Case Study Analysis: Registered Nurse's Role in Medication Errors

This assignment presents a case study analysis from the perspective of a Registered Nurse (RN), focusing on the responsibilities associated with medication administration and the potential for errors. The paper begins by comparing the roles and responsibilities of RNs and student nurses in medication administration, highlighting the importance of the five "rights" of medication administration: right patient, drug, dose, route, and time. It examines ward practices that may contribute to medication errors, such as overlooking drug interactions. The case study of Mrs. Mendez is used to illustrate the consequences of errors, including a discussion of the legal, ethical, and professional implications for RNs, emphasizing the importance of patient rights, safety guidelines, and standards of practice. The analysis concludes that RNs bear a greater responsibility for safe medication administration than student nurses. The case study highlights the importance of recognizing the combined effects of multiple medications and the policies, guidelines, and standards for RNs to ensure safe medication practices. The assignment underscores the implications of medication errors in legal, ethical, and professional contexts.

Running head: CASE STUDY ANALYSIS FROM THE POINT OF VIEW OF A RN
CASE STUDY ANALYSIS FROM THE POINT OF VIEW OF A RN
Name of the Student:
Name of the University:
Author note:

1CASE STUDY ANALYSIS FROM THE POINT OF VIEW OF A RN
The paper aims for discussing the provided case study involving Mrs. Melissa Mendez
with reference to the responsibilities of a registered nurse. The paper is going to start with
discussing the comparative responsibilities of a registered nurse and a student nurse while
administrating the medications including the erotic events in response to the provided case study.
Then the paper is going to focus on the identification and discussion of the ward practices that
may result in the erotic medication administration event. Lastly the guidelines, policies and the
standards that binds the registered nurses while administrating medication is going to be
discussed with the legal, ethical and professional implication in case of erotic medication
administration.
The roles of a registered nurse or RN is to administer medications to the patient while
keeping a few things in mind, which is known as the five “rights” of medication administration.
The very first of those concepts include ensuring the “right patient” is being subjected to the
medicine administration by checking their name and medical reports. The second concept is
ensuring the “right drug” is being administered, which can be checked by the generic name of
the medication. The next thing should be remembered by a registered nurse is the “right dose” of
the medication, which is being administered. This should be ensured by checking the labels for
the dose of medication and also the devices to make the proper measurement should be used. The
fourth right is known as “right route”. The RN must ensure the route of medication
administration in the patient is advised by a medical officer and that is being followed exactly.
The last “right” involves the “right time”. According to this concept, a RN must administer the
drug within the prescribed time in the patient (Kim & Bates, 2013).
The difference between a nursing student and a RN is that the former is considered to be
in a learning phase and thus is expected to make mistakes in various patient care practices.

2CASE STUDY ANALYSIS FROM THE POINT OF VIEW OF A RN
However in case of a RN, they are expected to carry out each of their responsibilities and
accountabilities without making mistakes. The responsibilities and accountabilities are same for
both the nursing student and a registered nurse. The only thing that varies between both types of
nursing professionals is the level of those responsibilities and accountabilities. Responsibilities
of a registered nurse or a nursing student in regards to the medication administration involves
ensuring the five “rights” mentioned before (Leufer & Cleary-Holdforth, 2013). The
accountability of a nursing staff involves them taking the responsibilities of their action during
patient care (Krautscheid, 2014). To explain this further, it can be said that a nurse must
understand the patient condition in depth, before starting the care procedure. Along with this the
nursing professional must take the responsibility of ensuring proper patient care and rectifying a
situation involving erotic events, with the application of proper knowledge and understanding. In
case of such an erotic event, like erotic administration of medications, a RN generally hold a
greater level of responsibility and accountability than that of a student nurse (Rebeiro et al.,
2015). The reason behind this is that in case of a mistake of overlooking or wrong assessment of
patient condition was performed by a student nurse, the RN has to take the partial responsibility
of that situation for being in a superior position of the student, even though in case of the
alternative situation, the responsibility of a mistake performed by a RN, does not fall upon a
student nurse.
The event of a medication error can be resulting from many instances, where either the
medical officer (MO) or the RN is at fault. The mistakes of the MO include prescribing a
medication administration plan that does not follow one of the five “rights” in regards to the
medication administration. The mistakes of the RN involves not ensuring that all those five
rights are being followed, while administrating a medication in the patient. If the RN fails to

