I realized that the past practice to monitor supply outdates for crash carts, conducted by two RNs periodically, was unfeasible in our new, three stories, multiple crash cart facility. Also, Logistics had assigned a Supply Chain Item Manager, tasked to maintain crash cart supplies, was using another process to monitor outdates. The RNs maintained a list on top of the crash cart clipboard and the Supply Chain Item Manager provided a supply list on the Crash Cart IV pole. These lists were not similar and presented an EOC and safety issue impression that expired supplies were possibly still stocked in the carts. I presented this concern to the designated Supply Chain Item manager and I shared the Pharmacy policy for NFSG crash carts. I pointed …show more content…
I Standardized seven carts located throughout the facility (CAU, PC, Specialty Unit, GI procedure area, Recovery Room, Radiology, and Training Cart) with: uniform top of cart bin/contents; clip board hooked to IV pole with ready to use RRT/Code Blue emergency forms; and red binders that include EE for cart specific Defibrillator and organized tabs with daily log, weekly test instructions, drawer contents, emergency algorithms, emergency forms, and instructions on cart replacement process. • Recommended blue temporary locks from logistics and these have been added to the top drawer for use when the red Pharmacy lock is compromised and cart needs to be temporarily secured. • Provided an in-service at the monthly Nursing staff meeting on crash cart changes with presentations by me, the Supply Chain Item Manager, and the Crash Cart Pharmacist. Visual displays and discussion included the medication tray, the crash cart with two labels, the red binder, organized bin, and clipboard on IV pole with emergency forms. Instructions were also provided on how to have the cart …show more content…
2. 1% Lidocaine was not documented by the nurse administering the medication even though it was mixed with the Rocephin. The Outpatient Medication Administration template does not trigger this entry to be made. 3. No order was found by the ordering PCP to use 1% Lidocaine as a diluent, although this is the current practice. o Micromedex, PubMed and other current evidence-based practice literature reports 50% pain reduction when 1% Lidocaine is used to dilute Rocephin for intramuscularly (IM) injection. o No specific order found with Rocephin and Lidocaine in same ordering block. Orders listed separately. o Providers and nursing not aware that a separate order was needed for 1% Lidocaine. o Outpatient Medication Administration documentation option, for any injections, regarding the observance of the patient for 30 minutes after first use and tolerance for the injection being selected within the same documentation of administration did not indicate a 30-minute window was followed. For example, the IM/SQ medication was noted given at 1400, patient observed for 30 minutes, and a tolerated well note option selected with the nurse note signed off at
Emergency cases must have equipment available at all times. The surgical area should house basic case carts to handle any emergency case that arises.
In conclusion the study showed a decrease in reported medication errors by 20% (Truitt et al. (2016). The introduction of these systems has greatly changed the delivery of medication in hospitals. Medication administration errors in hospitals put the patient in danger and cause great harm, depending on the severity. It is so important that medication errors do not happen in the hospital. It may not be possible to eliminate all errors, but reducing the amount of errors would benefit
medications is more than the act of getting drugs to a patient. The delivery of medication is directly tied to the charge for the medication. Thus the responsibility for charging or crediting medication belongs to technicians. This aspect of their job is strictly governed by federal regulations. These laws hold the technician directly responsible for the accuracy of a patient’s account’s charge and credit transactions. Because every dose is related to a specific day and time, when technicians credit they must apply that change to the corresponding dose. Assignificant as accuracy is to the patient’s account, accuracy in the making of their medications is even more important.
According to an interview, Dr. Brown states medication errors cost billions of dollars and can cause injury or even death. Brown later goes on to declare, “1.3 million people are injured and approximately 7000 deaths occur each year in the United States alone.” To aid in helping to avoid medication errors a nurse should first assess the five rights. They are right person, right medication, right time, right route and right dose. By assessing, the right patient, verify two identifiers, such as name and date of birth. When doing this a nurse should take the time to assess if a patient has any allergies. Right time is easier thanks to the pharmacy. Verified by the pharmacist correct medication times are determined and stored in the patient’s electronic medical record. Right medication becomes easier over time as staff becomes more familiar with different medications. Kept on most floors are drug books to assist nurses. Right dosing is normally up to the provider and pharmacist. It is good practice to utilize drug books to see safe dosages. Many medication doses are calculated by height and weight. Another safety system is high alert medications are always verified by two RN’s. High alert medications include insulin, heparin, and lovenox. Two nurses should be present when a medication is wasted. To do this many Pyxis require the fingerprint of two
Medication errors made by medical staff bring about consequences of epidemic proportions. Medical staff includes everyone from providers (medical doctors, nurse practitioners and physician assistants) to pharmacists to nurses (registered and practical). Medication errors account for almost 98,000 deaths in the United States yearly (Tzeng, Yin, & Schneider, 2013). This number only reflects the United States, a small percentage in actuality when looking at the whole world. Medical personnel must take responsibility for their actions and with this responsibility comes accountability in their duties of medication administration. Nurses play a major role in medication error prevention and education and this role distinguishes them as reporters of errors.
