End of the (Med) Error: or, How NOT To Bomb Your Survey - page 3
by VivaLasViejas Guide
As any nurse knows, a state survey or JCAHO inspection tends to bring out the worst in a facility. And as any nurse-manager knows, the survey team usually uncovers mistakes that we never even dreamed our departments were capable... Read More
- 0Oct 18, '12 by brick195969where are you getting your #s, sounds like your still making med errors,
"Warfarin 2 mg tab, 1.5 tabs PO Q PM on Mon-Wed-Fri, alternate with 4 mg on all other days." to me that is 1.5 tabs once a day in pm, equal to 3 mg (2mg tabs X 1.5), so it 9 mg total for all three days not "10 mg on the other three" infering 10 mg a day and "alternate with 4 mg on all other days" is equal to 4 mgs a day totaling 16 mg for 4 days, not "when he's supposedly getting 7.5 mg of warfarin 4 days a week", maybe you posted the order wrong but I am pretty sure my "math" is right , since i am using your order, "Warfarin 2 mg tab, 1.5 tabs PO Q PM on Mon-Wed-Fri, alternate with 4 mg on all other days." to do the calculations
- 0Oct 18, '12 by brick195969Quote from AndiSNDon't have time?, shortcuts?, condescending at times? ideal world? for us to be able to do things by the book but it just doesn't work like that.? REALLY, well i guess you don't value your liscense, cause at this rate your going to lose yours, med errors are the # 1 killer of patients when it comes to iatrogenic causes. Good luck if you continue with your attitude towards safe practices. If you don't have time and have to take shortcuts then either get administration to help or find a more professional facilityAll of that would be wonderful and all well and good if people actually had time to do all of those things. I know that the facility I work in we do end up taking shortcuts but it's not because we are all sitting around socializing. The vast majority of us are working our tails off constantly. I am still pretty new to all of this but even the nurses and the med aides that have been at this for years struggle to get everything done. It's easy to sit in the position of a supervisor and say all of the things that should be done but not so easy to actually do them. My supervisor worked the floor on what is normally my shift the other night and by the time I got there I could tell she was getting her rear handed to her. I am not someone who is easily offended and I can generally see all points of view but honestly your article came off as a little condescending at times. In an ideal world I would love for our shifts to go like this and for us to be able to do things by the book but it just doesn't work like that.
- 1Oct 20, '12 by dudette10I find the unit dose mentioned in orders problematic. On the MARs from NHs, the drug and unit dose is shown on the first line, while the administration dose, route, and timing is shown on the second line. Why is that done in NH/LTC/ALF?
When I transcribe for my admissions, I do it the more direct and less ambiguous way: drug, dose, route, timing. One time during chart checks, I saw that the admitting nurse put the unit dose as the administration dose, underdosing the patient. This is a system error, IMO.