Question

Suppose a physician ordered omeprazole capsules p.o. at bedtime for a patient with an active duodenal ulcer. You will note there is no dosage listed. The nurse thought the medication came in only one dosage strength, added 20 mg to the order, and sent it to the pharmacy. The pharmacist prepared the dosage written on the physician’s order sheet. Two days later, during rounds, the physician noted that the patient had not responded well to the medication. When asked about this, the nurse explained that the patient had received 20 mg at bedtime. The physician informed the nurse that the patient should receive the 40 mg dosage for high acid suppression.

Potential Outcome:?

Prevention:?

An order was written for ampicillin 500 mg IV PB q4.h, which was handwritten on the medication administration record (MAR). The registered nurse was distracted while verifying the order and writing in the scheduled times of administration. The nurse saw the number 4 and instead of scheduling the medication every 4 hours, scheduled the medication to be given 4 times a day at 6-12-6-12 timing. For 2 days, the shift nurses each checked to see what medication needed to be given on their scheduled shifts but did not take time to compare the ordered frequency to the scheduled times. Eventually a nurse did look over the entire medication record and noticed the error. The medication times were corrected and the doctor was notified. A medication variance form was completed, documenting the error, and it was submitted to the hospital risk management department.

Potential Outcome:?

Prevention:?

Answer 1

?in this case potential outcome is

Both dose of 20 mg, 40 mg omeorazole used for gasroesophageal reflux disease. Means, to prevent or suppress the acid reflux from stomach to esophagus. Omeporazole 40 mg will have more effects, compared to 20 mg. Based on disease condition, it chooses. Here the patient have duodenal ulcer, so the dose should be high to suppress to acid. Because of that, omeorazole 20 mg will not produce much effect, instead of that, omeorazole 40 mg will give a good result.

Prevention: here the basic issue is, doctor has not prescribed properly, and the nurse didn't clarify the medication doubts with doctor. Both are negligence and against medical ethics. It should be prevented.

?potential outcome: ampicillin is an antibiotic, should use for q4 h for 7 to 14 days, to get free from infection. So here, if patient taking q6 h, then will not get a good result. For antibiotic, effect, that should complete the complete course. Here there will not adequate result due to inefficient intake of drug.

Prevention: this is also negligence. It should preventable. All nurses should detaily check the prescription properly, then only administer medication.