A newly employed critical care nurse was just about to finish a 12 hour night shift when she realized she had one more patient to administer medication to. It was the busiest Friday night shift she has ever worked due to poor nurse-patient ratio, and the workload felt impossible. She gave her last patient the properly prescribed medication, but failed to notice that the physician hastily wrote an updated dosage for a high risk medication, Digoxin. The patient’s heart rate began to slow down and life-saving procedures had to be activated. Medication errors are “any preventable event that may cause, or lead, to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer
Physicians ultimately decide what dose and drug will benefit the patient and restore them back to health. Held by the standards set by The College of Physicians and Surgeons, Physicians must abide by the Health Professions Act. Physicians are responsible to prescribe the right medication and right dosage. It is thought that physicians and other prescribers are ultimately to blame for medication errors. Although malpractices do occur among physicians, nurses are responsible to have a thorough understanding of the medications one administers to their patients. A nurse does not just simply do what they are told and administer drugs without having a thorough understanding and background knowledge. Nurses are to know the purpose of each drug they administer, the therapeutic effects, side effects which can be harmless or injurious, and adverse effects which is a severe negative response to the drug (2009). In reference to the previously mentioned scenario, the physician’s handwriting was careless and illegible. Although the Physician demonstrated lack of clarity, the nurse noticed the hastily written sentence signed by the physician and continued to administer the drug as she had routinely done the past couple days. Nurse’s should have a strong pharmaceutical knowledge background and be aware of the potential harm a medication could cause. In the process of medication administration, registered nurses are responsible to “determine that each medication order is clear, accurate, current and complete. Medications should be withheld when a medication order is incomplete, illegible, ambiguous or inappropriate; with concerns being clarified with the prescriber (CNO, 2015)”. The critical care nurse demonstrated ineffective communication, which was shown by failing to ask the physician for clarification. Another instance of miscommunication is during medication
...estions if not 100% sure of something or use a double checking system. When a nurse is administrating medication, they should use the ten rights of medication administration (right patient, right drug, right route, right time, right dose, right documentation, right action, right form, right response, and right to refuse). Nurses should always keep good hand hygiene and always wear appropriate clothing to prevent from the spread of disease. Good communication with patients and healthcare team members is also key to success. Keeping on the eye on the patient within an appropriate time is important. If the patient ever seems to be looking different than their usual self vitals should be taken immediately. Encouraging patients to ask questions if they are unaware of something can prevent errors as well. Nurses should make sure the patient is on the same page as they are.
Medication Errors one of the biggest issues happening in an acute care setting today . Although, Medications are given based on the five rights principles: the right patient, right medication, right route, right dose, and right time. Even with the five rights principles medication errors are still happening. However, some of the errors that are occurring are due to poor order transcriptions and documentation, drug interactions, proper drug name and not paying enough attention and environment factors.
Almost everybody on Long Island, and probably all around the world, has been prescribed a drug by a doctor before— whether it was to knock out a nasty virus, or relieve pain post injury or surgery. However, what many people don’t realize is that these drugs can have highly addictive qualities, and more and more people are becoming hooked, specifically teenagers. But when does harmlessly taking a prescription drug to alleviate pain take the turn into the downward spiral of abuse? The answer to that question would be when the user begins taking the drug for the “high” or good feelings brought along with it—certainly not what it was prescribed for (1). The amount of teens that abuse prescription medications has been rapidly increasing in recent
The main quality initiative affected by this workaround is patient safety. The hospital switched to computer medication administration as opposed to paper medication administration documentation because it is supposed to be safer. So, when the nurse gets the “wrong medication” message the computer thinks something is wrong, this is a safety net that is built into the computer system. If the nurse were just to administer the medication without any further checks, he or she would be putting patient safety on the line. The policy involved that pertains to this workaround is the “8 rights of medication administration”, which are: right patient, right medication, right dose, right route, right time, right documentation, right reason, and right response (LippincottNursingCenter®, 2011). Each nurse it taught these eight rights of medication administration in nursing school, therefore it is a nursing policy. When this workaround occurs the nurse should use his/her judgment before “scan overriding” and ensure these eight checks before administering the
A medication error is any preventable event that may cause or lead to inappropriate medication use or harm to a patient (NCCMERP 2014). The death rate for medication errors averages around 7,000 deaths per year. Lawsuits for medication errors were mainly made against registered nurses because nurses are the last people to check a medication before it is administered. 426 medication error related lawsuits were made against registered nurses. (RightDiagnosis 2014).
