Hyperglycemia Vs Diabetic Ketoacidosis Protocols Clinical Paper

It is evident that patient safety is one of the most important principal in place as a nurse. To insure this there are many standards that are set in place that as a registered nurse need to be met, some including, professional responsibility and accountability, having knowledge based practice, ethical practice, service to the public and self-regulation (SRNA, 2014). “These standards and foundation competencies serve as the criteria against which all registered nurses, practising in all domains of nursing practice (direct care, education, administration, and research, and the evolving domain of policy) will be measured by clients, employers, colleagues and themselves”(SRNA, 2014). Having these standards allows register nurses and the public to have a clear understanding of what needs to be met in order to insure that there is proper patient safety. However there are still many issues that contribute to unacceptable patient safety, including medication administration errors, post operative care, and patients mental health. However, “medication errors are one of the most common types of medical errors that occur in healthcare institutions” (J.Choo, 2010). A medication error, according to The National Coordinating Council for Medication Error Reporting and Prevention “is any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient or

During one of my rotations, I was assigned a young adult patient who had run out of insulin and had been admitted to the hospital following a Diabetes Ketoacidosis (DKA) episode. I realized that my patient was probably torn between buying insulin and buying healthy food because her chart showed several admissions in the

When I say this, however, most people would picture the nurse giving the wrong medication due to lack of focus on the tasks at hand. While this could happen, I have noticed during my time at hospitals that the doctor orders are still hand written for the most part. Consequently, they can be very hard to be read legibly much less correctly translated into proper medication dosages. The first suggestion I would give to an organization would be that they required all orders to be submitted securely, by the doctors, to the pharmacy be electronic means.

Exploration of the concept of Medication Administration errors (MAEs) especially regarding Insulin and what contributes to New Grad Nurses (NGN’s) becoming second victims, and the impact of it on and its effects on their nursing. Nearly 1 in 3 hospitals that have patients with diabetes are affected by Medication Errors (National Diabetes Inpatient Audit, 2012). Controlling and managing glucose is essential as some health care professionals often overlook proper handling of this and most common error that occurs is over dosing, under dosing or complete omission of insulin administration (CITE), overlooking this can have a serious impact on the patient well-being and also on the health care team. In the case of MAEs, there are three (3) types of victims involved; firstly is the patient and their family, next would be the nurse or health care professional, lastly it would be the involved health care organization which is involved. In regards with the topic NGN’s are considered second victims in these cases, second victims is defined as a “health care provider involved in an anticipated and/or adverse event in which there has been a medical error, and/or a patient related incident or injury who has become victimized in a sense of that the provider is traumatized by the said event” (Dekker, 2013).

Not only did insufficient staffing contribute to the causes of this particular event, but human error also played a significant role. When Mr. B arrived at the ED, he was hyperventilating. His leg “appeared shortened.” He had edema in his calf, ecchymosis, limited ROM, and he rated his pain at a ten out of ten. Mr. B also had a history of prostate cancer, impaired glucose tolerance, elevated cholesterol and lipids, and chronic pain. He was admitted to the ED with a plan to relocate his hip. Dr. T ordered diazepam 5.0 mg to be administered through IVP and then just five minutes later ordered 2.0 mg hydromorphone to be administered because it appeared that the diazepam was not having the intended sedating effect. Again, just five minutes later, Dr. T was still not satisfied with the level of sedation and instructed the nurse to

The purpose of this paper is to bring forth awareness when it comes to patients and medication errors and further educates health care professionals on the importance of communication especially during transition of care. According to Williams and Ashrcoft (2013) “ An estimated median of 19.1 % of total opportunities for error in hospitals.” Although not all medication errors occur during transition it is the time most prevalent for these errors to occur. As per Johnson, Guirguis, and Grace (2015) “An estimated 60% of all medication errors occur during transition of care. The National Transitions of Care Coalition defines a transition of care as the movement of patients between healthcare locations, providers, or different levels of care within the same location as their conditions and care needs change, [and] frequently involves multiple persons, including the patient, the family member or other caregiver(s), nurse(s), social worker(s), case manager(s), pharmacist(s), physician(s), and other providers.”

Nurses were required to confirm the right patient, medication, dosage, time, and route. The five rights aided in the process but errors were still made. Nurses working long hours, mandatory overtime, budget cuts, increased patient nurse ratio, and high patient acuities are also noted to contribute to the increase of errors. For many of these issues there is not a quick remedy. Geiger shared the elimination of retribution for medications errors would help decrease the effects associated with medication administration.

