The Top 7 Nursing Errors and How to Avoid Them

No one is perfect, everyone makes mistakes. Well, yes that’s true and even understandable at times. Even nurses are prone to committing them (mistakes) sometimes, however, this shouldn’t be taken lightly especially in a profession which deals with actual lives. Studies have shown that errors, accidents, injuries, and infections are to blame for at least 180,000 patients killed every year in American hospitals.

We have pledged to help save lives, but why is it that some fatalities are even caused by the mistakes committed in our profession? What are the common errors committed by nurses and how can we prevent them from happening? Let’s find out.

The Top 7 Nursing Errors

  1. Failure to collaborate with other health care team members
  2. Failure to clarify interdisciplinary orders
  3. Failure to ask for and offer assistance
  4. Failure to utilize evidence-based performance guidelines or bundles
  5. Failure to communicate information to patients and families
  6. Failure to limit overtime
  7. Failure to adequately staff patient care units with enough nurses to allow them to safely provide care

Avoiding these types of errors

  • Preventing falls

* Encourage patients to ask for help when they get out of bed, and make sure there are no obstacles to the restroom or around the bed. Many patients believe that they don’t require assistance or can become tangled in equipment, causing them to fall.

* Verify activity orders. These can vary during the hospital stay and after changes in condition or medical-surgical interventions. Continuously assess and compare the patient’s ability with the written activity orders.

* Assess the patient’s gait when out of bed and offer assistance.

* Perform hourly rounding. Studies have directly correlated rounding with decreased falls in the hospital. Basic needs can be taken care of at this time, such as toileting, moving objects within reach, offering food, and asking about pain.

* Be aware of any medications that may cause drowsiness, dizziness, or impaired judgment. You should also discuss this with the healthcare provider.

* Use protective measures, such as nonslip socks and bed alarms, to decrease the risk of falls.

* Make sure nurse managers are monitoring for safe nurse-patient ratios.

– Keeping Infections Away

* Observe proper hand hygiene

* Use chlorhexidine for skin preparation, practicesterile technique, and follow guidelines for central line use and removal to prevent bloodstream infections.

* Appropriately clean urinary catheters, remove them in a timely manner, and avoid long-term use unless medically necessary to prevent catheter-related infections.

  • Preventing medical errors

* Utilize a bar coding medication scanning system. This allows nurses to verify the six medication rights (correct medication, patient, route, dose, time, and documentation) more accurately.

* Take an active role in consulting with the interdisciplinary team, including the pharmacy, to ensure all look-alike or sound-alike medications aren’t stored near each other.

* Double check all high-alert medications with another nurse. This can prevent errors such as neonates being administered an adult dose of heparin.

* Understand and know the medications that are being administered, along with adverse reactions. Tell each patient what he or she is receiving and the reason for each medication.

* Consult with other healthcare team members, such as senior nurses, for their insight and advice.

* If you have questions about a drug, ask. There are several resources that are available from the pharmacy to drug guides.

* Keep in mind that even if the healthcare provider orders the wrong medication, wrong route, wrong dose, or wrong frequency, the nurse still retains culpability.

* Trust your instincts!

  • Steering clear of documenting errors

*Accurately document all major events and changes in patient condition in a timely manner.

* Monitor patients regularly and document interventions performed.

* Report adverse events immediately to the nurse manager or supervisor.

* Check the healthcare provider’s orders for monitoring and notification intervals, such as BP parameters, fever, heart rate, and abnormal heart rhythms.

* Document as patient condition warrants. For example, if the patient is declining, document every intervention and notification you perform.

* Address all signs and symptoms of distress.

* Document the time and content of all healthcare provider notifications.

* Ensure all documentation is on the correct patient.

* Document patient education and patient and caregiver comprehension of the information.

  • Evading equipment injury

* Request training on equipment you aren’t sure how to use

* Examine all equipment and removing it if damaged

* Report any incidents or defects to the risk management department, patient safety department, or your supervisor

* Thoroughly document any injury related to the equipment

* Use the equipment only as recommended

* Routinely validate your clinical competence to operate your facility’s equipment to reduce the likelihood of injury to patients, staff, and yourself.

 

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Liane Clores, RN MAN

Currently an Intensive Care Unit nurse, pursuing a degree in Master of Arts in Nursing Major in Nursing Service Administration. Has been a contributor of Student Nurses Quarterly, Vox Populi, The Hillside Echo and the Voice of Nightingale publications. Other experience include: Medical-Surgical, Pediatric, Obstetric, Emergency and Recovery Room Nursing.

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