Escala, Stephanie Joy A.

4 - NB
Learning Experience 8.10
As nurses, one of our goals is to minimize/avoid medication error. This is to
emphasize the safety of our patients. According to Knapp and Roberts (2013), 1.3
million people are injured and approximately 7,000 people die from medication errors
each year in the U.S. It is estimated that as many as one in five doses of medication
given in a hospital is in some way incorrect. This just implies that medication error
happens more often than we realized.
Base from the scenario, the nurses have developed work-arounds on the new
system. Instead if reducing the risk for medication, they are increasing it instead.
Medication error is a very important matter for us, health providers, since it threaten the
lives of the patients. So in order to foster refreezing on the new system, I recommend to
use the Power-Coercive method. First, the new system should be reviewed first and
make sure that it does not have many flaws. It is just useless if the new system have
many flaws. Second, the nurses should have intensive training on how to use the new
system, BCMA and its importance. If the nurses are knowledgeable on the new system,
they will be able to utilize it correctly and will realize that the new system really does
minimize medication error. Lastly, rules should be implemented so that the nurses will
follow the new system. If a nurse commit a medication error while using BCMA, she will
have to write an incident report. The hospital management will then investigate if the
nurse did not know how to operate the system or if she purposely did not follow the
steps on how to use the system. The management will then deliberate if she will be
retrained or will be removed from the hospital.
Learning Experience 9.2
_7_ Check medication cards/sheets against the patient medication record.
Rationale: 7:40 8:00 AM. This should be done before 8 AM since some of the
medications are to be administered at 8 AM. It will also take some time since
nurses will have to be meticulous in doing this to minimize medication error.
_1_ Listen to night shift report 11:00 pm to 7:00 am.
Rationale: 6:45 AM - 7:00. It is a must to listen to the endorsements from the
previous shift before starting. This is necessary so that you will know the
improvements, possible schedule of procedures per patient, and other important
matter.
_4_ Take brief walking rounds to assess the night shift report and to introduce yourself
to patients.
Rationale: 7:10 7:20. This should be done at the start of the shift so that you
can assess if the night shifts endorsement coincide. It also important to introduce
 yourself at the start of duty so that you can build rapport with the patients. This
facilitates cooperation.
_10_ Hang four 9:00 am IV medications.
Rationale: 8:45 9:00 AM. You still have to check the medication cards and
observe the 10 rights of medication administration. This might take time so it
should be done before 9 AM.
_3_ Set up the schedule for breaks and lunch among your team members.
Rationale: 7:00 -7:10 AM. The leader will do this while assigning roles to each
members. The leader should quickly assess the schedule of each member. This
way, you will not have another meeting in the of the shift.
_9_ Give 8:45 am preop on patient going to surgery at 9:00 am.
Rationale: 8:15 8:45 AM. You have to implement health teachings before a
surgery since it is more effective that way than doing health teachings post-op.
_8_ Pass 8:30 am breakfast trays.
Rationale: 8:00 - 8:15 AM. This is done earlier since you have a vacant time and
you still need to do health teachings before a 9:00 AM surgery.
_2_ Meet with team members to plan the schedule for the day and to clarify roles.
Rationale: 7:00 - 7:10 AM. Assigning the roles of each member should be done at
the start of the shift so that they will know their roles for the day. In this way, they
can raise their concerns early and will then be clarified.
_6_ Read charts of patients who are new to you.
Rationale: 7:30 AM 7:40. This is done after insulin administration since its
schedule is 7:30 AM.
_5_ Check 6:00 am blood glucose laboratory results for 7:30 am insulin.
Rationale: 7:20 7:30 AM. This should be done before administering insulin so
that you can calculate the dosage and relay to the AP any problems that can
affect the patient.
Learning Experience 9.6
Time Task Rationale
8:00 AM - Break: - Assign breaks to the other
Clerical Worker (11:00 12:00 member since you know that you
AM) have a meeting.
Receptionist (12:00 1:00 PM) - Since theres still no patients,
You (12:00 1:00 PM) you can start doing you
- Finish Reports paperwork.

8:30 AM - Supervisor Annes Request - Ask her if when will she need it.
 Then plan on when you will start
on working on it.
9:00 AM - Pregnant Daughter and Drop-Ins - Prioritize on who is more
important to assist. In this case, it
is the client with a pregnant
daughter. Refer the drop-ins to
the receptionist for the
paperwork.
9:30 AM - Phone Call - Refer to the receptionist
- Dental Clinic - Refer to the Clerical Worker
10:00 AM - Confused Client - Ask the client to set another
appointment since you still have
to gather information about his
bills.
10:45 AM - Families with Food Vouchers - Refer them to the receptionist
for the paperwork. After talking
and assisting them, investigate
on what is the reason that they
were delayed.
11:00 AM - Drug Call - Refer the patient to a drug clinic
and a psychiatrist since you dont
have enough information.