Posts Tagged ‘Forensic Nursing Medication Errors’

Medication Safety, comment

March 8, 2012

I appreciate your article Medication Safety. My work as a forensic nurse I see as helping people. I am not set out to put people in jail or prove them wrong. Our consulting firm is about helping institutions and their employees do their jobs without major errors. I too have witnessed people cry when they realize a lethal mistake they have made. If I can help them prevent future mistake, I am happy. If I can help others avoid mistakes, then we have done our service well.

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Medication Errors

January 22, 2012

Medication errors occur when a patient receives the wrong drug or dose or is given a drug at the wrong time or by the wrong route. If a medication is administered without consideration for possible side effects or drug interactions there may be dangerous results for the patient. Elderly patients are at high risk for medication errors because they frequently take many medications at the same time which can result in drug interactions or dosage mistakes. Problems can also occur if patients do not report all of the over-the-counter drugs or natural products that they may be taking. Even drugs that are “natural” and considered safe may still interact with other prescribed medications and have harmful effects.

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Insomnia and the elderly

October 17, 2011

Not only is insomnia an issue for the healthy older adult, it can be even worse for the older adult with dementia as they frequently get their sleep/wake cycles confused. Families often call or present at the office requesting sleeping aids. These sleeping aids for healthy elders pose their own risks, but for a dementia patient these risks are increased. Sleep aids often cause confusion, which can lead to increased wander. With increased wandering, there is an increased potential for falls, especially if there are stairs in the home. The likelihood of a patient actually leaving the safety of the home is increased, with the very real possibility of becoming lost. Another issue associated with increased nighttime confusion is often frantic phone calls, most often to adult children/siblings, which can disrupt other households. These phone calls also are known to go to emergency response personnel requiring them to respond to the home for a non-emergency situation. For all these reasons, the use of sedative/hypnotics as sleep aids in the elderly, especially those with dementia, should usually be avoided at all costs. Other pharmacologic interventions, which have been found to be useful with fewer side effects, are trazadone or melatonin. These medications usually work, but the patient can develop a tolerance, requiring higher doses. These medications are not addictive, but higher doses increase side effects. Non- pharmacologic interventions include herbal teas or gentle massage, much as you would do to an infant’s back. The overall goal, of course is return the patient to the appropriate sleep/wake cycle. No one intervention is always effective, and several mat need to be tried. The use of sedative/hypnotics should always be used as an absolute last resort and only for very short periods of time.

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200,000 Americans Killed Each Year in Hospitals by Medical Error (comment)

July 26, 2010

Errors in medication administration can be fatal to patients. It is extremely important for nursing staff to have the training and experience to administer medication but they also need to pay attention to detail. Not just using the 5 rights when administering medication but using them accurately and correctly. A nurse can go through the motions of the 5 rights but if they are not vigilant in their medication administration they are likely to make an error. Of course an error in medication administration is not the only error that can be made within the hospital that can be harmful to patients.
Another error that is possible to be harmful to patients is negligence. If a nursing assessment is not performed as it should be then a change in patient’s condition could be easily overlooked. Or the onset of something like a bed sore could go unnoticed and undocumented casing harm to the patient because it wasn’t caught early enough. Or the signs of a DVT could be overlooked and the DVT could be come fatal all because the assessment was lacking in care and awareness.
Hospitals are not the only place where an error could bring harm to patients. For example pharmacies are a place that can make easy careless mistakes that lead to harm patients. Working as an RN in family physicians office I have had patients call and say their pharmacy gave them the wrong medication or the wrong dosage. As an RN in a doctors office I must be vigilant in my duties as much as if I worked in a hospital, if I don’t pay attention to detail an error I made could have the potential to be life threatening to a patient I am caring for.
It may lie within the duty of the forensic nurse to participate in the legal side of medication error after it has happened. A forensic nurse may need to testify on what happened leading up to the error or even to what may have cause it. A forensic nurse or any other line of nursing it is imperative to be very oriented to every detail in caring for patients.

