How ER Nurses Can Prevent Medical Errors
By M. Nell Quest, Ph.D., Contributor
Emergency departments are notorious for medical errors causing adverse events. Whether medical errors in nursing or mistakes by other staff, missing something is a terrifying part of ER nurse life. Preventing medical errors should be at the top of your list of responsibilities. One study found nurses to be responsible for up to 40 percent of these events.
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4 Ways Medical Errors in Nursing Can Be Prevented
Medical errors in the ER are unfortunate, but they make sense. EDs are stressful work environments. Staff with varied levels of training, knowledge, and familiarity must work together—at lightning speed, with patients’ lives at stake, on limited rest and long shifts. They have to make decisions with limited to no patient history, incomplete documentation and medication lists, and limited support.
The patient load is unpredictable, which also increases medical errors. ERs often become first-line treatment options handling all kinds of medicine rather than true emergencies. Triage staff are stuck trying to sort a larger variety of possibilities, and understaffing is frequent, making medical errors in nursing more likely.
So as an emergency room nurse, how can you prioritize preventing medical errors?
1. Learn your department’s teamwork procedures. Recent studies show that one of the most important methods for preventing medical errors in emergency rooms is teamwork. Many ERs have formalized teamwork procedures, including interdisciplinary training, so staff know each team members’ role as well as shared terminology to use.
Knowing your department’s teamwork culture is critical. Whether they are formal or not, these practices will help you ensure you know colleagues’ expectations, and help everyone keep a cool head in critical situations.
2. Ask questions. Many medical errors in nursing occur out of fear to take a pause to clarify something. Even if it makes you uncomfortable or wary of your skills being judged, if you encounter a situation you don’t understand, it is your responsibility to ask about it.
If working on a critical patient, ask immediately. Never take on a task you do not know how to do, and if you must, ask to be talked through it.
Take the moments of calm you can to review cases with other members of the ER team. Reviewing a case afterwards with another nurse or the provider can help you learn, which will increase your skills while also preventing medical errors.
3. Speak up. Although nurses aren’t in charge of how emergency rooms are run, don’t forget you’re highly trained and working under your own license. Be patient and sympathetic for your tired coworkers, but if someone is doing something that doesn’t make sense for one of your patients, by all means check in, collegially.
Preventing medical errors in nursing can mean asking a doctor, “Are you sure you want this high dose of insulin for bed 14? She’s here for a broken foot.” The outcome, however terrifying, is infinitely better than administering insulin intended for somebody else.
4. Document thoroughly. It’s easy to get behind on charting in a busy ER, but preventing medical errors means prioritizing thorough documentation ASAP. Remember that other team members are relying on you, too, and if a medical error happens because of inadequate documentation, someone might lose a loved one.
Take Responsibility for Medical Errors in Nursing
Preventing medical errors in nursing in the emergency department also takes the courage to admit when you’ve made a mistake. Speaking up as soon as you realize something is wrong can be the critical difference between life and death.
Ask yourself: would it be worse to say something immediately or be asked about what happened in an incident review two days later? The answer seems obvious.