Medication errors and how to prevent them – This is a real court…

Medication errors and how to prevent them – This is a real court case. In a reported case out of California, a 33-year-old male presented at his hospital’s ED with severe abdominal pain. He was diagnosed with appendicitis and admitted for an appendectomy. During the first postsurgical hour, IV Demerol was initiated in the post anesthesia recovery unit, starting with 100 mg in divided doses. The patient was then transferred to a med/surg unit where the Demerol was continued. The patient was placed on a liquid diet. Two days after surgery, the man’s physician wrote an order for two tablets of Vicodin orally for pain, as needed. The physician did not cancel or otherwise change the IV Demerol order. At this point, the patient had received a total of 675 mg of Demerol since he first came out of surgery. Because the patient continued to have significant pain, the nurse caring for him when the Vicodin order was written believed that the patient could not take the pain medication orally since he was still on a liquid diet. Nurses on subsequent shifts followed this rationale as well. What action should the nurse have taken at this time? 

 

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However, on the third postoperative day, the patient’s evening nurse informed the physician that the patient was still having severe pain and gave him the Vicodin. The patient informed the nurse that the pills were not working. She consulted with her nurse manager and afterward gave the patient more IV Demerol. What information should have been in the SBAR when the nurse called the physician? 

 

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Explanation & Answer

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