Can someone give me their opinion on this nursing question?

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    If a nurse determines that a prescribed medication wasn't administered as ordered on the previous shift, what action should that nurse take?
    Should she administer it immediately?
    Complete an incident report,
    Notify the nurse responsible for that error?
    Or just record it in the nurses notes .
    I would record it in the notes but shouldn't I administer it too?
  2. 7 Comments so far...

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    It depends on the medication and if another dose is due...also if it was an oversight or there was a reason documented it wasn't given such as with certain cardiac meds like digoxin, do not administer if apical heart rate is less than 60/min...
    loriangel14 and Olivia Ann like this.
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    Is this an either or question? or put them in order. You would check the med, notify/check with the nurse to be sure she didn't administer the med, and if appropriate....administer the med, the write the incident report.

    Now whether or not that is how they question is answered in the books....this is one of those book vs reality questions. It is how it is done in the real world
    Olivia Ann likes this.
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    If you give it now, will that result in a double dose, or two doses too close together? Or...? See, this is individual. Call the prescriber if you have truly determined the does as omitted in error (and not held for cause, as noted above) and ask for an updated prescription.
    Olivia Ann likes this.
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    It really depends. What is the medication? Why was it not given? If it's a med that was just ordered at 6:45P and you're coming on at 7P, you're not going to do the same thing as if it were a STAT med ordered at 9am.

    First things first, address it with the nurse. "Mary, did you happen to give X medication to Mr. Smith?" Perhaps the medication has not arrived from the pharmacy yet. Perhaps Mr. Smith refused the medication or is off the floor for a test or something.

    It may not be something that needs to be noted in the nursing notes at all. If you notice that Colace was not given at 8am and Mr. Smith had refused it but Mary just hadn't gotten around to charting that yet, why would you need to note that? If you remind her that it's sitting there not signed off, she will likely say "ok, I'll sign it off as not given before I go." This is also certainly not something that warrants an incident report and it would not be appropriate for the night nurse to spring into action and say "MR SMITH YOU MUST TAKE YOUR COLACE NOW!"

    It may very well be that you would do many or all of the things listed in the scenario but I think the only answer that's true across the board would be to call it to the nurse's attention.
    Olivia Ann likes this.
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    Thanku ! It was a multiple choice question.
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    I think because it was multiple choice your priority is always patient safety/care. With only the choices you gave I would choose "give the medication". HOWEVER, all the respondents are correct - there is no one-size-fits-all answer and the type of medication and why it was missed are important. THe incident report may or may not be done, but it certainly would not be done first.
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    Quote from Olivia Ann
    If a nurse determines that a prescribed medication wasn't administered as ordered on the previous shift, what action should that nurse take?
    Should she administer it immediately?
    Complete an incident report,
    Notify the nurse responsible for that error?
    Or just record it in the nurses notes .
    I would record it in the notes but shouldn't I administer it too?
    This is an Nclex style priority question. They are are kind of like if you could only bring one item to a island, what would you take. In this case it is more like if you could do only one thing for the patent, what do you have to do.
    At first glance I would say, "Notify the nurse responsible for that error?" or "Complete an incident report"
    Here is why.
    "Should she administer it immediately?" Depends on the medication and you don't know if the Nurse gave the med but didn't document, was there a reason the med wasn't given, (low BP for hypertensive medications or heart rate below 60 for dioxin). Does this medication need to be given at a particular time of day. So this is wrong.
    "Complete an incident report" This is defiantly high on the list, whether the medication was given or not, no documentation is considered a medication error and an incident report must be filled out. The major concern here is double dosing.
    "Notify the nurse responsible for that error?" In the real world, the first thing you would do is talk to the nurse and get clarification of why the medication wasn't given or recorded. But, while this looks good it doesn't actually address the situation. This answer doesn't say you are seeking more information or talking action. You are simply telling the nurse she messed up.
    "record it in the nurses notes" Errors are not documented in the nurses notes.
    So I would agree with the OP in that an incident report must be done, but the medication should not be given.


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