Multiple Choice Question
The nurse on your ward comes to you with a drug chart telling you that you prescribed co-amoxiclav despite the chart saying the patient is allergic to penicillin. She has already given the drug.
Choose the THREE most appropriate actions to take in this situation
A. Report the nurse to the ward sister as she has made a grave error in giving the drug
B. Assess the patient to ensure that they are not having an anaphylactic or allergic reaction
C. Inform your consultant of the error immediately
D. Shout at the nurse, and tell her she should not have given the drug without checking the patient's allergies
E. Inform the senior pharmacist of the error
F. Escalate the error to the medical director
G. Cross off co-amoxiclav to ensure it wont be given again and seek advice from microbiology about what to prescribe instead
H. Ask your SPR for advice after assessing the patient and ensuring you have their recent observations available
Answer: B, G, H
This question assesses your ability to prioritise patient safety and coping with stressful situations. You have made a mistake, and a patient's health has been put in danger. It is important to first assess the patient to ensure they are not suffering an allergic reaction by going to see them immediately, and assessing them in an ABC manner. It is quite likely that you will need senior advice on how to manage this patient, and calling your registrar is the best way to do this. Both B and H demonstrate that patient safety is your primary concern and are the most appropriate responses. G also puts the patient first, ensuring that the penicillin based antibiotic is not given, whilst still ensuring that the underlying infection is treated.
Shouting at a nurse (D) is unprofessional and therefore never appropriate. (A) reporting the nurse might be appropriate in the future as an incident has occurred and it is important to learn from it so that is doesn't happen again. You would inform your consultant (C) but that can wait until patient safety has been ensured. Escalation to the senior pharmacist and, much further down the line, medical director might be appropriate, but does not take precedent over patient safety.
The nurse on your ward comes to you with a drug chart telling you that you prescribed co-amoxiclav despite the chart saying the patient is allergic to penicillin. She has already given the drug.
Choose the THREE most appropriate actions to take in this situation
A. Report the nurse to the ward sister as she has made a grave error in giving the drug
B. Assess the patient to ensure that they are not having an anaphylactic or allergic reaction
C. Inform your consultant of the error immediately
D. Shout at the nurse, and tell her she should not have given the drug without checking the patient's allergies
E. Inform the senior pharmacist of the error
F. Escalate the error to the medical director
G. Cross off co-amoxiclav to ensure it wont be given again and seek advice from microbiology about what to prescribe instead
H. Ask your SPR for advice after assessing the patient and ensuring you have their recent observations available
Answer: B, G, H
This question assesses your ability to prioritise patient safety and coping with stressful situations. You have made a mistake, and a patient's health has been put in danger. It is important to first assess the patient to ensure they are not suffering an allergic reaction by going to see them immediately, and assessing them in an ABC manner. It is quite likely that you will need senior advice on how to manage this patient, and calling your registrar is the best way to do this. Both B and H demonstrate that patient safety is your primary concern and are the most appropriate responses. G also puts the patient first, ensuring that the penicillin based antibiotic is not given, whilst still ensuring that the underlying infection is treated.
Shouting at a nurse (D) is unprofessional and therefore never appropriate. (A) reporting the nurse might be appropriate in the future as an incident has occurred and it is important to learn from it so that is doesn't happen again. You would inform your consultant (C) but that can wait until patient safety has been ensured. Escalation to the senior pharmacist and, much further down the line, medical director might be appropriate, but does not take precedent over patient safety.