The reasons could be a lack of motivation, avoidance of information or the ignorance about the health behavior (Virginia Tech Continuing & Professional Education, n.d.). In this initial stage, the patients are still in the hospital. It is the responsibility of the discharge nurse to emphasize the importance of maintaining the blood glucose (BG) levels within the normal range while educating the patient, to prevent the surgical site infections (SSIs). The nurse should stress the need to check the patient’s BG levels at least two to three times a day and document the results in the BG monitoring chart provided to the patient at

System failures and poor communication has led to decreased patient safety and satisfaction within the hospital. Three critical areas that need immediate solutions are the drug administration system, hand washing protocols and follow ups and communication between patients and clinicians. Dosage issues whether it is frequency of a drug given or if the patient has even received their medication have occurred because there is no standard system for drug administration . Also, there is little adherence and enforcement to handwashing when interacting with patients. Lastly, there is no protocol when following up with patients leaving them feeling frustrated with the negligence of the clinicians.

Medication errors are one of the leading causes within a patient care setting thatcan jeopardize the client’s safety, and can even potentially be fatal. The six patient rights,right dose, time, route, medication, patient and documentation, all help prevent errors andpromote patient safety. The nurse needs to check off each patient right in order tosuccessfully pass medications. One of the leading causes for missing one of these patientrights is interruptions in the process of medication administration prep, or when activelygiving the medication to the patient. This paper will discuss why interruptions duringmedication administration can cause errors, and interventions the nurse can do to avoidputting the patient in

A major concern or challenge of ABC hospital is a recent incident of medication administration error in its emergency room (ER) which almost resulted in the death of a 55-year-old female patient. This is a case of medication administration through the wrong route. The Food and Drug Administration (FDA) defines a medication error as "any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer. Such events may be related to professional practice, health care products, procedures, and systems, including prescribing; order communication; product labeling, packaging, and nomenclature; compounding;

Medication administration is a multi-step process that is handled by multiple healthcare professionals. It begins with the prescription that is transcribed mostly by the physician, then dispensed by the pharmacist, and ends with the administration of the medication by the nurse. Throughout this multi-step process, medication errors can occur at any stage of the medication administration process. As expressed by L. Cloete in “Reducing medication errors in nursing practice,” “One third of the errors that harm patients occur during the nurse administration phase: administering medication to patients is therefore a high-risk activity.” Because the nurse is responsible for administering medication to the patient, he/she is considered and viewed as the most accountable in regards to the patient’s safety. Medication errors are one of the most common medical errors that can result in an adverse event that may pose a serious threat to the patient’s safety and well-being. In the article, “An inside look into the factors contributing to medication errors in the clinical nursing practice,” Savvato and Efstratios defined and characterized medication error as “any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer. Such events may be related to professional practice, health care products, procedures, and systems, including prescribing; order communication;

Diabetic Ketoacidosis (DKA) is a disease state, most often seen in individuals with Type I Diabetes. While it most often results from uncontrolled insulin levels, young children can often present in diabetic ketoacidosis as the initial presentation of undiagnosed type I Diabetes. The major symptoms of Type I Diabetes, polydipsia, polyphagia, and polyuria, are often subtle and can be normal in growing children (Urden, Stacy & Lough, 2014; Wilson, 2012). Unless alert to the symptoms of Diabetes they can often be overlooked until severe enough to warrant immediate medical attention.

Medication errors are the leading cause of morbidity and preventable death in hospitals (Adams). In fact, approximately 1.5 million Americans are injured each year as a result of medication errors in hospitals (Foote). Not only are medication errors harmful to patients but medication errors are very expensive for hospitals. Medication errors cost America’s health care system 3.5 billion dollars per year (Foote).Errors in medication administration occurs when one of the five rights of medication administration is omitted. The five rights are: a) the right dose, b) the right medication, c) the right patient, d) the right route of administration, and e) the right time of delivery (Adams). Medication administration is an essential part of

Medical errors caused by human oversight are the main issue inside Emory Healthcare. In 1986, it was calculated that 37% of the patient cases had medication treatment fault. The problems are due to the lack of standard for orders by physicians. Physicians would place orders by hand writing, and then they would call a nurse and ask him/her to write the