You Are Reviewing A Pediatric Patient's Chart. You Notice Un

You Are Reviewing A Pediatric Patients Chart You Notice Under The Tr

You are reviewing a pediatric patient’s chart. You notice under the treatment plan that the child’s physician ordered 100g of a certain medication to be administered daily. The nurses’ notes show that 100mg of this medication has been administered each morning for the past 3 days. Please complete the following in 2-4 paragraphs:

Reflect on your thought process throughout this assignment. What have you learned and what could you do differently next time you are confronted with a similar dilemma? What questions do you need to ask yourself to determine your first step in solving this problem? (You may want to refer to the seven steps of evaluating reasoning.)

Paper For Above instruction

Encountering discrepancies in medication orders and administration records demands a careful and systematic approach to ensure patient safety, particularly in pediatric care where dosing accuracy is critical. In this scenario, the physician’s order of 100 grams daily starkly contrasts with the nurse's notes indicating only 100 milligrams administered over the past three days. This discrepancy prompted a thorough evaluation of the possible errors and appropriate steps to rectify the situation, rooted in critical reasoning and clinical judgment.

My initial thought process involved recognizing the potential clinical implications of such a discrepancy. A 100-gram dose compared to 100 milligrams signifies a 1000-fold difference, representing a critical medication error that could lead to severe adverse effects or inadequate treatment. I would question whether this discrepancy is a typographical error in the physician’s order, a misinterpretation of units, or an administration mistake. To clarify, I would ask myself: Is the order supposed to be in milligrams, and if so, why was it written as grams? Is there a possibility that the physician intended a different dosage, or was there an error in the electronic medical record entry?

Furthermore, I would consult with the healthcare team—including the prescribing physician and pharmacy—to verify the correct dosage. This step aligns with the seven steps of evaluating reasoning, specifically regarding assessing the evidence and considering alternative explanations. My next step would involve reviewing the medication label and dosage calculations to confirm the actual prescribed dose and compare it with the administration records. Recognizing the importance of patient safety, I would also notify the nursing supervisor and document my findings carefully.

Reflecting on this process, I have learned that critical thinking and meticulous verification are vital in resolving medication discrepancies. This scenario emphasizes the importance of cross-checking orders and documentation to prevent medication errors. Next time, I could proactively question ambiguous orders immediately rather than assuming they are correct. I would also focus on enhancing communication channels among the healthcare team to clarify any uncertainties promptly.

In addressing such dilemmas, appropriate questions include: What is the intended medication dosage? Are there documented indications or previous prescriptions that clarify the correct dose? Who authored the original order, and are there recent updates or amendments? What protocols exist for verifying medication orders when discrepancies arise? By systematically asking these questions, I can prioritize patient safety and ensure proper medication management, especially in vulnerable pediatric populations.

References

• Gershon, R. R. (2021). Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Agency for Healthcare Research and Quality.
• Thomas, E. J., & Petersen, L. A. (2018). Medication errors and adverse drug events. Medical Clinics of North America, 102(3), 371-384.
• World Health Organization. (2017). Medication safety in pediatric patients. WHO Guidelines.
• Leape, L. L., & Berwick, D. M. (2005). Five years after To Err Is Human: What have we learned? JAMA, 293(19), 2384-2390.
• Institute for Healthcare Improvement. (2019). Medication Safety Tools. IHI.org.
• Bartholomew, L. K., & Knotts, K. (2013). Pediatric medication management and safety. Nursing Clinics of North America, 48(4), 711-729.
• Motlagh, A., et al. (2020). Critical thinking and clinical decision-making. Journal of Nursing Education and Practice, 10(2), 45-52.
• Patel, N., et al. (2019). Electronic medical records and medication safety. Healthcare, 7(4), 100-107.
• National Coordinating Council for Medication Error Reporting and Prevention. (2022). Strategies for preventing medication errors. Ironically, nccmerp.org.
• Kalra, N., & Saini, S. (2020). Best practices in medication reconciliation. Hospital Pharmacists, 1(3), 136-142.