Response to the listing “Medical Errors”

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This is in response to the listing “Medical Errors”

I would like to respond to this response from the Quality Director. She was talking about how she is responsible for investigating all medication errors in her facility and finding a solution. I was at a conference for Nurse Educators this past week. One of the statements made was how medication errors by nurses are responsible for a large majority of lawsuits.

I took this information back to my students and we talked about how this can happen. We discussed that in order to administer medications, a nurse must have a current license and a medication order signed by a practitioner licensed with prescription privileges. We discussed that the nurse must understand the client’s diagnosis and symptoms as they pertain to the medications they are getting. It is the nurse’s responsibility to know why a medication is ordered, actions, dosing, route, side effects, adverse reactions, contraindications, and drug compatibility. The nurse must also take an active role in the education of the client and family. This information the nurse needs to safely administer medications follows the nursing process. Assessment is an ongoing process. Nursing diagnosis helps to identify problems. Planning helps one to be ready to recognize therapeutic, side effects, and adverse reactions. Nursing interventions allow the nurse to perform baseline assessments and additional assessments to establish goals. Evaluation is an ongoing process as well. The nurse must assess, collect data and evaluate her client on an ongoing basis to be certain that the therapeutic effects and adverse effects of a medication regime are noted. I pointed out to my students that being “unfamiliar” with a medication is considered negligence.

We teach students the proper way to identify a client. They must have two patient identifiers. Examples of these would be validation of patient name, medical record number, or date of birth. These can be found on the arm band and patient worksheet. They are responsible for asking drug allergies at the bedside prior to medication administration. We teach them to do three checks on their medication. The three checks include; first to check the original doctor’s order with their worksheet, second to check their medication against the worksheet when pulling it from the pyxis machine, and third at the bedside in front of the patient. We also teach the five rights of medication administration: right drug, right dose, right route, right time, and right patient. One of the ways our hospital facility has tried to decrease medication errors is to have a mat placed on the floor in front of the pyxis machine that says “quiet zone”. When someone is on the mat, no one is to talk to them. There are also signs posted in the medication room warning of SALAD; sound alike, look alike drugs. Our facility has identified a list
of “unsafe” abbreviations. The doctors may no longer use certain abbreviations when writing orders. A few examples related to medications are: must write out units not U, magnesium sulfate not MgSO4, morphine sulfate not MSO4, and daily instead Q.D.

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