heparin med error

[b33110]

Im a new grad nurse and been orienting for only three weeks now and I already made a huge med error. I accidentally gave heparin 5000u subcu as an IV push. I quickly realized my mistake and told the charge and called the doctor. When lab came back a few hours later his PTT was a little high but his PT/ INR were both normal. By the end of shift his lab came back again and PTT/PT/INR were all normal, but I'm still so scared. I checked the patient every hour to make sure he wasnt bleeding from his iv site or anywhere. The nurses kept telling me Heparin should clear out of the pt in two hours and it will be fine, but it's still pretty traumatizing. I can't believe I made such a dumb mistake. I have to go to work tomorrow again and I'm so scared I'm going to lose my job.

[Davey Do]

You made a mistake. We all do. We're human.

The important thing is that you owned up to it and took action. That is what's important.

Don't beat yourself up over it, b33110. You won't make that mistake again.

The best to you!

[kataraang, BSN]

You did the right thing by reporting. You let someone know, you monitored your patient, followed their labs, and have now learned an important lesson. I guarantee you won't do it again. Being new is hard! I held lovenox for a stupid reason (in retrospect, there was NO reason to hold it) and I got in trouble with the doctor and had an occurrence report to sign. Patient was fine but I never take DVT prophylaxis lightly anymore. Every time I give a shot of heparin or lovenox I think back to my first mistake. You won't lose your job.

[sallyrnrrt, ADN, RN]

Any time I have made a mistake, it was a profound learning experience ! And made me a better nurse.

Congrats. In handling it the "right way & monitoring your patient"

[meanmaryjean, DNP, RN]

There are two types of scary nurses:

1) The one who would rather make a mistake than ask a question and

2) The one who makes a mistake and is more worried about covering it up than the good of the patient.

You are neither- you made a mistake (EVERYONE makes mistakes), you owned it, you did right by the patient and - most importantly- you learned someting from it.

[Vana21, ADN, BSN, RN]

Heparin in that small dose to an adult generally won't do a whole lot. In cath lab for a procedure, we regularly give 2 to 3 times that amount. The half life if Heparin is about 30 minutes. No real harm done thankfully for you, but the potential was there. Everyone makes mistakes and I bet from now on you will remember this event and use it for the best

[Goldengopher]

All the responses given thus far is excellent. You did all the right things after realizing the mistake. But where was your preceptor if you're on orientation?

[BedsideNurse]

We often bolus ppl 2-3 thousand units of heparin before starting at drip. 5,000 units is not an outlandish dose and fairly short acting thankfully. I know it

is traumatizing to make med errors especially when there is potential harm and you are new and you beat yourself up and all that. Try not to. Learn from it and be done with it. There are worse errors. A friend of mine infused an entire bag of heparin in one hour by accident. The patient was fine, but she was horrified, then had to tell the physician, inform the patient, and deal with all that.

[KatieMI, BSN, MSN, RN]

Heparin DOES NOT affect PT/INR. It also DOESN'T affect platelets. It ONLY affects APTT.

Overdose of heparin wouldn't cause bleeding from IV place, because closing such small, acute injuries is platelets' function. It is more likely to cause internal bleeding, like intracranial, renal or retroperitoneal. If you felt that you patient needed monitoring, these are big ones you had to look for.

You made a mistake, as every one of us here did at least once. It is OK. Nothing bad happened, and you won't repeat it. But it seems to me that you had little idea about the drug you were working with, and that scares me.

[pluckyduck, MSN, NP]

You did the right thing by reporting, monitoring and following up on lab results, and now that you've felt the horror that comes with a major med error you'll likely be way more careful next time. However, make sure you reflect on what happened contributing to the error--did you fail to scan the patient at bedside, fail to scan the med? Did you have anyone double blind check the dose and admin order? Why was the heparin ordered and was the route appropriate? (an example of what I mean is I often see MDs order regular insulin SQ for hyperkalemia with the D50W when it is supposed to be IV, or vice versa--order it IV when it's supposed to be SQ for hyperglycemia.) Try not to beat yourself up. Just remember and learn from it.