How to Avoid Medical Errors When Filling Prescriptions

¶ … Ethics and Legalities of Medication Error Disclosure

As Philipsen and Soeken (2011) note, it is the nurse's duty and ethical responsibility to inform the patient of any medical error in treatment, even if the error is "insignificant." The patient still has a right to know, as do all individuals who are impacted by the error (staff as well). This allows the medical community to remain transparent, which is a foundation of trust in the staff-patient relationship. Thus, the ethical implications of disclosure and non-disclosure are clear: to not disclose a medical error is to act unethically and without the transparency and loyalty that is owed the patient as well as the members of the staff. The legal implications of disclosure vs. non-disclosure are also clear. The severity of the error is what is most likely to affect the outcome if the error becomes known and there was no disclosure made initially. However, it is also the case that legal action is less likely to be pursued if disclosure is immediate and the severity of the error is not significant (Edwin, 2010). Indeed, Kentucky law states that each case shall be evaluated on a case by case basis, implying that there is some gray area regarding what will be tolerated in terms of disclosure policy, as individual hospitals set disclosure policy (Kentucky Revised Statutes, n.d.).

As the advanced practice nurse in this scenario, I would disclose the error to both patient and staff so that everyone impacted by the error would be on the same page. It is important for staff to be as clear about what is going on with a patient as it is for the patient to be clear about what the staff is doing for them. The error should be explained and the fact that it will have no significant effect on the patient is also important to explain so that the patient is not worried. Owning up to mistakes is part of life and avoiding doing so only complicates matters when admitting them can easily bring them to the fore where they can be resolved.

The process of writing prescriptions, including strategies to minimize medication errors is clearly outlined by The Institute for Safe Medication Practices (ISMP), which focuses on "10 key elements" that can prevent medication errors (Anderson, 2010). First off, the process of writing a prescription "is a complex multistep process that encompasses prescribing, transcribing, dispensing, and administering drugs and monitoring patient response" (Anderson, 2010). Therefore, it is important that when embarking on this process, the nurse takes care to follow the "10 key elements" prescribed by ISMP to prevent errors.

These elements consist of gathering the patient's information as well as the drug information. This means that the nurse should know the name, age, weight, birth date, diagnosis, allergies, vital signs and lab results of the patient. The proper drug information should be readily available as well and can be located from a variety of sources including protocols, order sets and administration records (Anderson, 2010).