Medication Errors: How to Avoid Them as a New Nurse

A new nurse graduate asked me how to avoid medication errors as a nurse. Very good question! Here’s what I told her.

How Do You Avoid Medication Errors As A Nurse?

I love hearing your questions. Here is one I received from a new nurse grad named Laura.

Hi! I love your blog and so do my classmates. I am currently in my second semester in nursing school in a second degree accelerated program. So far the more nursing classes I take the more I want to be a nurse! One thing that absolutely terrifies me though are med errors. I do not want to hurt anyone by making a mistake. Our instructors are emphasizing the 5 rights of medications and making sure you do your three checks before administering a med. Any tips from the real world that help you avoid med errors? – Laura

Med errors suck, but they happen. Some of the best nurses ever have them. And it’s okay – we’re human.  What matters is how you handle the situation and how you will not do that again in the future.

Here are my practical tips for avoiding medication errors.

Avoid Medication Errors: Don’t Chat While Handing Out Meds

Don’t engage the family in conversation when administering meds. I hate silence; it feels awkward to me. But I had to get used to being okay with silence while I’m getting meds together and scanned in the room.  That’s when you make mistakes – when you’re distracted.

Always Double Check With A Co-Worker

I always double-check my insulin and any other high-alert or partial doses with a coworker.

I always have a coworker do math separately from me. This way, if I make a mistake, someone that isn’t close to the problem will catch it.

Remember Pharmacy Can Make Mistakes Too

Pharmacy can make mistakes too; it happens.  Make sure you’re checking your order or what you know the doctor wanted against the actual med that’s sent up or that you’ve pulled from Pyxsis.

Avoid Medication Errors: Cut/Draw Half Doses After You Scan It In

If you have to give half of a pill or a partial dose of an IV push, cut/draw it up after you scan it in when the prompt comes up to tell you the partial dosage (if you use a computer med admin system that does that).  Errors occur when you’re scanning your meds and a pill needs to be cut in half, you think, “Oh, I’ll just scan these other 3 pills real quick and then cut my pill”  and then someone interrupts you innocently, and you forget to cut the pill.

Focus On One Thing At A Time

I also never go do something else mid-med pass unless it’s an emergency. People will try to interrupt you (phone calls, patient needs, etc.).  Just tell them you’re passing meds and you’ll get back to them once you’re done.

Correct Errors Immediately

If you have an error, immediately admit it and correct it. Don’t try to act like it didn’t happen or it’s not a problem; I’ve seen students and new nurses do that and it’s just not safe practice and a terrible habit to start.

Be honest and don’t afraid to admit your mistake. It’s okay to be embarrassed, but don’t let that keep you from doing your job appropriately.  Let your charge know, let the MD know, write yourself up, and move on.

My Story of my Medication Error

Once I forgot to cut a Lopressor in half. I gave the patient 25 mg instead of 12.5 mg. He actually took 50 mg BID at home and we were giving him 12.5 mg BID, so he actually probably needed the whole pill. Nonetheless, I had to let the doctor know and fill out my little report. He was fine, the doctor didn’t really care, and I felt terrible.

If you work in a place of EMR, they’re great because they make it pretty difficult to give the wrong meds. You have to scan the patient, scan the med, put in the dose, etc.. so you have multiple safety checks. They’re fantastic. That should never take the place of your nursing judgment, but they really do cut down significantly on the possibility of errors.

Keep your head up, you’re going to do great! And if you do have a med error, that doesn’t make you any less awesome of a nurse. It’s all in how you handle and correct it. And I bet you’ll never make the error again. I sure as heck have never NOT cut a pill in half after that Lopressor incident!