Original Post
July 7, 2010
Title: 200,000 Americans Killed Each Year in Hospitals by Medical Error, comment
The advent of medication distribution machines may give health care providers a false sense of security when administering medications to patients. As health care providers, we need to recognize that human error is still a potential part of this new medication administration process. The orders are entered by a human, then checked by a human. As nurses we need to review the 5 rights each and every time we administer a medication to a patient. If we become relaxed because the information is coming from a computer, or the medication pops out of a machine, then we are opening ourselves up to “high-risk” nursing practice. Each and every medication you administer to a patient needs to be considered independently. Medication errors should be reviewed monthly by nursing staff in a “morbidity and mortality conference” type of review meeting in order to educate ourselves and learn from others mistakes rather than shame ourselves with a discreet incident report. This may further bring to light the fact that we are human and we make errors, but accountability is key for us to reduce the numbers and make it a safer environment for providers as well as patients. Using machines and computers as tools, not as a replacement of our own cognitive skills, is the balance we need to embrace to reduce medication errors.

Original Post

March 31, 2010

Title: 200,000 Americans killed each year in hospitals by medical errors, comment

I definitely think this is a drastic number and being on the front lines, I can see how this happens. Especially in today’s ever changing healthcare field. First, you have EMR which has completely changed our world. There have been so many changes recently that it is very hard to keep up with it all. Not only they way we chart things, but how we administer medications. Caremobile, the pt scanning device, is supposed to help catch errors. But with the Electronic charting, the charts and orders are not getting checked like they were because it is too difficult to do and navigate around. Not to mention that there are alot of issues with connectivity, timeliness of entering meds by pharmacy, etc. That by the time the med could be given, alot of unnecessary time has passed, so you may just do a work around to get the task accomplished which defeats the purpose of using Caremobile to begin with! Throw long hours, after hours “catch-up”, high acuity, understaffing, and a whole slew of other issues that are dealt with daily, it is easy to see how these unfortunate things could take place. I definitely think that issues that are causing unnecessary deaths should take precedence over anything else. And fix what is the current problem before you add something else into the mix.

Original Post
March 29, 2010
Title: 200,000 Americans killed each year in hospitals by medical errors, comment
There is no simple answer to why medication errors occur. People die every year from preventable medical errors; wrong limbs are amputated, wrong organs removed, people receive the wrong medications, orders are incorrectly transcribed, medication reconciliation is often flawed, the list could go on forever. Errors are a result of human nature. While every effort is made to minimize and prevent errors, they still occur. Nursing education, annual and ongoing review of the Joint Commission National Patient Safety Goals, time outs prior to surgical procedures, are all great ways to work to prevent errors from occurring. Responses to errors should not be punitive; they are situations from which we learn. Errors result because processes fail.

Original Post
March 4, 2010
Title: “200,000 Americans Killed Each Year in Hospitals by Medical Error”
Listed in the above are common causes of medication errors: lack of sleep in caregivers, poor communication, illegible handwriting, poor staffing. These problems are encountered in all areas of patient care. There are never enough nurses, nurses have too many patients, work too many hours, and in reality are often rushed . Home medications are often not reported accurately and many physicians (who are also often rushed) write poorly. Several of the 2010 National Patient Safety Goals focus on medication administration as a result of reported medication errors. How do we change this? Change begins with education. Nurses must continue to learn about new medications and review old ones, never hesitating to consult resources if unsure about any aspect of a medication. As the last line of defense between the patient and a medication error, nurses must be dedicated to practicing the 5 Rights and the nursing process as it relates to medication administration, providing thorough assessments and evaluations even when rushed. Patients must be educated as well, and taught to ask and know about their medications, to report untoward effects and to learn about lifestyle changes which could reduce or eliminate the need for some medications. As nurses, we must continue to promote better nurse to patient ratio in all areas of care. We must exhibit professional and safe medication administration in our own practice and in mentoring new nurses just beginning their profession. The amount of reported medication errors is a sobering fact which should incite a call to all nurses and facilities to performance improvement in this area.

