that the associate dean agreed to this. I would be even more surprised if the curriculum committee agreed to remove it.

I'd be even MORE surprised if this is an actual educator posting. :)

chare · Sep 18, 2015

I'd be even MORE surprised if this is an actual educator posting. :)

Agreed.

(Please forgive me, but this seems like a posting from a student who failed an exam on the apothecary system so me.)

Again, agreed.

comocean · Sep 18, 2015

I agree completely with your posting about those that respond. Perhaps there is less to do than to arbitrairly respond to things you cannot substiantiate in a negative manner than to just pass the posting that requested assistance to support the matter. Perhaps reading the NAM from the ISMP where a mother inadvertently overdosed her child in July 2015 because the measurements on the cup were mistakenly read. Since 1947, even the JAMA required exact conversions when publishing and requests only the metric system be utilized.

Again, if you have nothing positive to contribute please find something more constructive to do rather than voice your unsupporting opinion to something that others may well find valuable in protecting and hopefully reducing the needless 100,000 deaths each year from mistakes in administering medicine. PLEASE, again, only those supporting this is requested to reply with substianted documentation...not personal opinions...and if your name has MEAN anywhere continued therein...pass the post for something you may find your opinion making a difference. Kindest regards,

Mavrick, BSN, RN · Sep 18, 2015

6:10 am by meanmaryjean[COLOR=#003366], MSN, RN[/COLOR] I cannot think why teaching this system of measurement 'causes' med errors. Can you substantiate this? I mean, you used the word four times in your post, and yet provided none. (Please forgive me, but this seems like a posting from a student who failed an exam on the apothecary system to me.)

I already like you better than that non-nurse.

Boy, you sure do get up early. (or stay up late)

Mavrick, BSN, RN · Sep 18, 2015

Maybe I'm just a nerd, but I liked the apothecary measures. I also like the word unguent and that's hardly, if ever, used anymore.QUOTE]
Poultice has a special place in my heart.

chare · Sep 18, 2015

â€¦Perhaps reading the NAM from the ISMP where a mother inadvertently overdosed her child in July 2015 because the measurements on the cup were mistakenly read.

Are you referring to the June 30, 2015 NAN Alert that reported the following?

A fatal event was reported recently to the ISMP National Medication Errors Reporting Program in which a nurse confused two dosing scales that appear on a plastic oral liquid dosing cup. It has an archaic measureâ€”drams (fluid drams)â€”which the nurse confused as mL. This particular dosing cup is commonly used in US healthcare facilities today.

If you are describing a separate incident, please provide a link.

â€¦Since 1947, even the JAMA required exact conversions when publishing and requests only the metric system be utilizedâ€¦

Source? And please note, what you provided states that the AMA requests the use of metric system measurements. There are more recent discussions of the use of metric system measurements in AMA manual of style, but, since this is your quest, I'll leave it to you to find them.

â€¦Again, if you have nothing positive to contribute please find something more constructive to do rather than voice your unsupporting opinion to something that others may well find valuable in protecting and hopefully reducing the needless 100,000 deaths each year from mistakes in administering medicineâ€¦

Are you suggesting that teaching the apothecary system in nursing school is responsible for a large percentage of the 100,000 deaths each year resulting from medication errors? A system that, in practice, is rarely, or every used? Can you provide a source for this?

The only medication that I can remember actually seeing ordered using apothecary measurements is nitroglycerin gr 1/150, and even that has been some years ago.

â€¦PLEASE, again, only those supporting this is requested to reply with substianted documentation...not personal opinions...and if your name has MEAN anywhere continued therein...pass the post for something you may find your opinion making a difference. Kindest regards,

You're demanding that we either substantiateâ€ your claims. As you are the one making them, it is incumbent on you to provide documentation.

And finally, as I mentioned in my first post, the use of the apothecary system in nursing school ensures that the learner actually understands the process of converting units.

AcuteHD · Sep 19, 2015

...to sway that committee to immediately remove this archaic system that causes more medication errors than any other singular aspect...

So much potential for fun and points on this thread, thanks OP.

1: Have you ever dealt with any kind of committee?? They do NOTHING immediately. and,

2: You claim that teaching apothecary causes med errors, but the only instance you cite is a mother that misread a cup. I don't see the connection.

Also, unless you are one of the great mods, you don't get to control what is appropriate on this forum. You can ***** and moan about it, but that's about it.