A nurse is conducting a root cause analysis of a medication error that occurred in their unit. Which of the following steps should the nurse take first?
Identify all the factors that contributed to the error
Implement corrective actions to prevent the recurrence of the error
Communicate the findings and recommendations to the staff and stakeholders
Gather information and evidence about the error
The Correct Answer is D
The first step in a root cause analysis is to collect data and facts about what happened, when, where, how, and why. This includes interviewing the staff involved, reviewing medical records, policies, procedures, and protocols, and examining equipment and environmental factors. Gathering information and evidence helps to establish a timeline and a causal chain of events that led to the error.
Incorrect choices:
a) Identify all the factors that contributed to the error: This is a later step in a root cause analysis, after gathering information and evidence. Identifying contributing factors helps to determine the underlying causes and system failures that allowed the error to occur.
b) Implement corrective actions to prevent recurrence of the error: This is another later step in a root cause analysis, after identifying contributing factors. Implementing corrective actions involves developing and testing solutions that address the root causes and improve patient safety.
c) Communicate the findings and recommendations to the staff and stakeholders: This is the final step in a root cause analysis, after implementing corrective actions. Communicating the findings and recommendations involves sharing lessons learned, best practices, and feedback with those who are affected by or involved in preventing similar errors.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
This statement reflects a lack of understanding of the potential consequences of medication errors. Even minor errors can lead to adverse events, complications, or increased length of stay. The client should be aware of the risks and benefits of their medication and report any errors or concerns to the nurse.
Incorrect choices:
a) "I should tell the nurse if I notice any unusual symptoms after taking my medication.": This statement shows that the client understands the importance of monitoring for adverse reactions and communicating with the nurse.
b) "I should check the label of the medication before I take it to make sure it is mine.": This statement shows that the client is taking an active role in preventing medication errors by verifying their identity and medication.
d) "I should ask questions if I am not sure about the purpose or side effects of a medication.": This statement shows that the client is seeking information and clarification about their medication, which can enhance their safety and adherence.
Correct Answer is C
Explanation
This statement shows that the client does not understand the potential consequences of medication errors, even if they seem minor. Minor errors can lead to serious adverse events, such as allergic reactions, drug interactions, or overdoses. The client should be informed that all medication errors should be reported and documented to prevent further harm and improve patient safety.
Incorrect choices:
a) I should tell you if I notice any unusual symptoms after taking my medication: This statement shows that the client understands the importance of monitoring for adverse reactions and communicating with the nurse.
b) I should check the label of the medication before I take it: This statement shows that the client is aware of their role in preventing medication errors by verifying the name, dose, and route of the medication.
d) I should ask questions if I am not sure about the purpose or side effects of the medication: This statement shows that the client is willing to seek clarification and education about their medication regimen.
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