Medication Errors Overview (01:21)
Caring for patients is often stressful. Frequent interruptions and changing patient needs can lead to errors. Nurses provide the last opportunity for error prevention. This program will examine potential error scenarios and discuss how to avoid them.
Scenario One (02:12)
Baby Juan was born 30 minutes ago; his parents do not speak English. A nurse fails to verify the patient's identification before administering vitamin K and erythromycin eye ointment; he has already received them. She should have checked his ID band and used a certified interpreter.
Scenario Two (01:41)
Mrs. Jones suffers dehydration secondary to diarrhea. A physical therapist asks the nurse's help to move Mrs. Smith; the nurse accidentally gives her Mrs. Jones' medication. He should not have been deterred by a non-emergency situation, and should have checked Mrs. Smith's armband.
Scenario Three (01:09)
Mr. Hall’s order reads D5 one-half normal saline at 125 ml per hour IV. After checking the MAR, the nurse replaces the IV bag but hangs D5 normal saline. Nurses should be familiar with available IV solutions, read labels carefully, and compare bags against the MAR.
Scenario Four (01:35)
Mrs. Rogers is NPO and has an NG tube set to low suction. Medication orders read Klor-Con 20 ml-equivalent orally daily; the nurse administers the Klor-Con orally without noticing she is NPO. He should have called the physician to amend the order to an IV route.
Scenario Five (01:12)
The nurse comes in to administer Mrs. Dern’s Toprol XL 100 mg and finds her blood pressure low. He returns to the desk to notify the physician and documents withholding the medication with initials and time but forgets to circle the medication.
Scenario Six (03:20)
The physician orders 10 units of insulin via IV push to lower Dawn’s blood sugar; the nurse’s supervisor is not available to double check her dosage. Using a TB syringe, she draws up 100 units, instead of 10. Nurses should be especially careful with syringe types; night shift nurses are at risk of error.
Scenario Seven (01:26)
Mr. Reed has an allergic reaction to a new medication. His medication order reads Benadryl 25 mg deep IM every 4 hours but the nurse administers it via IV. He should have carefully read the MAR and rechecked the medication several times.
Scenario Eight (01:17)
Mrs. Long's order includes Zestril 10mg by mouth twice daily; hold if systolic blood pressure is less than 100. Her blood pressure shows 95/56. The nurse administers morning medications without checking the morning vital signs. She should have checked the MAR and qualifiers.
Scenario Nine (02:23)
A medical-surgical nurse administers morning medications to three of five patients when she gets an OR call to administer a pre-operative medication to the fourth. She later realizes she forgot her fifth patient. Nurses commonly use report sheets to track tasks.
Scenario Ten (01:23)
Mr. Daniels' physician orders Buspirone hydrochloride for anxiety. The nurse notes that he appears agitated and has an increased pulse. He should immediately notify the physician of the adverse response, medication given, and any other medications within 24 hours, and then take a verbal order.
Scenario Eleven (01:46)
A nurse administers Mrs. Frost’s morning Synthroid 0.125mg PO. Returning to the cart, she responds to another patient without documenting the administration on the MAR. She should have asked that patient to wait a moment and documented Mrs. Frost’s administration.
Scenario Twelve (02:17)
The nurse notices a new order for Remeron 4mg PO for Mrs. Monroe. She calls the pharmacy and learns Remeron does not come in a four milligram tablet. She calls the ordering physician, who had intended to order Reminyl, and confirms the spelling.
Medication Errors Summary (00:47)
Correct and safe administration forms a crucial part of any nurse's job; errors can lead to death. Following the eight rights of medication administration will help prevent medication errors.
Credits: The Eight Rights in Practice (00:17)
Credits: The Eight Rights in Practice
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