Forensic Healthcare Medication Error Attorney Lawyer

200,000 Americans Killed Each Year in Hospitals by Medical Error, comment

July 7, 2010

The advent of medication distribution machines may give health care providers a false sense of security when administering medications to patients.  As health care providers, we need to recognize that human error is still a potential part of this new medication administration process.  The orders are entered by a human, then checked by a human.  As nurses we need to review the 5 rights each and every time we administer a medication to a patient.  If we become relaxed because the information is coming from a computer, or the medication pops out of a machine, then we are opening ourselves up to “high-risk” nursing practice.   Each and every medication you administer to a patient needs to be considered independently.  Medication errors should be reviewed monthly by nursing staff in a “morbidity and mortality conference” type of review meeting in order to educate ourselves and learn from others mistakes rather than shame ourselves with a discreet incident report.  This may further bring to light the fact that we are human and we make errors, but accountability is key for us to reduce the numbers and make it a safer environment for providers as well as patients. Using machines and computers as tools, not as a replacement of our own cognitive skills, is the balance we need to embrace to reduce medication errors.

Original Post

March 31, 2010

Title: 200,000 Americans killed each year in hospitals by medical errors, comment

I definitely think this is a drastic number and being on the front lines, I can see how this happens. Especially in today’s ever changing healthcare field. First, you have EMR which has completely changed our world. There have been so many changes recently that it is very hard to keep up with it all. Not only they way we chart things, but how we administer medications. Caremobile, the pt scanning device, is supposed to help catch errors. But with the Electronic charting, the charts and orders are not getting checked like they were because it is too difficult to do and navigate around. Not to mention that there are alot of issues with connectivity, timeliness of entering meds by pharmacy, etc. That by the time the med could be given, alot of unnecessary time has passed, so you may just do a work around to get the task accomplished which defeats the purpose of using Caremobile to begin with! Throw long hours, after hours “catch-up”, high acuity, understaffing, and a whole slew of other issues that are dealt with daily, it is easy to see how these unfortunate things could take place. I definitely think that issues that are causing unnecessary deaths should take precedence over anything else. And fix what is the current problem before you add something else into the mix.

Original Post
March 29, 2010
Title: 200,000 Americans killed each year in hospitals by medical errors, comment
There is no simple answer to why medication errors occur. People die every year from preventable medical errors; wrong limbs are amputated, wrong organs removed, people receive the wrong medications, orders are incorrectly transcribed, medication reconciliation is often flawed, the list could go on forever. Errors are a result of human nature. While every effort is made to minimize and prevent errors, they still occur. Nursing education, annual and ongoing review of the Joint Commission National Patient Safety Goals, time outs prior to surgical procedures, are all great ways to work to prevent errors from occurring. Responses to errors should not be punitive; they are situations from which we learn. Errors result because processes fail.

Original Post
March 4, 2010
Title: “200,000 Americans Killed Each Year in Hospitals by Medical Error”
Listed in the above are common causes of medication errors: lack of sleep in caregivers, poor communication, illegible handwriting, poor staffing. These problems are encountered in all areas of patient care. There are never enough nurses, nurses have too many patients, work too many hours, and in reality are often rushed . Home medications are often not reported accurately and many physicians (who are also often rushed) write poorly. Several of the 2010 National Patient Safety Goals focus on medication administration as a result of reported medication errors. How do we change this? Change begins with education. Nurses must continue to learn about new medications and review old ones, never hesitating to consult resources if unsure about any aspect of a medication. As the last line of defense between the patient and a medication error, nurses must be dedicated to practicing the 5 Rights and the nursing process as it relates to medication administration, providing thorough assessments and evaluations even when rushed. Patients must be educated as well, and taught to ask and know about their medications, to report untoward effects and to learn about lifestyle changes which could reduce or eliminate the need for some medications. As nurses, we must continue to promote better nurse to patient ratio in all areas of care. We must exhibit professional and safe medication administration in our own practice and in mentoring new nurses just beginning their profession. The amount of reported medication errors is a sobering fact which should incite a call to all nurses and facilities to performance improvement in this area.

Forensic Healthcare Medication Error Attorney Lawyer


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