problems with calculating doses and drawing up medicines??!

Posts: 3 · Joined: 27 Oct 2007 Posts: 3 Location: Leicester

Hi everyone,

Again i am asking nurses if they could spare 2 minutes just to write down any problems they have while calculating doses of medicines, and drawing up medicines, and whether they think there are opportunities for changes to the way its done to make it easier/safer, by reducing dose calculation errors.

Thanks again,

Toby

Posts: 10 · Joined: 02 Feb 2008 Posts: 10 Location: indiana

Reading the hand writting of the doctor is problem number one. The key to safety is paying attention to the concentration of the med. Also, the doc may write give 4 ml of drug x. the problem with this is; that is not an amt. ml is a volume. another issue is time, qd- every day, qid- four times a day (easy to confuse). It is so important to know is this a safe dose for this patient? if I'm not sure I call the pharmacy or look it up. if I'm still not sure I call the doctor that wrote the order and ask.
You probably have heard about the heparin incident. The labels and contanier looked the same, pharmacy filled the pixis with the wrong concentration of the right drug. At the hospital that I work at the pharmacy switches the location of the meds in the pixis, this helps to keep you on your toes. It is to easy to grab something that you are so used to getting 20 times a day and feel confident that you know exactly what it is. For drugs with greater risk; mandate that two nurses check the calculation, or call pharmacy to check.

Posts: 19 · Joined: 14 Mar 2008 Posts: 19 Location: Phoenix AZ USA

I agree with Indiana Nurse.
I've been an ER nurse for over 9 years now. I'm so used to what meds to give in certain situations and where they are in the PIXIS... I hate to admit it, but 1/2 the time I don't even look at the label anymore. I know by the color of the top and the placement in the Pixis if it's the right med. The only med error I've ever done was a wrong patient error - I had 2 "Mrs. Jones" and didn't know it because my patient board wasn't up to date (Had 18 patients in ER at the time). Picked up chart, got meds ready, asked pt "are you mrs jones?" she says yes, I give her the meds. Come to find out had 2, gave 5000 SQ heparin to the wrong one. Luckily nothing bad ever happened.
Angela