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Asked by geletahelen1987

John, a registered nurse, was administering medications to his client, Mr. Antahem – a 45-year-old client with end-stage liver disease awaiting a liver transplant.  Antahem was scheduled to receive his IVPB Flagyl at 2200.  John pulled the premixed bag sent by the Pharmacy from the medication room.  He visually confirmed that this was the 2200 dose for his client.  He then went to the room where he carefully scanned his badge, Mr. Antahem’s arm band, and the pharmacy applied label on IVPB bag indicating the medication with the barcode scanner.  The pharmacy applied label covered the front of the bag and wrapped slightly around to the back obscuring any printing on the bag from view when viewed from the front.  The electronic health record acknowledged everything was correct.  At 0100, Sue, who took over care from John, was in Mr. Antahem’s room and happened to glance at the back of the IVPB bag.  She saw the manufacturer’s printing showing through that this was a 250 mL bag of Heparin 20,000 units.  She immediately realized that Mr. Antahem had received the wrong medication at 2200 the previous shift.  After notifying the healthcare provider, obtaining and implementing appropriate treatment orders, and completing the incident report, Sue continued to monitor Mr. Antahem closely.  Mr. Antahem did not experience any significant effects from the medication error.

 

did John skip any safety behaviors in medication administration? Support your answer.
The IVPB arrived on the unit after having been prepared and labeled in the pharmacy. What is the pharmacy’s role in this error?
Is the system or the nurse more responsible for this error? Support your answer.
If you were John’s nurse manager, how would you approach him?  Would you console him for a human error that resulted in a medication error or would you discipline him for the error?  Support your position using Human Factors.
SCIENCE
HEALTH SCIENCE
NURSING
NURSIING 300

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