Ethical dilemmas are the issues that nurses have to encounter everyday regardless of where their workplaces are. These problems significantly impact both health care providers and patients. Patient safety is the most priority in nursing and it can be jeopardized by a slight mistake. Medication errors and reporting medication errors have been major problems in health care. Errors with medications have been found to be the most common cause of adverse drug effects (Brady, Malone, Fleming, 2009). Northwestern Memorial Hospital in Chicago conducted a research in 2012 that approximately forty percent of the hospitalized clients have encountered a medication error (Lahue et al., 2012). A nurse’s role is to identify and report these medication errors immediately in order to stop or minimize any possible harm to the patients. Ethical moral dilemmas arise when reporting the mistakes that have been made by one’s own colleagues, acquaintances, peers, or physicians.
Tzeng, H., Yin, C., & Schneider, T. E. (2013). Medication Error-Related Issues In Nursing Practice. MEDSURG Nursing, 22(1), 13-50.
Medication errors made by medical staff bring about consequences of epidemic proportions. Medical staff includes everyone from providers (medical doctors, nurse practitioners and physician assistants) to pharmacists to nurses (registered and practical). Medication errors account for almost 98,000 deaths in the United States yearly (Tzeng, Yin, & Schneider, 2013). This number only reflects the United States, a small percentage in actuality when looking at the whole world. Medical personnel must take responsibility for their actions and with this responsibility comes accountability in their duties of medication administration. Nurses play a major role in medication error prevention and education and this role distinguishes them as reporters of errors.
Patient safety should be the highest priority when it comes to health care, so why wouldn't the administrators reduce the ratio of nurse to patients to provide maximum patient care? Nurses that have a higher workload of patients are probably more prone to commit a medication error because they may not have the time to do the five checks of medication administration: the right drug, the right dose, the right route, the right time, and the right patient.
Drug administration forms a major part of the clinical nurse’s role. Medicines are prescribed by the doctor and dispensed by the pharmacist but responsibility for correct administration rests with the registered nurse (O'Shea 1999). So as a student nurse this has become my duty and something that I need to practice and become competent in carrying it out. Each registered nurse is accountable for his/her practice. This practice includes preparing, checking and administering medications, updating knowledge of medications, monitoring the effectiveness of treatment, reporting adverse drug reactions and teaching patients about the drugs that they receive (NMC 2008). Accountability also goes for students, if at any point I felt I was not competent enough to dispensing a certain drug it would be my responsibility in speaking up and let the registered nurses know, so that I could shadow them and have the opportunity to learn help me in future practice and administration.
Thank you for you post. Medication error is a serious issue which may affect patients and even cause death. In my hospital, in order to reduce the medication mistakes, except medical record and date of birth, we use the scanner scan the patient’s ID bandage and medication to match the e-MAR. The computer system will notify us any errors. This system helps us to avoid medication errors.
Care planning is one of these tasks, as expressed by, RNCentral (2017) in “What Is a Nursing Care Plan and Why is it Needed?” it says, “Care plans provide direction for individualized care of the client.” A care plan is for an individual patient and unique for the patient’s diagnosis. It is a nurse’s responsibility to safely administer a patient’s medication prescribed by the doctor. Colleran Michelle Cook (2017) in “Nurses’ Six Rights for Safe Medication Administration,” she says, “The right patient, the right drug, the right dose, the right route and the right time form the foundation from which nurses practice safely when administrating medications to our patients in all health care settings.” Nurses must be safe when dealing with medications, and making sure they have the right patient. Nurses document the care that is given to their patient, as said by, Medcom Trainex (2017) in “Medical Errors in Nursing: Preventing Documentation Errors,” it states, “Nurses are on the front lines of patient care. Their written accounts are critical for planning and evaluation of medical interventions and ongoing patient care.” Nurses must provide an exact, complete, and honest accounts of everything that happens with a patient. Doing this allows for the proper evaluation, and medical interventions for the patient. The typical tasks a nurse involves care planning, administration of treatments and medication, and documenting the care given to a
A physician was accused of professional misconduct for having his office nurse sign her name to his preprinted prescription forms for medications that the physician prescribed for his patients. The physician did not delegate any medical discretion to the nurse; in fact, it was the physician who determined the type of medication, administration, strength, and other particulars of the prescription the patient was to be given. The state board of nursing charged the nurse with professional misconduct for agreeing to sign these prescriptions.
I was also responsible for monitoring medication orders and reviewing patient profiles to ensure that the proper drugs and dosages were prescribed and that the pharmacy technician had prepared them properly. In many instances there were mistakes made in the preparation phase and sometimes even before, with incorrect dosages or drugs being prescribed and prepared, which could result in serious adverse effects for the patient. A clinical pharmacist’s role, however, is to make sure that these mistakes never reach the
Firstly, the main role of a pharmacist is to dispense medicines to their patients according to the prescription given. Before this, they have to ensure that they delivering the right drug, the strength and dosage of the medicine are appropriate, as well as ensuring the medication is safety and can work effectively in the human body. (Swanson, 2005)