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Difficulty: EasyAccident, Error, and Injury Prevention

While working on a step-down unit, a practical nurse (PN) is organizing the workflow for morning medication administration. To prevent clinical errors and ensure patient safety, which of the following practices must the PN implement? Select all that apply.

  1. Compare the medication label with the electronic medication administration record (eMAR) immediately before administration.Answer
  2. Require the client to verbally state their full name and date of birth while verifying their identification band.Answer
  3. Remain with the client at the bedside until they have completely swallowed all oral medications.Answer
  4. D
    Accept a task to administer an intravenous (IV) push medication to expedite care when the unit is understaffed.
  5. E
    Administer the medications without checking the identification band if the PN recognizes the client from previous shifts.

Answer

The essential safety practices are comparing the medication label with the eMAR, requiring the client to state two identifiers (name and date of birth) while checking the ID band, and staying at the bedside until oral medications are swallowed.
Safe medication administration requires strict adherence to established protocols, often referred to as the 'rights' of medication administration. This includes verifying the medication against the eMAR, confirming the client's identity using two distinct methods (like name and date of birth), and directly observing the ingestion of the medication to ensure compliance and safety.

Step-by-Step Solution

1
Identify the core objective of the clinical scenario.
The goal is to determine the correct safety protocols for medication administration that prevent clinical errors.
Understanding the focus on error mitigation helps eliminate unsafe shortcuts and out-of-scope practices.
2
Evaluate each practice against standard medication administration rights and scope of practice.
Checking the eMAR, using two identifiers, and ensuring medications are swallowed align with the 'rights' of medication administration.
These established guidelines are designed to systematically catch potential errors before they reach the patient.
3
Identify practices that violate safety protocols or the PN scope of practice.
Bypassing identifier checks due to familiarity and accepting IV push medication assignments are identified as unsafe and incorrect.
Familiarity does not replace mandatory safety checks, and IV push medications exceed the PN scope of practice, increasing the risk of severe patient harm.

Key Concept

Error Prevention and Safe Medication Administration
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Topics

Accident, Error, and Injury Prevention

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