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Home Food Drugs Medical Devices Radiation-Emitting Products Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products Drugs Home Drugs Resources for You Information for Consumers (Drugs) Strategies to Reduce Medication http://www.fda.gov/Drugs/ResourcesForYou/Consumers/ucm143553.htm Errors: Working to Improve Medication Safety Share Tweet Linkedin Pin it More sharing options Linkedin http://www.confidenceconnected.com/blog/2012/08/22/clinical_reasoning_can_prevent_medication_errors/ Pin it Email Print When Jacquelyn Ley shattered her elbow on the soccer field, her parents set out to find her the best care in Minneapolis. "We drove past five other hospitals to get to the one we wanted," says Carol Ley, M.D., an occupational health physician. Her husband, an orthopedic surgeon, made sure Jacquelyn got the right medication error surgeon. After a successful three-hour surgery to repair the broken bones, Jacquelyn, who was 9 at the time, received the pain medicine morphine through a pump and was hooked up to a heart monitor, breathing monitor, and blood oxygen monitor. Her recovery was going so well that doctors decided to turn off the morphine pump and to forgo regular checks of her vital signs.Carol Ley slept in her daughter's hospital room that night. When medication errors in she woke up in the middle of the night and checked on her, Jacquelyn was barely breathing. "I called her name, but she wouldn't respond," she says. "I shook her and called for help." The morphine pump hadn't been shut down, but had accidentally been turned up high. The narcotic flooded Jacquelyn's body. She survived the overdose, but it was a close call. "If three more hours had gone by, I don't think Jacquelyn would have survived," Ley says. "Fortunately, I woke up."Ley was pleased with the way the hospital handled the error. "They came right out and said the morphine pump was incorrectly programmed, they told me the steps they were going to take to make sure Jacquelyn was OK, and they also told me what they were going to do to make sure this kind of mistake won't happen again. And that's very important to me." The hospital began using pumps that are easier to use and revamped nurses' training. Ley believes there were many contributors to the error, including the fact that it was Labor Day weekend and there were staff shortages. "It goes to show that this can happen to anyone, anywhere," says Ley, who now chairs the board of the National Patient Safety Foundation.Multiple FactorsSince 1992, the Food and Drug Administration has
Health Care Clinical eLearning ClinicalKey for Nursing Additional Elsevier Resources Blog Resources Whitepapers Videos Podcasts Webinars & Events Mosby's Heritage Contact e-Commerce store Request Demo Home \ Connect Blog \ Clinical Reasoning Can Prevent Medication Errors August 22, 2012 Clinical Reasoning Can Prevent Medication Errors Medication errors are the most common errors in health care. In fact, the average hospital patient can be subjected to at least one medication error per hospital day, and these errors may account for up to 7,000 hospital deaths every year. Fortunately, by relying on clinical reasoning and appropriate actions to intercept these errors before they reach patients, nurses can prevent many medication errors before they occur. According to a recent study in Qualitative Health Research, nurses intercept 50% to 86% of potential medication errors. Through in-depth interviews, researchers found that medical-surgical nurses use more than the traditional “five rights” of medication administration: right patient, medication, route, dose, and time. They also rely on two clinical reasoning themes—maintaining medication safety and managing the environment—to protect patients from medication errors. Clinical Reasoning and Medication Safety Nurses know that although electronic medical records are valuable tools, relying too heavily on them can pose risks. Keeping clinical reasoning skills sharp helps keep patients safe. To support clinical reasoning, nurses follow specific safety practices that include: • Patient education—Nurses review each medication and dose with the patient before administration. If anything seems odd, the nurse stops, checks the original order, and may go back to the notes to confirm the medication or discuss it with the physician or pharmacist. Nurses also collect information about their patients to help them predict which medications they need and recognize when something isn’t right. • Considering everything—Nurses consider the patient’s age, weight, laboratory test results, treatments, allergies, and other factors related to medication administration. If a drug does not seem right for a patient based on this information, they make evidence-based decisions, consulting drug books, web-based drug data, and pharmacy personnel. • Patien