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Discussion

Help with Assignment

hi everyone! i'm a new member here and i was wondering whether anyone could help me with my university assignment.

i'm writing a critical incidence assignment on a child who was given too much of an antihistamine medication and i just need help with a section with the assignment. i'm stuck on what to write for 'nurse medication administration'. obviously, the child's name isn't really his.

this is what i've written so far:

when computing drug doses, nurses and doctors may make mistakes, which may be life threatening (prot et al 2005). in paediatrics it poses a unique set of risks of medication errors, predominantly because of the need for dosage calculations, which are individually based on the patient's weight, age or body surface area. this increases the likelihood of errors, particularly dosing errors (ghaleb and wong 2006). in james's case the doctor had not worked out his dose according to the children's british national formulary. also, the nurse administered the medication without double checking the dose.

in a french study by prot et al (2005) they observed 1719 administrations to 336 patients by 485 nurses, 538 administration errors were detected, and 15 per cent of these errors were dosage errors. in the findings they discussed that the pharmaceutical industry had not produced dosage forms suitable for paediatric patients. however in the uk, there is the children's british national formulary, which outlines dosages of each medication for children according to their weight. the reason as to why the doctor did not observe this is unknown, but the nurse should have questioned the dose.

although james did not present with any complications as a result of the overdose the nurse should have made every precaution before administering the medication. according to the nmc's guidelines for the administration of medicines (2004) the nurse should check the right drug, dose, route, time and patient identity before administration. any unusual volumes or doses should be questioned and verified; and this did not happen with james.

much of the literature pertaining to nurses and medications draws on legal discourse, emphasizing the responsibility and accountability of the nurse in administering medications correctly and thus preventing errors (gibson 2001). the writing of many nurses emphasises the legal ramifications of errors. this can be seen in a study by morris (1999) where it summarises that if an error does occur, reporting it may enables the facility to "fix the system," and prevent similar mistakes from harming patients. as highlighted in the nmc's guidelines for the administration of medicines, morris (1999) further states that if the nurse follows the 'five rights' then errors would not occur.

i'd appreciate help from anyone! thanks!

Featured Replies

Where is the 'nurse medication administration' section supposed to go? I'm not sure I understand what is supposed to be included in that section.

  • Author

Thanks for replying :)

What I've posted just above is the 'drug admininstration' section. My assignment is 5000 words long and so it'd be quite a read if I posted the whole thing!

I just want to know what else I should add to what I've already wrtten. I was trying to find articles of nurses who make mistakes not because of negligence but just simple human error. Obviously the articles would have to be qualitative research papers. But there doesn't seem to be any online.

need help for care plan,where can i find some referrences online without buying a book

i think there are enough information to start your assignement; any book of pharmacopoiea contains a list of substances or drugs with their dosis; the dosis depends on pathology and other aspects like weight and incompatibilities.

could you give more information about the conditions on what the nurse provide "double" dosis?, there was understaffed when it happened?

at any case, this is not a malpractice case; malpractice law is joined to injury and as long as you have written there was not the case, see any book about health malpractice topic.

  • Experts

hi, intrepidstudentuk!

i can give you information on where to find information on medication errors here in the u.s. if that would be of any help to you. our federal government that administrates the medicare program has been tracking medication errors for a number of years. information is tracked through the fda (third link i've listed) and the ismp (the second link). however, the first link i've listed actually has a case archive where you can read case histories of medication errors which i think is what you are looking for.

http://www.webmm.ahrq.gov/ - morbidity and mortality rounds from the agency for healthcare research and quality (ahrq). this site has case archives (you'll see the link on the menu bar under their logo bar) that list out specific incidents of drug errors that you'll want to check out. when i went to the case archive page, i saw there was a listing of 13 pediatric cases dating from 2003 to 2006 that you might want to check out.

http://www.ismp.org/default.asp - home page of the institute for safe medication practices. they track medication errors here in the u.s. and make recommendations on how to avoid errors. you can use the search box to look for information or go to the site map to link in to areas on the site. i don't recall seeing anything specific to pediatrics, but then again, i've never looked for anything connected with pediatrics because it's not my area of practice. there is a link to tools there that has all kinds of interesting information that people would find interesting. they publish a monthly newsletter that is free to nurses and available on line. you can view back issues free here: http://www.ismp.org/newsletters/nursing/backissues.asp but you'd have to pull up each issue to see what it addresses.

http://www.fda.gov/cder/drug/mederrors/default.htm - this is the home page of the u.s. food and drug administration medication error page. there is a link there to error reports that you can view.

welcome to allnurses! :welcome:

  • Experts
need help for care plan,where can i find some referrences online without buying a book

when you are asking a question that is unrelated to the topic of a thread you really need to start a new thread. to do that you merely go to the start of one of the forums where the threads are listed and click on the "new thread" button. the links back to these forum pages are at the top of this page. you will see them in blue color and underlined.

in answer to your question. . .i've linked you to two websites where you can get information on nursing diagnoses and nursing interventions for writing care plans. you will also see this information posted on the allnurses threads i am giving you links to as well.:

  • http://www1.us.elsevierhealth.com/merlin/gulanick/constructor/index.cfm - this is a list of the nursing diagnoses that are available for viewing on the website. just click on one for the accompanying page to come up.
  • http://www1.us.elsevierhealth.com/evolve/ackley/ndh6e/constructor/ - you want to know which nursing diagnosis you want to look for, or have a specific symptom the patient is experiencing in mind. in the area where is says "start new plan" you want to click on the alphabetic range that the diagnosis or symptom you are looking for will be and click on those letters. a page of links will come up. clicking on symptoms will give you a list of potential nursing diagnoses. clicking on a nursing diagnosis will take you to that particular nursing diagnosis page.

there is a great deal of helpful information on writing care plans on these threads including sample care plans and case studies that you can look at:

which are on these two nursing student forums of allnurses:

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