Case Study: Medication Safety Review for Patient Alfina - Hospital

This case study examines the medication safety of a 61-year-old female patient, Alfina, admitted to a hospital medical unit with palpitations, shortness of breath, and decreased activity tolerance. The patient's medical history includes hypothyroidism, early-onset Alzheimer's, and left-sided heart failure. The study details the patient's vital signs, lab results (including electrolyte imbalances), and current medications, such as Levothyroxine, Digoxin, Metoprolol, and Lasix. The analysis emphasizes the importance of safe medication administration, referencing the "seven rights" and the need for coordination among care providers, medication record maintenance, and resources from the Canadian Patient Safety Institute and ISMP Canada. The case study provides a practical application of medication safety principles in a clinical setting.

SAFETY OF
MEDICATION
ADMINISTRATION

REVIEW OF THE CASE STUDY
• The case depicts the study of a sixty-one year old female patient, Alfina. She is
a roman catholic Italian.
• The previous medical history shows presence of hypothyroidism, the early
onset of Alzhiemers. There was also left sided heart failure along with
Myocardial infraction in the year 2010.
• The current status of the patient as revealed shows that the patient was
admitted to the medical unit of the hospital with episodes of palpitations
followed by shortness of breath. There was also a significant decrease in the
tolerance of the activity along with the inability to complete simple activities
of the daily living. There was also a demonstrate in the increase of agitation
along with the difficulty in concentrating which were followed by the

• In order to assess the condition of the patient, there was conduction of the
labs which were as follows:
-Stool positive for occult blood
-WBC 6.7 L
-HCT 0.40
-HGB 119 g/L
-Ca 2.10 mmol/L
-Na 131 mmol/L
-K 3.1 mmol/L
-Mg 0.70 mmol/L

• The vital signs of the patient were as follows:
36.8 Celsius, 124, 18 at rest, 26 when ambulating, 98/54 mmHg, 91 % on room air.
• The medications provided to the patient were as follows:
- IV NS with 20 mEq KCL at 50 mL per hour
- Levothyroxine 25 mcg orally 30 minutes before breakfast each day
- Digoxin 0.75 mcg po daily
- Metoprolol 12.5 mg XL po formulation once daily
- Lasix 40 mg IV once daily
- Diltiazem 40 mg po tid
- Risperadone 1 mg po prn at bedtime for agitation
- Sodium restricted diet
- 1500 mL fluid restricted intake per 24 hours

SAFE MEDICATION APPLICATION TO THE PATIENT
• Coordinate with all of the care providers
• It is important to ask the doctor to help check the possible drug
• Getting details is necessary
• Take medicines as directed
• Maintenance of medication records (Keers, Williams, Cooke & Ashcroft,
2013)

THE SEVEN RIGHTS OF MEDICINE ADMINISTRATION:
The rights are:
1. right medication
2. right dose
3. right client
4. right route
5. right time and frequency
6. right documentation
7. right reason (Canadian Patient Safety Institute, 2018).

RESOURCES FOR FUTURE LEARNING:
• The resources are provided by the Canadian patient safety institute
• The institute for safe medication practise Canada also known as ISMP is also
known to provide the resources for the purpose of maintaining medication
safety.
• The CMPA provides sound understanding of medication management in
Canada (Keers et al., 2014).

REFERENCES
Canadian Patient Safety Institute. (2018). Retrieved from
http://www.patientsafetyinstitute.ca
Keers, R. N., Williams, S. D., Cooke, J., & Ashcroft, D. M. (2013). Causes of
medication administration errors in hospitals: a systematic review of
quantitative and qualitative evidence. Drug safety, 36(11), 1045-1067.
Keers, R. N., Williams, S. D., Cooke, J., Walsh, T., & Ashcroft, D. M. (2014).
Impact of interventions designed to reduce medication administration errors in
hospitals: a systematic review. Drug safety, 37(5), 317-332.
Kushniruk, A. W., Bates, D. W., Bainbridge, M., Househ, M. S., & Borycki, E. M.
(2013). National efforts to improve health information system safety in Canada,
the United States of America and England. International journal of medical
informatics, 82(5), e149-e160.
Institute for Safe Medication Practices Canada. (2018). Retrieved from
http://www.ismp-canada.org