Case Study – Medication Error / Reflective Practice As a per

Case Study – Medication Error / Reflective Practice As a per diem… Case Study – Medication Error / Reflective PracticeAs a per diem staff nurse for the float pool, Mary found herself assigned to a patient who had received opioids via epidural catheter during his recent surgery. Her patient had returned from the PACU to her surgical unit with a periodically low RR accompanied by lower than normal BP and pulse. Narcan was ordered to be given in doses of 0.2 mg IV PRN for a RR <10. Mary checked VS every 30minutess. After he arrived, she assessed his vital signs: RR=8, BP 88/60, and P=50. According to the physician's order, she prepared an IV dose of Narcan to bring the patient's vital signs up to the appropriate parameters left with her by the anesthesiologist. After Mary had injected the IV medication, she immediately started to chart the medication she had given. In horror, she looked at the empty vial in her hand. It was labeled "2 milligrams per 1 ml" and she had just injected the entire 1 ml vial. She quickly reported the mistake to her charge nurse and hurriedly returned to her patient's side. Within minutes, the patient complained of nausea. Mary immediately took his VS again, finding that his RR, pulse and BP had come up to normal rates and her patient was much more alert than he had been. Mary then called the attending MD and the anesthesiologist to report her mistake and the patient's present condition. Both told her to just watch her patient closely, stating that it may have been just what the patient needed. A sense of relief came over Mary, and yet her mistake almost overpowered her ability to finish the shift. She knew that if she had given 10 times a normal IV dose of most other meds, her patient would be in dire consequences and likely transferred to the ICU, with death being a real possibility. Mary filled out an incident report and headed home. She had been able to stay composed until she walked in the door of the house, but as her husband asked about her day she broke into tears and headed to the bedroom. She could not quit thinking about how easily she could have "killed her patient."Using a reflective practice model, how do you reflect on this situation? What s do you ask (and answer)? 6. Other thoughts: What other factors could have impacted Mary's ability to provide safe care?Health Science Science Nursing N 213

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