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Difficulty: HardAccident, Error, and Injury Prevention

A practical nurse (PN) is preparing to administer scheduled oral medications to an older adult client who has expressive aphasia following a stroke. Upon entering the room, the PN notes that the client's identification band is missing. The client's adult child is at the bedside. Which action is the priority for the PN to prevent a medication error?

  1. A
    Delegate the task of verifying the client's identity to the assistive personnel (AP) who provided morning care to the client.
  2. B
    Verify the client's identity by checking the name and room number listed on the unit's public census whiteboard.
  3. Withhold the medications, verify the client's identity using the medical record photograph, and apply a new identification band.Answer
  4. D
    Ask the adult child to verbally state the client's full name and date of birth to confirm identity before administering the medications.

Answer

Withhold the medications, verify the client's identity using the medical record photograph, and apply a new identification band.
The nurse administering medications is legally and ethically responsible for verifying the client's identity using two approved identifiers. Because this client has expressive aphasia and cannot state their information, and the identification band is missing, the nurse must use an approved alternative method, such as a medical record photograph, to confirm identity. A new band must be applied before any medications are administered to ensure safety for all future interventions.

Step-by-Step Solution

1
Recognize the safety hazard presented by a missing identification band on a client who cannot self-report their information due to expressive aphasia.
The PN determines that standard verbal verification is impossible and the primary physical identifier is absent.
Administering medications without proper identification violates the rights of medication administration and creates a high risk for severe errors.
2
Eliminate plausible but unsafe identification shortcuts, such as relying on family members, other staff, or public information boards.
The PN rejects these unsafe workarounds.
Facility policies require at least two approved patient identifiers. The nurse administering the medication is directly and solely responsible for this verification.
3
Utilize an approved secondary identification method and replace the missing band before proceeding.
The PN uses the medical record photograph to verify identity and applies a new identification band.
This action guarantees immediate safety for the current medication pass and prevents potential errors for all subsequent care providers.

Key Concept

Strict adherence to the rights of medication administration requires using two approved patient identifiers; when primary methods fail, approved secondary methods must be used.
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Topics

Accident, Error, and Injury Prevention

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