A 79 year old dialysis patient was admited to the ICU after a dialysis session where he experienced severe shortness of breath.  The next day his doctor prescribed him an antacid after the patient complained of an upset stomach. His nurse instead gave him pancuronium (a paralytic and muscle relaxant).  The drug put him in respiratory arrest.  He remained in a vegetative state until his death one month later.

What happened?

The packaging for pancuronium and the antacid were similar.  The nurse failed to look at the medication and read the packaging, she failed to scan to determine the right medication counts and she failed to match the patient’s ID with the scanned medication.

Here are a few tips on administering medications safely and avoiding harming the patient.

  1. Check the order – make sure the physican’s order is complete and correct. This means it includes the drug’s name, dosage, frequency and route of administration.  If unclear or incomplete, check with the ordering physician before proceeding.
  2. Check the patient – Check the patients name using two methods of identification .
  3. Check the medication – Check the labels and compare with the order. Look for an expiration date and make sure it is not expired.  Check the characteristics of the medication.
  4. Document everything – this includes proper medication labeling and proper recording of administered medication. A lack of proper documentation can result in an error.
  5. Learn the facilities policies – become familiar with the facilities policies, regulations, guidelines and procedures. These policies often contain valuable information regarding the practices of medication ordering, transcribing, administration and documentation.
  6. Know the 5 Rights of Medication Administration
    1. Right Patient
    2. Right Time
    3. Right Drug
    4. Right Route
    5. Right Dose



Floating Policy:

As a contract professional you are required to float to any floor that needs help in a capacity in which you are proficient and qualified to work.  A contract professional is considered to be of higher caliber and quality, with the ability to multitask.  Do not complain about floating.  If you are asked to float and you refuse, you will receive no compensation unless you are not qualified for that area.  This I critical to the success of the contract and you must be flexible.  You cannot be floated to an area above your scope of practice.

You may be asked to float within a healthcare system of sister facilities.  This must be done within an acceptable mileage and within your skills set.  If a change in work site is required, you may be asked to commute up to a distance of 60 minutes or 60 miles from the original work site.

Please see your Healthcare Traveler Handbook for more information.  A copy of the Healthcare Traveler Handbook is available on the Traveler Hub on www.therightsolutions.com




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