A nurse is educating a client about the importance of reporting any medication errors that may occur during their hospital stay. Which of the following statements by the client indicates a need for further teaching?

This is the safest and most environmentally friendly way to dispose of expired or unused medications. It prevents accidental ingestion, misuse, abuse, or diversion of medications by others. It also reduces the risk of contamination of water sources or soil by pharmaceuticals.

Incorrect choices:

a) Dispose of the expired or unused medications in a trash can: This is not a safe way to dispose of expired or unused medications. It can expose others, such as children, pets, or scavengers, to potentially harmful substances. It can also allow medications to leach into landfills or groundwater.

c) Advise the client to keep the expired or unused medications for future use: This is not a safe way to manage expired or unused medications. It can lead to medication errors, such as taking the wrong medication, the wrong dose, or an ineffective or harmful medication. It can also encourage self medication or sharing of medications with others without medical supervision.

d) Flush the expired or unused medications down a toilet or a sink: This is not an environmentally friendly way to dispose of expired or unused medications. It can contaminate water sources or aquatic life with pharmaceuticals. It can also damage plumbing or sewage systems.

This statement shows that the nursing student understands the importance of reporting errors or near misses, which are events that could have resulted in harm but did not. Reporting errors or near misses helps to identify system failures, root causes, and contributing factors that can be addressed to prevent similar errors in the future. Reporting errors or near misses also fosters a culture of safety, transparency, and learning in healthcare organizations.

Incorrect choices:

a) I should follow my intuition when making clinical decisions: This statement shows that the nursing student does not understand how intuition can lead to cognitive biases, heuristics, or shortcuts that can impair clinical reasoning and judgment. Intuition can be influenced by emotions, assumptions, stereotypes, or previous experiences that may not be relevant or applicable to the current situation. Nursing students should use evidence-based practice, critical thinking, and clinical guidelines when making clinical decisions.

b) I should use abbreviations and acronyms to save time when documenting: This statement shows that the nursing student does not understand how abbreviations and acronyms can cause communication errors, confusion, or misinterpretation among health care providers. Abbreviations and acronyms can have multiple meanings, vary by context or setting, or be easily mistaken for other words or symbols. Nursing students should use clear, concise, and standardized terminology when documenting.

d) I should work longer shifts to reduce handoffs and transitions of care: This statement shows that the nursing student does not understand how working longer shifts can increase fatigue, stress, burnout, or distraction among health care providers. Working longer shifts can impair physical, mental, and emotional well-being, as well as performance, attention, memory, and decision-making skills. Nursing students should work reasonable hours, take breaks, and ensure adequate rest and sleep. They should also use effective handoff techniques, such as SBAR (Situation-Background-Assessment-Recommendation).