Giving a PRN Medication on Accident

[ichiro12]

I am currently in orientation and my educator and my preceptor stated two different things.

I was told by the educator that if a PRN medication Trazodone (tx insomnia) is given before bed instead of PRN Tramadol (opioid pain med the pt actually asked for) that an adverse action report be written. However, my preceptor stated that it doesn't have to be, just as long as we inform the patient, document it was given, and we follow up and because both meds were PRN medications, the patient shouldn't have adverse reactions.

I'm confused? So because both are medications the patient is assigned that an incident report nor an adverse action report needs to be written as long as we document and follow up?

[mmc51264, BSN, MSN, RN]

Because the trazadone is ordered HS, it is a med error, not an adverse reaction. If it were me, I would notify provider and file a report on myself. And of course, monitor the patient.

[roser13, ASN, RN]

Because the trazadone is ordered HS, it is a med error, not an adverse reaction. If it were me, I would notify provider and file a report on myself. And of course, monitor the patient.

Administering a prn hs order at hs is a med error? Since when?

[Farawyn]

If both meds are ordered PRN and the patient asked for/needs them you can give them as ordered.

[smf0903]

Trazadone was not the med that was suppose to be given, it's a med error. What's the difference if you have Trazadone instead of Tramadol (both PRN meds) versus say, Dilaudid instead of colace (both PRN meds)? Extreme example but really it's no different--wrong PRN med was given.

[Farawyn]

Trazadone was not the med that was suppose to be given, it's a med error. What's the difference if you have Trazadone instead of Tramadol (both PRN meds) versus say, Dilaudid instead of colace (both PRN meds)? Extreme example but really it's no different--wrong PRN med was given.

Oh, I misunderstood the OP.

[ichiro12]

That's what I thought. My orientation has been so conflicted, I've had to read the BON and hospital policy. I don't want to not do something, if something were to happen like that to me. The question I got on my assignment stated This patient scenario took place at 2100. Patient goes to bed at 2300. Trazadone (wrong med) given instead of requested (Tramadol). Answer was a report should be written. Preceptor said no because it was PRN hs, and though it was the wrong med, the patient has prescriptions for both and to just monitor and document "given" on the MAR.

[Farawyn]

That's what I thought. My orientation has been so conflicted, I've had to read the BON and hospital policy. I don't want to not do something, if something were to happen like that to me. The question I got on my assignment stated This patient scenario took place at 2100. Patient goes to bed at 2300. Trazadone (wrong med) given instead of requested (Tramadol). Answer was a report should be written. Preceptor said no because it was PRN hs, and though it was the wrong med, the patient has prescriptions for both and to just monitor and document "given" on the MAR.

Did the patient ask for it?

[AJJKRN]

That's what I thought. My orientation has been so conflicted, I've had to read the BON and hospital policy. I don't want to not do something, if something were to happen like that to me. The question I got on my assignment stated This patient scenario took place at 2100. Patient goes to bed at 2300. Trazadone (wrong med) given instead of requested (Tramadol). Answer was a report should be written. Preceptor said no because it was PRN hs, and though it was the wrong med, the patient has prescriptions for both and to just monitor and document "given" on the MAR.

Personally I think your preceptor is trying to say no biggie AKA no harm no foul. Me personally, you did not give the correct med the Pt asked for so yeah, is write it up.

This is however a learning experience to be diligent and go through your Pt's meds each and every time you administer them. It may have been caught if you had said "Here's your Trazadone that you take to help you get to sleep" as opposed to "Here's your Tramadol that you take to help relieve your pain". Lesson learned aye?

[adamRn79, BSN, RN]

I see no issue

[Farawyn]

I see no issue

The issue was that he had the wrong med. Yes, it was prescribed as well, but he gave the wrong one. He is "covered" because the med he gave was also ordered, but technically it was still an error.

He got lucky.

[klone, MSN, RN]

Patient asked for tramadol. Patient given trazadone. Yes, that is a med error. Doesn't matter if both meds were on the patient's MAR. No, not a huge deal, but still a med error.