Four Common Clinical Mistakes to Avoid as a Nurse

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Mistakes are part of the human condition — they’re inevitable. On the job, some mistakes are little more than minor inconveniences while others are catastrophic. In the nursing profession, clinical mistakes can often lean towards the latter, putting a great deal of responsibility on nurses to avoid medication mistakes, infections, documentation errors, and fall accidents that can cost patients their health and in some cases, their lives. Here are four common clinical mistakes that nurses should avoid.

1. Medication Errors

Medication errors are among the most common clinical mistakes that nurses — and their patients — face. When it comes to medicine, nurses have a lot of responsibility. They must interpret instructions and administer medicine correctly, often while managing a patient’s entire medication profile. Nurses should understand what causes medication errors and what can be done to prevent them.

Types of Medication Errors

There are many different mistakes that can occur during the process of prescribing, dispensing, and administering medication:

Prescribing Mistakes

A doctor may prescribe the wrong medication, or they may misspell a drug. They may write a prescription for a higher or lower dosage than indicated, or they may prescribe a medicine that is contraindicated with other drugs the patient already takes.

Dispensing Mistakes

A pharmacy may dispense the incorrect dosage of a medication, or they may fail to put the correct warning labels on the outside of the bottle.

Administration Mistakes

Nurses can administer medication too fast or too slow, or they can administer too much or not enough. They may retrieve and administer the wrong medication, or they may improperly administer the medicine by giving it in the wrong place or using the wrong equipment.

2. Most Common Causes of Medication Errors in the Nursing Profession

The causes of medication errors within the nursing profession can be attributed to many things, including:

  • Lack of Knowledge

    A core lack of pharmacological knowledge creates scenarios ripe for mistakes. For example, without a solid foundation in pharmacology, a nurse may misinterpret medical abbreviations or similar sounding medications.
  • Medical Abbreviations

    Nurses without good pharmacological knowledge may misinterpret common medical abbreviations, such as “PO” for medications administered orally, or “PRN” for medications administered on an as-needed basis.
  • Similar Sounding Drugs

    Many medications sound similar and nurses may mistake one for the other. For example, clonazepam, alprazolam, and lorazepam all sound similar and are in the same family of drugs. However, the dosage for each is often different because the half-life of each drug is unique.
  • Inadequate Written Communication

    Physicians often write prescriptions quickly and may use shorthand to write names of medications, dosage instructions, and refill information. If a medication’s instructions are written illegibly or are difficult to decipher, the chances of misinterpretation leading to a medication mistake are much higher.
  • Poor Communication

    In some cases, physicians and nurses may lack good communication entirely. They may not discuss the patient’s case together and may only rely on notes in the patient’s chart. When nurses and doctors aren’t on the same page regarding a patient’s medical care, it’s easier for mistakes to occur.

3. Infections

Bacteria and pathogens are present in every medical setting. When people who are ill or have an otherwise compromised immune system become patients, their risk for contracting an infection increases because it’s more difficult for their bodies to fight off pathogens or bacteria. These infections are called Healthcare-Associated Infections (HAIs), and the CDC estimates that approximately 1 in 31 patients have at minimum one HAI on any given day. HAIs can be troublesome at best and may be fatal.

How to Prevent Infections

Because HAIs are a real threat in medical settings, it’s important for nurses to take as many precautions as possible in the field. Proper sanitation of equipment and good hygiene habits are critical for nurses, regardless of the specialty.
  • Proper Hygiene

    Follow best practices for hand washing, and wash your hands frequently. Wear gloves when touching a patient, even if you’re only touching their clothing or bed linens.
  • Equipment Sanitation

    Never use equipment that hasn’t been sterilized or sanitized. After using equipment that needs to be sterilized, either sanitize it before putting it away or place it in the appropriate receptacle to be sanitized.

4. Improper Documentation

Healthcare workers rely heavily on a patient’s chart to gather the information they need to make critical decisions about a patient’s care. Mistakes occur when this documentation isn’t thorough or done in a timely fashion.

How to Prevent Documentation Mistakes

It’s important to be proactive and pay attention to detail when preventing documentation mistakes. Make sure you always chart for your patients as soon as possible and that any handwritten notes are printed clearly and legibly.
  • Timely Charting

    When charting isn’t done in a timely manner, other nurses and physicians won’t have all the information they need to treat the patient. For example, a double dose of medication could be administered to a patient if a nurse administers a dose, doesn’t chart it, and another nurse administers the same medication too soon after the first dose.
  • Write Clearly

    Any handwritten notes should be printed in neat handwriting and should be as easy to read as possible. Avoid using shorthand or jargon that only you will understand. A nurse should be able to review notes and glean important information quickly.
  • Pay Attention to Detail

    Small details can sometimes be overlooked when caring for a patient, but it’s often these details that are the most important. Pay attention to details and make note of them so you can easily refer back to them later.

5. Falling Accidents

Falling accidents occur frequently in medical settings. Patients are often at a physical disadvantage due to injury or illness, or they may be sedated and unable to walk well independently. Falls can cause injury, lengthen a patient’s hospital stay, thus increasing their risk of contracting an HAI. Nurses are responsible for ensuring that falling accidents are prevented when possible.

How to Reduce the Risk of Falling Accidents

Disabled, elderly, injured, and very ill patients are at the highest risk of falling. To make falls less likely, nurses should:
  • Evaluate the Physical Environment for Hazards

    Hallways, patient rooms, and recreation areas that patients have access to should be scanned regularly. Look for hazards like spills, broken tiles or frayed carpet, a loose rug, and objects on the floor that could cause a patient to trip.
  • Assess the Risk of Each Patient

    Nurses also need to assess the risk of falling for each patient they work with. If a patient is young and able to get up and around fairly well, they’re less at risk for falling than someone who has just been sedated or someone who has sustained an injury to their lower extremities. Patients who are at a higher risk should not be allowed to move about without supervision.

Develop Strategies That Promote Patient Safety

Nurses are also responsible for developing and implementing reasonable strategies to promote patient safety. For example, unstable patients may be given a walker to use, or a patient who has just had an epidural may not be allowed to get out of bed without a nurse present for a period after the last dose of medication.

Nurses are responsible for a great deal of a patient’s care, and it’s important to actively prevent common clinical mistakes whenever possible. Strategize ways to increase patient safety, maintain proper hygiene, and chart frequently and clearly.

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