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Risk of errors is 'much greater' in the emergency department
A man was given 10 times the normal dose of epinephrine, after presenting to an ED in June 2010 with an acute allergic reaction. He experienced chest pain and shortness of breath, and he died from the overdose. Could you be the one to prevent a devastating mistake like this from happening in your ED?
Ewa Drapala , RN, BSN, CMSRN, an ED nurse at Providence St. Vincent Medical Center in Portland, OR, has worked in a medical/surgical and ED and thinks the potential for errors is "much greater" in the ED.
"In the ED, medication administration doesn't happen at specific times like 0900 and 2100, with a preprinted Medication Administration Record," says Drapala. "Potential for interruptions goes up. There is so much less structure around the procedure."
Messy handwriting and the incorrect usage of decimals, commas, and zeros can result in tenfold errors, adds Drapala. "Computerized charting can be helpful in eliminating some of these errors, along with diligence regarding standardized charting," she says.
Kyle Kennedy , DO, medical director of emergency services at Freeman Health System in Joplin, MO, says one challenge in preventing tenfold errors is a high turnover of nursing staff, with new graduates frequently rotating through high-acuity clinical areas.
To prevent catastrophic dosage errors, says Kennedy, "EDs, ICUs and other critical care areas should only allow those nurses with a mandatory level of clinical experience to work in those high-acuity areas."
Kennedy says that medications...