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Lecture notes Acute Care (SHN2004)
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Legal Aspect of IV Therapy
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Legal Aspects of IV TherapyDrug Errors in IV Therapy
Introduction
This session will not focus on specific drug errors but rather some of the ley issues
that may arise when undertaking IV therapy on patients
Errors in IV Therapy
As a group consider errors in IV Therapy and how you may me be held accountable.
o Who are you accountable to if an error were to occur?
Professional Bodies
NMC/Ombudsman
Health Board
Employer – Contract Law
Patient/Family
Moral Accountability
Court of Law
Criminal and Civil
Yourself – you need to deal with the fact that you have made an error
o Why?
So there is accountability in the profession
Patients/families can get resolution from what has occurred (whether
financial or just to see that the issue has been investigated
Improvements can be made in how the nursing process is carried out
o What are the consequences of being held accountable for such errors?
Loss of job
Loss of confidence in your own ability
Judgement from others
Financial impact on the NHS
Medications errors are the 2nd most common cause of claims in the NHS (after slips,
trips and falls)
o Excluding those errors that have resulted in injury/death to that of a child
IV medications are at a higher risk due to their complexity
Estimates suggest that medication errors have contributed to 12000 deaths per
annum in the NHS
It is also estimated that errors may result in between £0.75 billion – 1.5 billion in
additional health expenditure
Legal Requirements
Law requires that:
o Medicines are prescribed, dispensed and administered to a person safely
o Medicines are given to:
, Legal Aspects of IV Therapy
The right person
At the right time
In the right form
Using the correct dose
Via the correct route
Where do the Five Rights go Wrong?
Most common errors:
o Wrong dose/strength/frequency – 29%
o Omitted medicines – 17%
o Wrong Medicine – 12%
o Wrong patient – 5%
o Wrong formulation – 2.4%
o Wrong route – 2.1%
Why might these errors occur?
o Understaffed
o Complicated calculations
o Not doublechecking
o Confusing incomplete drug chart
o Similar looking drugs (labelling)
o Distraction when giving medication
How can these errors be rectified?
The standards of dispensing and administration
These standard have been developed through the common law, or rules of law
developed from the decisions of judges in decided cases
Two key principles of common law apply to the dispensing and administration of
medicines namely the persons right to self-determination and the practitioner’s duty
to apply due care
Wayne Jowett Case
The following case shows how tragedy can strike when preparing and administering
IV drugs
Read the investigation and the report which is located on canvas – also read the
other article on canvas where research was conducted on IV and the incidences and
causes of errors made.
Medical labelling of drugs were very similar – whilst the use was on the labelling it
wasn’t particularly clear
What happened:
o In 2001 in Nottingham Dr Morton, a Senior House Officer, carried out a
lumbar puncture and administered intrathecally (IT) (i.e. via the spine) the
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