im injection mistake

sissiesmama, ASN, RN · Dec 11, 2008

i'm taking Lvn program and my clinical area instructor ask our class
what would happen if IM injection's given though iv by mistake.
well.. answer would be differ from each med.
but want to know general(?) reaction.
thank you.
with couple of my classmate we had discussion and came out with:
fast reaction, overdose....^^;;??

Hello - Well, not long after I finished nursing school, I was giving a push for one of the LPNs on a busy med surg floor. She had written on a small card pt's name, room number, med to be given, which was Phenergan. She also wrot down route IVP and the last dose the patient had received.

I was in a hurry and did not pull the chart to double check the order. I had the MAR with me at the patient's bedside. I went by the info she had given me on the card. I gave the Phenergan IVP, and got the MAR to document and saw my mistake.

faster reaction, poss overdose, site reaction, since Phenergan is so hard on the veins, oversedation possibility, especially if the patient is elderly or on other sedating meds. You can lose fingers or even an arm if the IV site is not good.

Hope that helps a little. There are some others, but I'm drawing a blank here.

Anne, RNC

diane227, LPN, RN · Dec 11, 2008

There are many drugs that can be given both ways without much difficulty. It depends on the drug. Many drugs may require additional monitoring on your part after IV injection. It is important to document in the record how you gave the drug and what you did about it, any additional monitoring that you did. Even if it was an error, the record must accurately reflect the facts of the situation. You should assure that you report the error to the supervisor/charge nurse and state that in your note. You should fill out an incident report but NEVER reference in your note that you filled out an incident report. When you reference an incident report in your notes, it makes the report discoverable in a court of law.

It is also important to explain the incident to the patient (depending on what drug was given) and the actions you will be taking to assure the patient feels no ill effects of the medication.

And remember, NEVER GIVE any medication drawn up by another nurse. Diane

nerdtonurse?, BSN, RN · Dec 11, 2008

I'm a LPN in RN school, and I would do the following:

Look up the situation in the drug guide

Tell the MD

File an incident report.

wrd62279spn · Dec 11, 2008

Hello - Well, not long after I finished nursing school, I was giving a push for one of the LPNs on a busy med surg floor. She had written on a small card pt's name, room number, med to be given, which was Phenergan. She also wrot down route IVP and the last dose the patient had received.
I was in a hurry and did not pull the chart to double check the order. I had the MAR with me at the patient's bedside. I went by the info she had given me on the card. I gave the Phenergan IVP, and got the MAR to document and saw my mistake.
faster reaction, poss overdose, site reaction, since Phenergan is so hard on the veins, oversedation possibility, especially if the patient is elderly or on other sedating meds. You can lose fingers or even an arm if the IV site is not good.
Hope that helps a little. There are some others, but I'm drawing a blank here.
Anne, RNC

I am a student as well, just wondered how your supervisor/charge nurse handled that incident. I only ask because as a student I am terrified about the possibility of my first mistake being a biggie. I see you have quite a bit of experience, how did the whole situation effect your developement ? Also, thanks 4 sharing, I'm about 2 start clinicals in jan, looking 4 all the insight I can get.

sissiesmama, ASN, RN · Dec 13, 2008

I am a student as well, just wondered how your supervisor/charge nurse handled that incident. I only ask because as a student I am terrified about the possibility of my first mistake being a biggie. I see you have quite a bit of experience, how did the whole situation effect your developement ? Also, thanks 4 sharing, I'm about 2 start clinicals in jan, looking 4 all the insight I can get.

wrd - My charge nurse was so very nice. I wrote it up on an incident report and took it to her. She realized how upset I was, and I began crying before I finished talking to her. We talked about how I made the mistake, and how not to do it again.

After that, if an LPN brought a med to be pushed to me written on a card, I got the MAR and double checked. I took the MAR with me to the bedside every time, even if it was a med a d a patient I was familiar with, so every time I pushed Mr. X's Solumedrol, I had my MAR at the bedside.

I always made sure that I checked my 5 rights before med administration, after being out of school for a while, I admit I had gotten kind of lax about that at times, if I was busy.

And, when I was giving meds for an LPN, I necer ever gave any meds that had been drawn up already. Even if they said it was ----- drug, or had it labaled as NS for a flush, it was discarded and I drew it up again. I offended a few of them, but that was not my intention.

I had to get back to "the basics" of nursing, the 5 rights, and bringing the patients MAR to the room. There are little things like that that you think is not needed until you injure a patient from a med error. Thank goodness I didn't with this one, but I always try to learn from my mistakes before someone gets hurt.

Good luck to you, please pm me if I can be of help!

Anne, RNC