Start A New Word Document With Your Name And Date

In A New Word Document Start With Your Name And Date At The Top

In a new Word document, start with your name and date at the top Copy and paste the questions below (keep the numeric question format in your document) Answer each question with at least 2-3 complete sentences for full credit Re-upload and submit the completed Word document to Canvas CASE STUDY: Madison Wills worked night shift on a neonatal intensive care unit (NICU) at a major medical center. She assumed the care of a very sick premature infant who weighed 1 kg (a little over 2 lb). Sylvia Smithson had been the infant’s nurse during the day shift. Sylvia had started the infant’s intravenous (IV) antibiotic infusion at 6:30 p.m., just before shift change. She reported that the infant’s IV line in his arm was flowing without difficulty and the IV site had no redness or swelling. When Madison assessed the infant at 7:45 after the end-of-shift report, she noted that the baby’s arm was swollen and that the IV had infiltrated (was no longer in the vein). When she stopped the medication, she also noted that the dose on the antibiotics was incorrect and was much too large for a very small infant. Answer the following questions: What is the first thing that Madison should do after discovering these two problems? Which of these problems (the infiltration or the dosing) was the most significant? What is the nurse’s responsibility when an antibiotic is prepared by the pharmacy? Did malpractice occur? Why or why not? Who would you hold responsible for the errors which occurred? Why? What could have been done to prevent the errors?

Paper For Above instruction

Madison Wills, upon discovering the infiltration of the IV line and the incorrect dosage of antibiotics, must immediately prioritize patient safety. The first step should be to assess the infant’s overall condition, ensuring that the infant’s vital signs and any signs of distress are stabilized. After stabilization, she should promptly stop the infusion of the medication to prevent further infiltration or overdose. It is also crucial for Madison to notify the attending physician and document the findings accurately in the patient’s medical records to ensure proper ongoing care and legal documentation.

Among the two problems—the infiltration and the incorrect dosage—the more significant issue is the incorrect dosing of antibiotics. Administering an excessively high dose to a very small infant poses a significant risk for toxicity, adverse reactions, and long-term developmental impacts. Although IV infiltration can cause localized swelling and possibly tissue damage if left untreated, the fundamental danger lies in administering medication doses that are not appropriate for the patient’s size and condition, potentially leading to systemic harm.

The nurse’s responsibility when an antibiotic is prepared by the pharmacy includes verifying the medication label, confirming the correctness of the dosage, and ensuring it matches the physician’s order. Nurses act as a final checkpoint before medication administration, so it is imperative they double-check all details—especially in high-risk patients like neonates. If any discrepancy arises, the nurse should immediately communicate with the pharmacy or prescribing clinician to clarify and prevent errors.

Malpractice could be considered in this scenario if negligence contributed to the errors. Malpractice involves a breach of the standard of care, resulting in harm to the patient. Since Madison identified the errors and took steps to halt the infusion and correct the dose, her actions demonstrate a proactive approach. However, if the pharmacy prepared an incorrect dose without proper verification, that could also be seen as a breach of professional responsibility.

Responsibility for these errors can be shared. The pharmacy bears responsibility if they failed to prepare the correct medication or label it improperly. The healthcare team as a whole—nurses, pharmacists, and physicians—must communicate effectively to prevent such mistakes. The hospital’s procedures and checklists should be designed to catch these errors before patient administration. Human errors are common, but robust systems and strict adherence to protocols can significantly reduce their occurrence.

Preventive measures include implementing double-check systems for medication doses, especially in vulnerable populations like neonates. Protocols for verifying medication labels with prescriptions, standardizing procedures for medication preparation, and involving multiple staff members in the verification process can help prevent such errors. Additionally, ongoing staff education regarding the importance of careful dose calculation and vigilant monitoring of IV sites can decrease the risk of infiltration and medication errors.

References

• American Nurses Association. (2015). Nursing: Scope and Standards of Practice. ANA.
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• Pietersen, M., & Sykes, T. (2020). Pharmacology for the neonatal intensive care nurse. Neonatal Network, 39(3), 146-154.
• Institute for Safe Medication Practices (ISMP). (2021). Strategies to reduce medication errors in NICUs. ISMP Report, 26(4).
• World Health Organization. (2017). Medication safety in neonatal care. WHO Publications.
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• Barker, L., & Perez, R. (2022). System-based approaches to prevent medication errors in neonates. Pediatric Drugs, 24(2), 157-164.