Transcription error

the transcriptionist, and, perhaps the giver, if it would have been obvious to the "reasonably prudent nurse" that the timing was wrong.

Meds on paper MARS usually have to be signed off by 2 nurses. (and actually reviewed on the orginal order) Most electronic medical records have to have pharmacy approval before you can get it out of the machine, or over-rides that require 2 nurses.

With all that being said, a nurse should take a look at the original orders to review the plan for the day. Someone also does chart reviews, sometimes every 24 hours. So with all this reviewing going on, it seems unlikely that a transcription error can occur, but it does. So always take a look at the original orders,as you could be held liable as you should be reviewing the orders otherwise.

Do nurses really have time to look at all the original orders in the chart every time they give a med? Yes, I am being sarcastic.

Do nurses really have time to look at all the original orders in the chart every time they give a med? Yes I am being sarcastic.[/quote']

LOL! I wish!

This is where the beauty of EHRs really kicks in. No handwriting errors, just clear orders. They can still be wrong (especially when placed by the brand new intern who still has no idea what to do), but at least then, it is true nursing critical thinking that catches it.

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But one thing here also, what if the chart was reviewed too and even then the error was not caught at that time, then whos responsible for that?

But one thing here also, what if the chart was reviewed too and even then the error was not caught at that time, then whos responsible for that?

I would imagine whomever transcribed the order has to sign the order sheet. In addition, the RN who verifies the order must sign it as well. While I image both those individuals are responsible, the primary responsibility, in my mind, lies with the RN who did not make sure the order on the MAR was a correct "interpretation" of the order on the chart.

I blame (in order of who I blame the most):

1. The facility (for not getting with the times and mandating doctors write orders in an EMR)

2. The doctor (for having illegible handwriting, if applicable)

3. The nurse who transcribed the order (for either not clarifying bad handwriting or for incorrectly transcribing a legible order)

Do nurses really have time to look at all the original orders in the chart every time they give a med? Yes, I am being sarcastic.

No, however, it is always not a bad thing to look at the orders at the start of one's shift.

But, How can you when you have 30 patients in long term, or almost 20-24 patients in short term?

It would seem as tho the initial transcribing nurse and the verifiing cosigner would be ay fault after all this is THEIR hancock of approval. When I get a new order I should be able to intrust that not one but TWO competant nurses have transcribed reviewed and verified appropriately....don't u agree?

Sadly, I used to see this all the time. The error falls on the RN who gave the med incorrectly. I only know this because I work nights and when we had paper MARs, it was our job to sign off the MARs for the next day, which meant, having to go into the chart and check all the med orders against the printed MAR. Our manager always came down hard on the RN who gave the med incorrectly, saying it was our job to check the orders for any med before giving, we could not blame the RN who transcribed the order or signed off the order on the MAR. However, if another RN caught a transcription error and it was signed off, the transcribing/signing RN would be at fault. Pharmacy used to make a lot of mistakes that were printed and we would have to correct.

If this happened to you, I am very sorry it did. It's happened to me, one time a 24 hour chemo was cut one bag short, so I ended the chemo and when night shift came along, the nurse working all week with the patient said 'no, tonight should be the last bag!' so we went a'researching in the chart and sure enough. The pharmacy made the error in the MR and by not sending up the seventh bag. Oops.

I was the one that 'executed' the error, so my name is included in the incident report. Even so, considering all the times we get it exactly right, the times an error is made is (hopefully!) rare. And human. Going hardcore into 'who exactly IS TO BLAME??' doesn't really help YOU cope with the aftermath. It's the attitude about blaming that I'm trying to illustrate.

It is AWFUL to find yourself responsible for a mistake, there's no feeling like it .

But rushing to assign the blame on another and absolving yourself is . . . well, bad teamwork. And, getting caught up in that messes with your head, makes you feel worse, not better. I've seen nurses go on for MONTHS defending themselves lest they have any blame whatsoever, and my impression was they were miserable and creating the misery themselves. It may not be OK to screw up but its gonna happen in spite of your best efforts. So go easy on yourself, and go easy on the coworkers, you're all in this together. Especially go easy on yourself. That is actually a sign of maturity, to be willing to accept responsibility in whatever capacity you were involved. Your life as a nurse will be SO much better when you ease up on yourself as well as your coworkers :)