It was time to administer medication. My patient was on the unit because he had a schedule test. “ Omission of medication was the most frequent often related to patient absences from the unit” (Johnson, et. al., 2011, p. 548). Upon his return, I was no longer administering medication but I had documented that I gave this medication to the patient. All medications must be accurately documented to ensure all prescribed medications are being given to the patient. I know my shift was ending soon and tha...
A newly employed critical care nurse was just about to finish a 12-hour night shift when she realized she had one more patient to administer medication to. It was the busiest Friday night shift she has ever worked due to a poor nurse-patient ratio, and the workload felt impossible. She gave her last patient the properly prescribed medication, but failed to notice that the physician hastily wrote an updated dosage for a high risk medication, Digoxin. The patient’s heart rate began to slow down and life-saving procedures had to be performed. Medication errors are “any preventable event that may cause, or lead, to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer (About Medication Errors, 2015)”.
Overall, I retain three goals for this clinical day: Safely and efficently administer medication, enhance my nursing/CNA skills, and determine how to implement infection control into a health care setting. This week reflects my assigned time to administer medication in a health care setting for the first time, with a resident who retains nearly twenty medications. I except this experience will be a great learning experience, but it will also subsist slightly stressful. With the assistance of my FOR, my goal is to administer all of my resident 's medications without complications. To ensure that medication safety, I will perform the six medication rights and three checks prior to administration. Along with medication administration, a goal
while transferring patients between units. [After reviewing these events], “The Joint Commission identified “Improve the Safety of Using Medications” as one of the 2009 National Patient Safety Goals (Cleveland Clinic, 2009, p.1). In relation to this safety goal, hospitals created a medication reconciliation form that resides in the patient’s ch...
Non-comprehensive and non-uniform patient handovers stand as a current concern within the department. Inadequate handovers may lead to delays in care and communication errors. Additionally, poor communication and poor teamwork in relation to handovers pose a threat to patient safety. The proposed intervention is to implement the utilization of a paper, SBAR formatted, standardized template with patient information on it that can be passed on from nurse to nurse at shift change. The template will be updated throughout the patient’s stay at the facility and will help provide a comprehensive view of the patient. This SBAR formatted template will provide the framework for the verbal report given during patient handovers on medical-surgical units of a Midwestern, rural hospital. The review of the literature supports the implementation of this intervention, by noting error reduction with the employment of a template. The results of a study by Triplett and Schuveiller (2011) suggested that over half of the nurses surveyed had discovered errors during the patient handover process with the addition of the template. According to Johnson, Jefferies, and Nicholls, (2012) not only did the employment of a template complement verbal handover, but it also provided a tool to allow for easy access to comprehensive information on any given patient in the units. Overall, the
Wieman TJ and Wieman EA (2004) demonstrates communication factors that result in MAE. They say that nurses’ failure to question unclear orders or pursue concerns because of intimidation by prescriber (physician or pharmacist) contributes to these errors. Illegible handwritten orders and ambiguous orders written in MARs or patient profiles further contribute to these medical errors. Moreover, other factors that also contribute are an incomplete medication orders such as missing dose or route, abbreviations misunderstood (Appendix B) (Davis N.M., 2005), and spoken orders misheard. According to Cohen M.R. (2007), nurses’ who contributes to MAE fail to identify the patient (checked ID band, allergy band, MAR sheet), unable to share correct information during the shift report and ineffective communication.
Discuss the possible drug and excipient-related constrains of the formulation (no identity of the drug was given to you at this
Administration of medicines is a key element of nursing care. Every day some 7000 doses of medication are administered in a typical NHS hospital (Audit Commission 2002). So throughout this essay I will be evaluating and highlighting the learning that took place whilst on placement at a day unit.
Educate the patient to ask for help when ambulating. Teach them that equipment such a IV pole can be tricky to maneuver and have lines that make it easy to get caught in and trip. During rounds on patients ensure that patient has all the important things they need such as glasses, water, and cellphones. Encourage patients wear devices such as hearing aids and glasses if needed and assess for the need of a walker. Most importantly never leave a patient’s room without leaving the call bell within reach, the side rails up, and the bed in the lowest