Medication Errors

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Outline

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

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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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Concepts Covered:

  • Studying
  • Test Taking Strategies
  • Basics of NCLEX
  • Terminology
  • Substance Abuse Disorders
  • Communication
  • Documentation and Communication
  • Legal and Ethical Issues
  • Community Health Overview
  • Respiratory Disorders
  • Suffixes
  • Cardiac Disorders
  • Respiratory
  • Respiratory System
  • Cardiovascular Disorders
  • Intraoperative Nursing
  • Microbiology
  • Postpartum Complications
  • Urinary Disorders
  • Urinary System
  • Medication Administration
  • Musculoskeletal Trauma
  • Musculoskeletal Disorders
  • Dosage Calculations
  • Central Nervous System Disorders – Brain
  • Cognitive Disorders
  • Hematologic System
  • Lower GI Disorders
  • Endocrine and Metabolic Disorders
  • Pregnancy Risks
  • Circulatory System
  • Integumentary Disorders
  • Renal Disorders
  • Disorders of Thermoregulation
  • Prefixes
  • Adult
  • Learning Pharmacology
  • EENT Disorders
  • Fundamentals of Emergency Nursing
  • Bipolar Disorders
  • Depressive Disorders
  • Emergency Care of the Cardiac Patient
  • Note Taking
  • Shock

Study Plan Lessons

Steps in the Nursing Process 1 Nursing Mnemonic (ADPIE)
Anatomy of an NCLEX Question
Diagnostics Terminology
Head to Toe Nursing Assessment (Physical Exam)
How to Take Nursing Report
How to Write A Nursing Progress Note
Intro to Community Health
Lung Sounds
MedTerm Suffixes
Nursing Process
Nursing Process – Assess
Nursing Process – Diagnose
Nursing Process – Evaluate
Nursing Process – Implement
Nursing Process – Plan
Nutrition (Diet) in Disease
Overview of the Nursing Process
Head to Toe Nursing Assessment (Physical Exam)
10.02 Breath Sounds for CCRN Review
Heart (Cardiac) Sound Locations and Auscultation
Heart (Cardiac) and Great Vessels Assessment
Heart Sounds Nursing Mnemonic (APE To Man – All People Enjoy Time Magazine)
Lung Sounds
Biohazard Material Handling and Disposition (Blood, Microbiology, Creutzfeldt-Jakob Disease) for Certified Perioperative Nurse (CNOR)
Inserting a Foley (Urinary Catheter) – Female
Inserting a Foley (Urinary Catheter) – Male
Sterile Field
Sterile Gloves
Sterile Field Maintenance (Aseptic Technique) for Certified Perioperative Nurse (CNOR)
Sterilization and Cleaning (Instruments, Reusable Goods) for Certified Perioperative Nurse (CNOR)
Sterilization and Storage Environment Conditions for Certified Perioperative Nurse (CNOR)
Transportation and Storage (Single Use Items) for Certified Perioperative Nurse (CNOR)
Using Aseptic Technique
Wound Care – Assessment
Wound Care – Dressing Change
Wound Care – Wound Drains
Complex Calculations (Dosage Calculations/Med Math)
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
ABGs Nursing Normal Lab Values
Albumin Lab Values
Altered Mental Status- Delirium and Dementia for Progressive Care Certified Nurse (PCCN)
Blood Plasma
Bowel Obstruction Concept Map
C. Difficile for Certified Emergency Nursing (CEN)
Dehydration
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Electrolyte Imbalances for Progressive Care Certified Nurse (PCCN)
Electrolytes – Location in Body Nursing Mnemonic (PISO)
Electrolytes Involved in Cardiac (Heart) Conduction
Fluid & Electrolytes Course Introduction
Fluid Shifts (Ascites) (Pleural Effusion)
Fluid Volume Deficit
Fluid Volume Overload
Formation & Excretion of Urine
Giving Medication Through An IV Set Port
Heart (Cardiac) Failure Therapeutic Management
Heat Temperature-related Emergencies for Certified Emergency Nursing (CEN)
12 Points to Answering Pharmacology Questions
54 Common Medication Prefixes and Suffixes
ACE (angiotensin-converting enzyme) Inhibitors
ACLS (Advanced cardiac life support) Drugs
NRSNG Live | The S.O.C.K Method for Mastering Nursing Pharmacology and Never Forgetting a Medication Again
The SOCK Method – Overview
The SOCK Method – S
The SOCK Method – O
The SOCK Method – C
The SOCK Method – K
6 Rights of Medication Administration
Drawing Up Meds
EENT Medications
Ethical Dilemmas for Certified Emergency Nursing (CEN)
Hanging an IV Piggyback
Insulin Mixing
IM Injections
IV Drip Administration & Safety Checks
IV Push Medications
Medication Errors
Medications in Ampules
NG Tube Med Administration (Nasogastric)
NG Tube Medication Administration
Nursing Case Study for Mania (Manic Syndrome)
Pill Crushing & Cutting
Safety Checks
Spiking & Priming IV Bags
SubQ Injections
Topical Medications
02.08 Cardiac Catheterization & Acute Coronary Syndrome for CCRN Review
ACLS (Advanced cardiac life support) Drugs
C – Content
Epinephrine (EpiPen) Nursing Considerations
Nursing Care Plan (NCP) for Angina
Renin Angiotensin Aldosterone System
Renin Angiotensin Aldosterone System (RAAS)
Artificial Airways
Hierarchy of O2 Delivery
Oxygen Delivery Module Intro
54 Common Medication Prefixes and Suffixes