Med Errors- would you report one? - page 3
by country mom 5,674 Views | 24 Comments
How comfortable do you feel reporting a medication error? How about a "close-call"? If you do not feel safe in reporting an error, or a near-miss/good catch/close call, why not? What if someone else made an error and you... Read More
- 1Jul 14, '09 by country momI sure feel for the people who work in an environment that uses error reporting in a punitive manner. I've been in that kind of place myself, and it's very stressful. You can't change anything because you cannot bring the problem to light. In the end, it's the patient who suffers. It needs to change. No way should med error reports be included in a performance review!
- 0Jul 14, '09 by kanzi monkeyI have reported myself 5 or 6 times--2 med errors where luckily no harm was done, patient falls, the beginning of a stage II on a patient that came from a SNF where unfortunately the skin hadn't been well examined on admission, etc.
I believe that in each of these cases I was part of a mechanism that has some faulty wiring. I accept as much responsibility as is appropriate, and in my incident reports I include extraneous factors that prevented me from providing acceptable care. For those factors I am only responsible in as much as I am an employee of the hospital.
As for reporting other people--that depends on what the outcome was (ie, was the patient harmed?), and what factors may have led to the error. I always talk about it with my coworker--if it's something that happened that clearly would benefit the system to report, I tell them that. They can report themselves. Someone told me to report myself once. I have a very good relationship with this nurse, and her pointing out my error was helpful and I had no problem filing the report.
We're nurses. We have to be accountable for our actions, like any other professional. The way I see it is, non-punitive reporting gives us the opportunity to speak out for ourselves and show the powers that be some of the obstacles we face day to day.
- 0Jul 15, '09 by nina4nursingQuote from blondy2061hYes, I am a CNA but as my first post stated I work in a MR/DD group home. I pass meds via a Medication Administration Record and have to sign off on it just as nurses do. Threre are also Certified Medication Aides that are CNA's but also trained to dispense meds to a certain degree.Probably not, as she's a CNA.
- 0Jul 15, '09 by nina4nursingQuote from jzkfelYes I have and have been written up once out of two years of employment. The statement you made above,I think you're missing the reason for reporting errors - its to identify patterns of errors and to improve systems to reduce them. You aren't "turning in" an error or a person. And everyone at some point in time is going to make an error. What is dangerous is when people are afraid to talk about them or to acknowledge them. Then nobody gets the chance to learn from them or to improve systems or working conditions to reduce them. I am comfortable reporting errors, including ones that I make, but I don't act like I am turning anyone in.
By the way, have you ever made a med error (that you know of)?
"What is dangerous is when people are afraid to talk about them or to acknowledge them" is what is going on where I work. I have even tried to avoid turning med errors in however when you come in and the pill is punched but the med book not signed, or the med book is signed but the pill is not punched, or the pill is not passed nor is the med book or the punch card signed as is often the case where I work and you try to bring it up you get the
"Just go ahead and turn me in then" response. A certain individual I work with had two valid med errors in less than three days. And at this point have not even asked her to retake med training. Also a lot of her other work is reflecting this same attitude. As my boss told me not to long ago, I am kinda square and by the book.