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02.02 Medication Errors

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Overview

  1. Medication errors in nursing
    1. Most common nursing mistake
    2. Reduction is goal
    3. Follow facility policy and procedure
  2. Implications to patient
    1. Increased mortality
    2. Increased length of stay
    3. Increased costs
  3. Implications to nurse
    1. Counseling
    2. Possible
      1. Suspension
        1. Loss of pay
      2. Loss of license
      3. Legal suit

Nursing Points

General

  1. Prevention of medication errors
    1. Follow 5 patient rights
      1. Right patient
      2. Right medication
      3. Right route
      4. Right dose
      5. Right time
    2. Question unclear orders
    3. Remove distractions
    4. Double check!
    5. Medication review
    6. Patient education
      1. Talk to patient about meds!

Assessment

  1. What to do
    1. Assess patient!
    2. Contact provider
    3. Disclose mistake to management
  2. What to document
    1. Facts only!
      1. Administration details
        1. Drug
        2. Time
        3. Route
        4. Amount
      2. When the provider was notified
      3. If any new orders were given
      4. Completion of new orders
    2. Do not state in chart 
      1. Medication mistake made
    3. Incident report
      1. Internal review
      2. Root cause analysis
  3. Absolutely DO NOT
    1. Falsify documentation
    2. Omit information in documentation
    3. Lie about mistake

Nursing Concepts

  1. Clinical judgement
  2. Ethical and legal practice
  3. Safety

Reference Links

Video Transcript

Hey guys!  Today I am going to talk to about medication errors, including what we document when one occurs as well as a few implications if one unfortunately occurs.  

Ok so I am completely aware that this isn’t something fun to talk about as nurses but unfortunately it does happen.  Guys medication errors are one of the most common mistakes made by a nurse. I truly hope this never happens to you but I must tell you some of the most fantastic of nurses make medication errors remember we are all human.  So guys through checks and balance and policy and procedures we strive to not make mistakes but we know it does happen so the reduction of medication errors is our goal. Remember always follow your state and facility policy and procedure if a medication error occurs to your patient.

So why is this issue so important or what are the implications?  Well of course with any error including medication errors there is increased mortality to the patient.  But in addition to this there is an increased length of stay and also increased costs to the patient and the facility.

Again I know this isn’t a fun topic but it’s definitely something we as nurses need to be aware of.  So if you were involved in a medication error with your patient….what may be the implications to you?  Well you can definitely count on being counseled on the error most likely from you nurse manager. Guys this is ok…the hope is that there is no harm done to your patient and you are able to review and understand where and why the mistake was made a move on.  In addition to counseling there is always a possibility of suspension or even loss of license depending on the graveness of the situation or if there was possibility any neglect of the patient identified. Finally guys, especially if death occurs because of the error there is most definitely the chance of a legal suit.

Ok so I think it is very important in this lesson to do a quick review on the prevention of medication errors.  Guys you are professionals and this is most definitely all things that I am sure have been drilled into you but it never hurts to review again.  Ok remember always follow those 5 patient rights, right patient, route, drug, time, and dose. Always question unclear orders and always go with your gut!  If something just doesn’t feel right to you….it probably isn’t! Be sure you remove distractions, focus on what you are doing only! Double and triple check!  And even if you have been a nurse for years it is always good to review medications.

Ok so if medication error does occur….what do you do?  First and foremost guys assess your patient!!! Notify the provider of the error and also the nurse manager.
In the event of the medication error what do you document?  Remember guys facts only! Do document all of the administration details, when the provider was notified, if any new orders were given, and the completion of the new orders.  Ok so let me give you an example. Lets say your patient is allergic to morphine but the provider orders morphine prn for pain and it is on the MAR. You administer morphine to your patient.  Now I know that some of you are thinking that would never happen to me because the EMR wouldn’t let me but guys don’t count on that because sometimes these checks an balances fail. At any rate you administered morphine to your patient.  Here is an example of what you may document. Morphine 4mg administered IV, provider notified, no new orders given. Additionally, you would document the assessment of your patient. So basically you gave the facts, you were truthful, and you did not alter a legal document in any way.  Remember, this is just an example, follow your facilities policy.

I just want to say this again because it is critical that you DO NOT falsify documentation, omit medication information, or lie about a mistake.

Ok guys lets review!  Medication errors are a common nursing mistake, implications to a patient and nurse include increased mortality, loss of license, and legal suits.  Prevention of medication errors include following the 5 patient rights, no distractions, double and triple check, and the review of medications. What do you do if a medication error occurs?  Assess the patient, contact the provider, and notify the nurse manager. What do you document, the facts only, administration details, do not falsify documentation or omit medication information.

A few nursing concepts that we can apply to medication errors include clinical judgement, patient safety as reducing errors keeps patients safe, and ethical and legal practice because as nurses we want to be legally safe.

We love you guys! Go out and be your best self today! And as always, Happy Nursing!

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