Patient Safety Issues in Medical Surgical Nursing

Running head: HEALTH CARE
Health care
Name of the student:
Name of the University:
Author’s note

1HEALTH CARE
Introduction:
Nursing practice has many specialty areas in which registered nurse take special
qualification and training to provide advanced level of care to patient. Some example of specialty
nursing role includes critical care nursing, medical surgical nursing, mental health nurse and
pediatric nursing. The duties of specialist nurse differ from that of registered nurse in the areas of
greater clinical responsibility and providing excellent patient care (Joel, 2017). The main purpose
of this paper is to explore an issue of patient safety in the speciality area of medical surgical
nurse and critically analyse factors leading to the issue. After the analysis of the event based on
the current role and responsibilities of nurses in the specialty area of medical surgical nursing,
the paper will provide recommendations regarding the way speciality nurse should engage in
care to promote safety of patient.
Patient safety issues in the specialty area:
During the placement as a medical surgical nurse in an acute care hospital, a major
patient safety risk was witnessed due to the involvement of a nurse in serious medication
administration error. The patient under care was Mr. A (pseudonym), 65 year old patient had
undergone hip replacement surgery. He was brought to the general ward post two hours of the
surgery and the nurse on duty was assigned to assess his vital signs and provide morphine
medication for management of pain. As per the medical order, the nurse completed assessment
and found that the patient’s pain level was 5/10. The nurse administered the medication to the
patient. However, to her horror, she suddenly realized that she had given a much higher dose of
medication than what was actually prescribed. However, considering her responsibility towards
patient safety, she immediately raised an emergency call to the physician and informed him

2HEALTH CARE
regarding the issue. The effect of drug toxicity and risk to life of patient was avoided after the
physician came and provided naloxone to the patients. The patient’s vital sign was constantly
monitored throughout the process.
On reflecting on the safety issue that took place, it can be said that nurses was involved in
a medication dose related error as she failed to follow the standard procedure while
administering medication to patient. Considering the nurse was working in a medical surgical
unit, the nursing error was a significant issue as medical surgical nurses are expected to act as
advocated for patient and they must follow all existing procedures and standardized plans during
care delivery. The main factor behind medication error was the ignorance of following the six
rights of medication administration. The six rights include following the step wise process of
confirming that the right patient, the right route, the right drug, right dose, right time and right
documentation is maintained during medication administration (Hayes et al., 2015). In case of
patient safety issue witnessed at the hospital, it was found that the surgical nurse followed
checked the patient’s identity with that of the band tied in his hand. The right route and right
drug was also checked. However, in a hurry, she failed to pay attention to the right dose of
medication. The six rights is a guideline for nurse to maintain security. However, dosage related
errors occurred because of failure to complete all the rights of medication administration. The
incidence is a case of poor commitment to principles of six rights which is described in the study
by Kartika and Melani (2018) too.
While analyzing the overall actions taken by the nurse during the risk event, it can be said
that not preparing adequate dose was a serious mistake. There can be many reasons for the
nurse’s engagement in such adverse event. The first factor is negligence, that means the nurse
did not regarded medication dose to be important during the clinical situation. The second factor