Reply comment 1
A nurseàoath is to do no harm. Our main objective is to deliver quality care, safely and
efficiently. “Nursing interventions, particularly surveillance, have been recognized as playing a
role in both the early detection of complications and in the identification, interruption, and
correction of medical errors” (Henneman et al., 2012). We are constantly re-educated on
preventing medical errors by having clinical educators teach us on how we should
appropriately go through our protocols and checklists to ensure quality and safe care. We had
an incident once in which our CRNA had their ropivacaine bags stored next to the patient’s
penicillin bags. One of our nurses accidently took the bag of ropivacaine but did her medication
administration rights and realized it was the wrong medication. We took it upon management
and were able to get our penicillin stored away from the ropivacaine bags. It is small details
such as those that we may overlook, but by following our administration rights and taking our
time, we prevent major medical errors which can cost our patients lives.
Reply comment 2
After viewing the video, Chasing Zero, analyzing every incident and near misses allows our
health care system to correct faulty processes and develop better, safer ways to administer
healthcare (QSEN, 2020).
I positively affect the quality and safety of the care my patients receive by following policies
and procedures for all patients regardless of pushback for others. Following rules, policies,
and procedures reduces errors that can be been avoided. For example, a time-out
immediately prior to a procedure that involves the entire team and the patient reduces
medical errors. The time-out is the essential, last check before a procedure. During a timeout for one of my patients, the patient revealed that he was on eliquis and that he had taken
this anticoagulant the same morning as his procedure. The procedure was cancelled for the
patient’s safety as anticoagulants are held for 24 hours prior to the procedure to prevent
unwanted bleeding. Some institutions do not take the time-out seriously for procedures
that are done in Interventional Radiology (IR) and GI setting, stating that it really isn’t the
OR thus making it difficult to actually do a proper time-out. In fact, I remember when there
wasn’t a time out and there was just a simple check list that the nurse did on his/her own.
This check list did not involve the whole team stopping and participating in the preprocedure checklist rendering it ineffective. Since time-outs are now used and taken
seriously with every patient for every procedure, various types of errors have reduced.
Other instances I have witnessed were medication errors. One event in particular was a
nurse who administered heparin rapidly because she thought she was administering
vancomycin. Both in 250 ml bags, she confused the mediations. She immediately notified
the MD and the patient was given protamine. Thanks to the nurse’s swift action of
reporting, the patient was fine.
After this incident, a two-person check was needed to give heparin in our hospital. This was
soon followed by other medications such as insulin. Many years after this incident, the bar
code entry for mediation administration was developed that enhances the 5 rights of
mediation administration and reduces errors. Thompson et al. found that medication
errors decreased after the introduction of bar code administration, hence, barcode
technology to assist in mediation administration improves patient safety by reducing
medication errors (Thompson et al., 2018).

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