Med Errors and reality

[nursinghumor]

In the public's eye, the last person to "handle" their medications is the nurse at the bedside, so they're expected to "catch" errors (and get blamed when an error is discovered). When they say we are the patient's "last line of defense" they are not joking.

As Mark (1mg.epi) said, from the time the doctor writes the order, to the time pharmacy dispenses and sends the med to the floor, there are a million and one things that can go wrong, many that we as nurses have no control over.

Andrew Lopez, RN
http://www.4nursing.com

[cassioo]

we use a pysix also (just got all new ones they spent big bucks on..work just like the old ones)We still have patient drawers for routine meds. But we do the scan to pharmacy also and get preprinted MAR's from pharmacy but there's still the transcription problems. All the same problems everyone else has. We do the no blame reporting too and are told we don't report enough. For our l&d post part. patients we have preprinted orders so not too much usually too different on them it's the GYN's that are different for us.

[explorer]

<font color="purple">I disagree with you. The orders are put in the computer by the doctor, so that does away with the sloppy writing. When the order is input by the doctor it then goes to the pharmacy were were the pharmacy verifys the order wether it is correct and reasonable and that it is formulary. After that the order is sent to the BCMA program and then when the medication arrives on the floor it is administered. It isn't perfect, but it is one of the best things going. It was developed by the Veterans Administration.Text</font>

[cassioo]

A computer is still only as good as the person typing the order. If there are several consulting docs do they see all the meds that all the other docs have ordered? We have summary sheet on the chart (on M/S units) that list everything as it's ordered and yellowed out as d/c...more writing for the nurses to help the docs.

[nursinghumor]

[ QUOTE ]
explorer said:
<font color="purple">I disagree with you. The orders are put in the computer by the doctor, so that does away with the sloppy writing. When the order is input by the doctor it then goes to the pharmacy were were the pharmacy verifys the order wether it is correct and reasonable and that it is formulary. After that the order is sent to the BCMA program and then when the medication arrives on the floor it is administered. It isn't perfect, but it is one of the best things going. It was developed by the Veterans Administration.Text</font>

[/ QUOTE ]


Tell that to the patient that gets digoxin toxic because the pharmacy sent 2.5 mg instead of 0.25 and labelled it wrong.

As long as the nurse gave it (labelled as 0.25 or not), they can establish liability on the part of the hospital and you've got a viable lawsuit.

Andrew Lopez, RN
http://www.nursefriendly.com

[1mg.epi]

It all comes down to the person that hand that med to the patient. We can try to shift responsibility to the pharmacy or to the transcriber. The person that hands that drug to the patient is responsible. If the doctor orders patients home meds and I notice the dosage is ordered different I bring it the the dr.'s attention. Because, it is me giving the med. It is MY Responsibility. We do not have the computer system that allowes the doctor to order medications. Even with that I am the person that gives the meds and it is MY Responsibility.

[cassioo]

you are right about handing the medication to that patient but you still have meds that are labeled wrong. I'd like to know what every medication looks like but I don't so when I get a med that's not familiar to me the label says ABC but what's inside is XYZ and to me looks like little white pill.
When I worked home health it was real confusing for little old people let alone me they were used to the green pill then their pharmacy changed generics and now it was a blue pill.
Several years ago my son was on a routine med and it was white then I got yellow ones...guess what not generic but wrong med but it was labeled correctly. I also one time got 3 times the number of pills ordered guess the TID really threw them.
It'll be a cold day someplace when the docs at my hospital enter their own orders only a couple can look up their own patient lists let alone lab results then to get them to type I just can't see it in my lifetime.

[1mg.epi]

Hi cassioo your post before you last on said, [ QUOTE ]
A computer is still only as good as the person typing the order

[/ QUOTE ] I once was a computer programmer. we said garbage in, garbage out.

[udali]

Is it true that the average doctor kills 3 patients before he/she graduates? or is that just legend?

[1mg.epi]

From things I have heard from nurses that work at teaching hospitals this is probably not true. The Nurses save the patient before the student doctor kills them.