Let us take a moment and look back at a time when we were not nurses nor any other health care providers, a time when we only trusted three people with our health, a physician, nurse, and a pharmacist. A time when falling ill meant seeing the physician whom you trusted to give you the best care available. If you had an illness, you would visit a physician and after running tests and diagnosing you with a specific illness, you are given a prescription that ‘you cannot read’ because of the poor handwriting, but at the back of your mind you are confident that the pharmacist will definitely understand the prescription. True to your expectations, the pharmacist reads the prescription and dispenses the medication. A few days later, you realize your condition is getting worse, you decide to visit your physician again who runs some tests and realizes that you had taken an overdose of the prescribed medicine. It then happens that while the pharmacist was reading the prescription, he or she interpreted a 1.0mg dosage as a 10mg dosage. Now that you are a nurse, the same problem could occur; the only difference is that you could be the one causing the error. For example, while doing your rounds and dispensing medication, you end up giving a child, 3 tablespoons of an antibiotic liquid instead of 3 teaspoons, because the prescription read ‘3 TBS’.
These are some example of real life situations that the victims might live to tell the story, but as studies indicate some patients never get the chance to recover. According to the US Food and Drug Administration organization, a medication error is any form of a preventable incident that may lead or cause harm to a patient or an incident that results in inappropriate use of medication. CDC reports over 1.5 million incidents reported per year and the common consequences of such errors include long hospital stay, disability, and loss of life.
It is unfortunate that over 60% of these errors are caused by nurses, reason being that nurses spend about half of their clinical care time, administering medication to patients. During this time, other factors such as stress, fatigue, bad handwriting, packaging, and miscommunication come into play, hence increasing nurses’ chances of committing medication errors. Since we play the biggest role in medication error, we should also be at the forefront in promoting medication prevention strategies, both at personal and organizational level. To start with, here are three personal strategies that can help you avoid committing most of these medication errors.
Pay attention: avoid distractions and concentrate on the administration process. If need arises and you happen to be involved in a conversation, for example with the physician, its best to first stop the process and resume once you are through conversing, with other people other than the patient.
Know the five R’s: As a nurse, it is very important to follow the five R’s checklist. These include the Right patient, right drug, right dose, right time, and right route.
Confirm where there are doubts: finally, this applies in the cases where you have doubts about the prescription because of the handwriting or because of experience and the dosage does not add up.