Nursing is an incredibly demanding yet rewarding profession. Nurses work long hours caring for sick and injured patients, often under stressful conditions. While most nurses strive to provide excellent care, mistakes inevitably happen from time to time. However, by being aware of some of the most common nursing errors, steps can be taken to prevent them.
1. Medication Errors
Medication errors are one of the most prevalent mistakes made by nurses. A medication error occurs when there is a failure in the treatment process that leads to, or has the potential to lead to, patient harm. Common medication errors include:
- Administering the wrong medication
- Administering the incorrect dose of a medication
- Failing to check for allergies
- Giving a medication at the wrong time
There are many reasons medication errors occur, including heavy nurse workloads, distractions, lack of drug knowledge, and poor communication. Nurses should always follow the 6 rights of medication administration to avoid errors:
The 6 Rights:
- Right patient
- Right medication
- Right dose
- Right route
- Right time
- Right documentation
Additionally, nurses should always use two patient identifiers, carefully read medication labels, have medications double checked by another nurse when possible, and document administration properly.
2. Poor Documentation
Proper documentation is a critical component of nursing practice. Unfortunately, documentation errors are very common due to factors like a high nursing workload and staff shortages. Examples of documentation mistakes include:
- Failing to document critical details about a patient’s condition
- Documenting care that wasn’t actually provided
- Recording vital signs incorrectly
- Forgetting to sign a document
Inadequate documentation can compromise patient safety, lead to poor handoffs between nurses, and open nurses to liability. To avoid documentation errors, nurses should:
- Document care accurately and completely
- Record objective information without personal opinions added
- Use a co-signature when needed
- Document in real-time instead of waiting
- Review documents for completion before signing
3. Failure to Practice Standard Precautions
All nurses should consistently practice standard precautions, including hand hygiene, to prevent healthcare-associated infections. However, sometimes nurses become complacent about infection control. Common mistakes include:
- Neglecting proper hand washing
- Not using personal protective equipment properly
- Improperly cleaning/disinfecting patient care equipment
- Failing to isolate infectious patients
To improve infection control, nurses must wash hands before and after every patient contact, wear PPE when indicated, correctly clean equipment between patients, and isolate patients with transmissible infections appropriately.
4. Improper Use of Patient Restraints
While restraints should be avoided whenever possible, they are sometimes necessary for patient safety. Errors nurses make with restraints include:
- Applying restraints too tightly
- Failing to monitor restrained patients
- Forgetting to remove restraints after the ordered timeframe
- Using restraints without an order from a provider
Nurses have an ethical and legal duty to use restraints only when absolutely necessary and to ensure patients’ dignity and rights are protected. Proper restraint protocol must be followed every time.
5. Poor Patient Handoffs
Shift changes increase the risk of miscommunication that could impact patient care. Common handoff mistakes include:
- Rushing through the report without confirming the oncoming nurse understands
- Omitting critical details about patients’ needs/status
- Failing to clarify any unclear or questionable orders
- Not allowing time for questions
Complete, clear handoffs are vital for positive patient outcomes. Nurses should use structured tools like SBAR (Situation, Background, Assessment, Recommendation), allow enough time without distractions, limit interruptions, verify understanding, and address questions.
6. Failure to Speak Up About Safety Issues
Speaking up immediately about anything that could impact patient safety is crucial. However, some common reasons nurses fail to speak up are:
- Fear of appearing incompetent
- Worrying about negative reactions from colleagues
- Lack of confidence
- Feeling it’s not their place to speak up
Nurses must speak up right away about concerns like unclear orders, medication issues, inadequate staffing, equipment problems, and anything else that seems unsafe. Patient well-being should always come first.
7. Poor Self-Care
Many nurses struggle with poor self-care, leading to issues like exhaustion, illness, and burnout. Common self-care mistakes include:
- Skipping meals and breaks
- Not getting enough sleep
- Avoiding vacations
- Ignoring early signs of illness
- Neglecting stress management
Nurses cannot safely care for patients if they aren’t caring for themselves first. Prioritizing healthy nutrition, adequate rest, relaxation techniques, and paying attention to emerging health problems are essential.
While all nurses strive for error-free practice, mistakes do happen. By being mindful of some of the most prevalent nursing errors like medication mistakes, poor documentation, and failing to speak up about safety issues, steps can be taken to improve practice.
Most importantly, nurses should make self-care a priority, as it’s impossible to provide exceptional care when nurses themselves are running on empty. Awareness, education, and proactive solutions will help nurses avoid common pitfalls in 2024 and beyond.
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