Wrong injection!

Nurses Medications

Published

As the title says, I administered a wrong injection! After going through the initial shock stages, crying, shaming myself, and all other negativity emotional primal reactions, I am now seeking rational answers

The case: I administered a T-DAP, not a TD. The order was for a TD. I accidentally gave a TDAP

Health professionals I ask you this: Is there that much of a difference in the two vaccines? I mean technically didnt the patient get "Extra" vaccines (pertussis, diphtheria ON TOP of tetorifice)? So the pt needed TD- tetorifice, but instead got more for his buck so to say: the tetorifice, diptheria AND pertussis.

What harm could be done??

Some MD's do not even pay attention to the difference. Are you sure they just needed the TD not the TDap?

Reaction wise they might have a "stronger" reaction to the vaccine (swelling, redness, pain). Unless they have an allergy it is unlikely to cause an issue.

In my facility the patient and MD must be informed. We also write off the incorrect vaccine cost and admin fee and in some cases they need to come back in for the correct vaccine (obviously not the case here).

Specializes in Med/Surg, Ortho, ASC.

Are you a nurse?

"Health professionals I ask you this: Is there that much of a difference in the two vaccines? I mean technically didnt the patient get "Extra" vaccines (pertussis, diphtheria ON TOP of tetorifice)? So the pt needed TD- tetorifice, but instead got more for his buck so to say: the tetorifice, diptheria AND pertussis

Attempting to minimize a wrong dose/wrong patient/wrong med injection by way of rationalization ("didn't the patient get extra vaccine?) is definitely NOT the way to go. This is a reportable violation of standard injection rules.

I hope your facility has appropriate reporting policies in place and that you follow all policies and report.

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

The only "extra" the patient got was pertussis. TD = Tetorifice and Diphtheria.

First, did you give TDaP or DTaP? Second, how old was the patient? If the patient was a younger child, the DTaP (or TDaP, for that matter) is not supposed to be administered under a certain age.

your stern reprimand echoes what already has been repeatedly said internally in my head and externally by those above me in the chain of command in nursing. To sum, your reply was redundant and predictable which is why i worded my question in such a way to address it straightforward, past the politics.

You did not address my question

Yes well our facility did the research and it turns out the patient did not necessarily "need" the Tdap, just "got the extra" vaccine. So they made administrative adjustments to that. I got coached and reprimanded heavily for it.

I understand I am putting that in simple terms but in no way am I underestimating my error. I recognize the principle behind it. I should have paid attention to detail..etc, but I thank you for your input to address my question.

The patient was a senior in his 60's. He has never had the Tetorifice

Oh no if it was a child the results/cascading effects would have been much more magnified

Specializes in Underserved Populations; ER.
your stern reprimand echoes what already has been repeatedly said internally in my head and externally by those above me in the chain of command in nursing. To sum, your reply was redundant and predictable which is why i worded my question in such a way to address it straightforward, past the politics.

You did not address my question

Oh, for crying out loud.....You asked a question on a widely read board, and you got an answer. You don't get to dictate the nature of the responses. If you truly are concerned about the consequences of your medication error, a better approach would be to actually read the appropriate clinical literature. If you make a mistake, educate yourself. Instead, you are here seeking some sort of validation that your error was harmless. Here is an answer for you: You made a mistake; it wasn't the worst one in the history of nursing; learn from it, change the behavior that lead to the error, and move on.

Specializes in Pediatrics, Emergency, Trauma.

What is the process for verifying vaccines at your employer?

It may be a systems error; learn from it and help improve the process.

Specializes in Med/Surg, Ortho, ASC.
your stern reprimand echoes what already has been repeatedly said internally in my head and externally by those above me in the chain of command in nursing. To sum, your reply was redundant and predictable which is why i worded my question in such a way to address it straightforward, past the politics.

You did not address my question

1). To whom are you responding? We have no way of knowing since you did not respond directly to someone.

2). If you only wanted predictable responses, why did you even ask?

3). Clearly you have erred. What do you need to do to address your mistake? (Apart from trying to justify said mistake)

Specializes in HH, Peds, Rehab, Clinical.

Are you a nurse? Regardless, you should know "what the difference" is between the two medications that you administer!! That you don't and then post here about it is a little frightening.

Specializes in ED, Pedi Vasc access, Paramedic serving 6 towns.

I wouldn't worry at all since more physicians and ERs are giving TDAP instead of TD since there is clearly a loss of immunity to Pertussis in adulthood! You did them a favor if it was an adult!

Annie

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