Scenario: Sarah, a registered nurse working the night shift at

Scenario: Sarah, a registered nurse working the night shift at a busy urban hospital, is responsible for administering medications to her assigned patients. One of her patients, Alex, a 60-year-old transgender male with a history of hypertension and diabetes, was admitted for pneumonia. Alex, who transitioned from female to male many years ago, takes hormone therapy alongside his routine medications. Due to an increase in patient load and an understaffed shift, Sarah is overwhelmed and trying to keep up with her duties. Around 2 AM, Sarah prepares medications for Alex, including his routine insulin, testosterone, and an antibiotic to treat his pneumonia. However, in her haste, she mistakenly administers a higher dose of insulin than prescribed. Shortly after the medication administration, Alex starts exhibiting signs of hypoglycemia: sweating, confusion, and weakness. Sarah realizes the error when she double-checks the medication administration record (MAR) and sees the incorrect dose logged. Questions: 1. Primary Safety Issue and Immediate Response: Identify the primary safety issue in this case study. What are the immediate steps Sarah should take to address Alex’s condition? 2. Human Factors Analysis: What human factors contributed to Sarah’s medication error? How might workload and staffing levels have impacted her performance? 3. Error Prevention Strategies: What strategies could have been implemented to prevent this medication error? Discuss the role of technology (e.g., electronic health records, bar[1]code medication administration) in preventing such errors. 4. Role in Preventing Errors: Reflect on Sarah’s role and responsibility in preventing medication errors. How can nurses value and prioritize their role in patient safety? 5. Safety Culture: Describe the elements of a strong safety culture in a healthcare setting. How can healthcare leaders foster a culture of safety among their staff? 6. Immediate Response and Reporting: What should Sarah do immediately after realizing her mistake? Outline the steps for reporting the medication error according to hospital policy. 7. Root Cause Analysis (RCA): Conduct a root cause analysis to identify the underlying causes of the medication error. What corrective actions should be recommended to prevent recurrence? 8. Patient Communication: How should Sarah communicate the error to Alex and his family? What principles of effective communication should be followed in such situations? 9. Training and Education: What type of training and education can help prevent medication errors? Discuss the importance of ongoing professional development in maintaining patient safety. 10. Policy and Procedures: Review the hospital’s policies and procedures for medication administration. What changes, if any, should be made to enhance these policies and ensure patient safety? Diversity, Equity, and Inclusion Focus: • Consider how Sarah’s understanding of transgender health needs and medications like hormone therapy could impact care delivery. • Explore how inclusive practices and cultural competence can be integrated into patient care and safety protocols

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