High Risk Meds

[Special31]

Good evening, I am trying to get a little information. I work in an institution where high risk needs to be double checked and signed by two RNs independently. The process is to verify patient, drug, and dose. The nurses are running around extremely short and with severely high acuity patients and there are still med errors even with this process. I am trying to understand or get input for what is done at other institutions?? How are high risk or even standard med errors eliminated??? We are not a facility that is computerized yet we are still using paper charts...help please

[Esme12, ASN, BSN, RN]

as long as humans are involved in the process, you will never "eliminate" errors. the best you can hope for is to reduce or limit them. regardless of the safety nets put in place, under staffing will always diminish the effectiveness of these attempts to prevent med errors.

excellent point!!!

nursing perspectives:

rebecca hendren, for healthleaders media, august 30, 2011

nurse staffing costs must be weighed against cost of errors

https://allnurses.com/nursing-news/nurse-staffing-costs-613739.html

[Orange Tree]

Do other hospitals require double checking on SQ Lovenox? With the huge push for DVT prevention our facility has largely increased in Lovenox administration... curious if other facilities are doing the same with double checking.

Ours "officially" requires a double check, but it doesn't happen.

[PediNurse3]

At the end of the shift, everyone gives their list of what needs to be co-signed to a co-worker. That's how we complete our required "double checks" in the computer. No one has time to do it the right way. Insulin is often given hours late by one nurse, and would never be given (at all!) if we had to wait for two nurses to become available.

This is completely horrifying! There is no way in h*ll that I would ever co-sign something that I didn't actually double check...especially something like insulin. I wouldn't want to be on the receiving end of insulin, or any other medication that required a cosigner that wasn't double checked.

Can you imagine the fall out if something were to happen? Like the wrong patient given insulin, or given the wrong amount? What would happen? Not only to the patient, but to the organization and it's employees? To the nurse that cosigned but shouldn't have because he/she didn't really see what was given? Would they all of a sudden retract their electronic signature and say that they didn't really see what was given? Or admit that they actually saw 100 units of insulin drawn up when it should have been 10 and thought that it was ok? What would they tell that loved ones family and friends? I'm sorry..we were just too busy to do things the right way?