3CASE STUDY ANALYSIS FROM THE POINT OF VIEW OF A RN
observe the combined effect of two or more medications in the patient and the medication error
occurs in response to that, it is also considered as a mistake from the RN’s part. When
considering the case study of Mrs. Mendez, the medication error involved the mistakes from both
the MO’s part and the RN’s part. The MO prescribed a medication to treat the urinary tract
infection (UTI) in the patient, without taking the other medications of the patient, which are
already being administered into consideration. The RN also failed to observe the risk of that
practice and thus did not start a discussion in regards to the problem with the MO. The
medication trimethoprim has been observed to show severe side effects when the administration
of methotrexate is done alongside with it. Trimethoprim is a medication, that fall under antibiotic
category and it is commonly used in cases of treating the UTI and methotrexate is an
immunological agent, which is used in cases of autoimmune diseases like rheumatoid arthritis.
Even though the exact mechanism of this increased toxicity of trimethoprim and methotrexate is
not understood properly yet, the combined effect result in the harmful effects on the renal system
along with the dermatologic and haematological system, which can lead to severe medical
complication in a patient leading to death (Al‐Quteimat & Al‐Badaineh, 2013). There are a few
ward practices that can be hold responsible for this medication error. The practice of
administering the most common medication to treat a condition in the patients without
referencing to the other medications, especially if the harmful combined effect of two medicines
is not well known, is a very common instance for the MO (Shahrokhi et al., 2013). The deeper
level research on finding out the possible combined effect of multiple medications is not much
widely practiced among the nurses, which can also be considered as a practice that was
responsible for the medication error occurred in this case study.

4CASE STUDY ANALYSIS FROM THE POINT OF VIEW OF A RN
When a medication error is identified, the first activity should be stopping the
administration of the erotic medication immediately. After that the level of damage, which was
caused by the erotic event should be judged very carefully and appropriate actions in order to
lower the level of the damage must be taken.
The policies bound the RN while administering medicines involve many aspects. The
first one of them is to take care of the patient’s rights. According to those rights, the patient is
allowed to know and understand the rationale behind the medication, he or she is being
administered. The patient have the right to reject the use of the medicine also, even if that means
inviting a risk to their own health as long as they understand the risk properly. Taking care of not
causing harm to the patients while administering medication is another policy in regards to this
topic.
The guidelines for administering a medication to patient can be described as followed. At
first, an explanation regarding the reason for the administration of a particular medicine should
be given to patient, making sure to answer all the questions of the patient in regards to that. If the
administration process is sensitive, the patient must be provided with proper level of privacy.
After that the RN should be fully concentrated, while carrying out the whole administration
process, taking care of not making any mistakes (Anf.org.au, 2020).
The standard of medication administration practice in the nursing practice can be said to
be adequate if the RN had complete knowledge on the medication along with its administration
process and have not shown any kind of negligence or recklessness during the process of
medication administration.

5CASE STUDY ANALYSIS FROM THE POINT OF VIEW OF A RN
If a medicinal error can be legally proved to be the intentional fault of a RN or other
healthcare professional, the convicted might face the punishments such as getting arrested,
having to apply for a bail in order to get out of the prison, restriction in international visiting,
cancellation of their professional licence and many others.
In cases of the harm to patient by the medication error, the healthcare ethics of non-
maleficence is violated. According this ethics a RN is not allowed to cause any harm to patient,
even if that is unintentional.
In case of medication error under the care of a particular RN, the professional life of that
individual is greatly affected, since the assumptions involve that it was the direct fault of the
nurse. As a result her professional impression to her colleagues, superiors and the patients is
affected.
Hence it can be concluded that the responsibility of a RN outweighs that of a student
nurse for the safe administration of the medication in the patients. The administration process
involve five “rights” that should always be remembered by the nurse. The ward practices of
showing negligence in finding the possible combined effect of multiple medicines before
suggesting its administration can be identified as the reason for the medication error occurred in
the case study. There are various policies, guidelines and standards for the RN, in order to ensure
safe medication in patients. The RN or other medical professionals face various implications in
regards to the law, ethics and professional level, in case of a medication error.

6CASE STUDY ANALYSIS FROM THE POINT OF VIEW OF A RN
References:
Al‐Quteimat, O. M., & Al‐Badaineh, M. A. (2013). Methotrexate and trimethoprim–
sulphamethoxazole: extremely serious and life‐threatening combination. Journal of
clinical pharmacy and therapeutics, 38(3), 203-205.
Anf.org.au (2020). [online] Anf.org.au. Available at:
http://anf.org.au/documents/reports/Management_of_Medicines_Guidelines_2013.pdf
[Accessed 3 Jan. 2020].
Kim, J., & Bates, D. W. (2013). Medication administration errors by nurses: adherence to
guidelines. Journal of Clinical Nursing, 22(3-4), 590-598.
Krautscheid, L. C. (2014). Defining professional nursing accountability: a literature
review. Journal of Professional Nursing, 30(1), 43-47.
Leufer, T., & Cleary-Holdforth, J. (2013). Let's do no harm: medication errors in nursing: part
1. Nurse Education in Practice, 13(3), 213-216.
Rebeiro, G., Edward, K. L., Chapman, R., & Evans, A. (2015). Interpersonal relationships
between registered nurses and student nurses in the clinical setting—A systematic
integrative review. Nurse education today, 35(12), 1206-1211.
Shahrokhi, A., Ebrahimpour, F., & Ghodousi, A. (2013). Factors effective on medication errors:
A nursing view. Journal of research in pharmacy practice, 2(1), 18.