Archive for February, 2008

Medical Identity Theft

February 27, 2008

I notice you deal with the subject Computer Forensic Science. What do you teach Forensic Nursing and Public Health Nursing students about preventing medical identity theft? This is regarding the public and clients that I communicate with during my Public Health Nursing duties.


Medication Error, comment

February 26, 2008

Adhering to the 6 right of medication administration is really the only sure way of preventing medication errors the best way we can. As a nurse who works on very busy and fast-paced area, it is very easy to overlook the 6 rights, especially when you are pulling meds from a medication-dispensing machine. An incident similar to this one occurred on my unit not too long ago. Fortunately, it did not result in patient harm or death. Misoprostil is used on my unit for cervical ripening. The M.D. ordered for the nurse to place 25mcg of misoprostil. The tablets normally come in 100mcg or 200mcg form. As far as everyone knew, we never had 200mcg tablets. The nurse pulled a 200mcg tablet, and without looking at the label, cut the tablet into 4’s. The patient ended up getting twice the correct dose. The pharmacy had stocked the wrong amount even though the nurse thought she was getting 100mcg. So, it is very important to read labels on medication prior to giving them to the patient, even if you think you are getting the right thing.

Original Post:
September 24, 2007
In 2006, a Wisconsin nurse administered the incorrect medication to a 16-year old girl who was in labor. The medication killed the girl almost instantly. The nurse had been working in the field for 15 years and was described as very competent. Following this incident, it was determined that the medication was labeled incorrectly. The nurse was subsequently charged with involuntary manslaughter.

In reading about the 6 Rights of Drug Administration, I couldn’t help but think of this case and so many other cases with similar circumstances. Any system is going to have flaws as humans are the ones designing the system and entering the data into the system. The 6 Rights can be adhered to, which will greatly reduce these types of occurrences, but they won’t be eliminated.

The charges against the nurse were dropped, but it’s something that she will have to live with for the rest of her life…that’s more punishment than any court could have imposed on her.


Medication Abuse, comment

February 25, 2008

I agree too, that physicians and nurses contribute to the addiction process of some patients. Very often I’ve seen the physician order the patient what he/she is requesting just to make their jobs a little easier, and so that they don’t have to deal with the many complaints these patients may have. Drug seekers definitely know how to work the system and get what they want. If the patient is unhappy with one doctor because they didn’t get the drug they wanted, they will go “doctor shopping” until they find a doctor that will prescribe the drug of their choice. I have also known an individual that goes by several different names, such as married names and her maiden name to be able to go to several different doctors to get her narcotics.

Original Post:
November 14, 2007
I cared for a patient the other day who is well known to our facility. She is an insulin dependant diabetic and extremely labile. Unfortunately, she is also a cocaine addict and abuses prescription pain medicines. The physician wanted her to be admitted to the psychiatric unit for detox. A crisis consult was made and a social worker came to evaluate her. The social worker was unable to evaluate her because she was so “snowed” on the medications we had given her she was unable to speak clearly or stay awake for the interview. The physician had prescribed dilaudid every two hours, vicodin every four hours, xanax every four hours and soma every eight hours. This was done because of the medication reconciliation form that we fill out on each patient on admission. It just seems as though nurses and physicians sometimes contribute to the abuse issues.


Public Health Nursing and Forensic Nursing, response

February 19, 2008

Yes, you can combine Public Health Nursing with Forensic Nursing.

You can take the Public Health Nursing program alone. One topic covered includes legal issues about abuse. Another topic includes abuse within the prison population.

You can take the Forensic Nursing program alone. An example of a topic in this program is Mann’s health and human rights triad. Another example is global health and human services.

The Public Health Nursing and Forensic Nursing program can be taken together. A detailed topic that could be covered is prevention programs for violence against women. Another is the promotion of safety, rules, regulations, and laws regarding elder abuse.

You will find links on the right side of the main page of this blog. These links will lead you to the online educational programs mentioned above.

Examples of employment that combines the two fields include working with a large police department emphasizing in prevention, working with Greenpeace International, and working as a consultant.

Original Post:
November 7, 2007
There was a discussion in October about combining Forensic Nursing with Health Promotion and Disease Prevention. Can I combine Public Health Nursing with Forensic Nursing? Can I do this via education and employment?


Autopsy defined

February 12, 2008

An autopsy is also commonly called a post-mortem examination. This procedure is a detailed and very careful medical examination of a person’s body and its organs after death in order to help establish the cause of the person’s death. A physician, most commonly a pathologist who specializes in the study of human diseases, performs the autopsy along with a forensic nurse/death investigator or nurse coroner. Surgical techniques are used to remove and examine each organ, and some tissue samples are selected for microscopic or other special tests. An autopsy is usually carried out within 48 hours after the death of a person. An autopsy can be hospital-based or coronial. The state coroner orders coronial autopsies, whereas hospital based autopsies may be performed at the request of the family. Autopsies will usually include testing for any infections through microbiology, changes in body tissue and organs by looking at the anatomical histology, and also any chemicals, medication or drugs poisons.


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