Running head: ALLERGY DETECTION AND MEDICATION ERRORS 1

Adverse Reactions: Allergy Detection and Medication Errors

Shannon OShea
University of South Florida, College of Nursing

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Adverse Reactions: Allergy Detection and Medication Errors

As a clinical nurse one of your main duties is providing your patients with the proper
medications. Unfortunately, over 770,000 people are effected by adverse effects per year due to
medication errors (Koppeletal.,2005). Although the process of medicine distribution is a joint
effort between nurses, doctors and the pharmacy, it usually falls on the nurses to prevent errors
from occurring. The nurses role in providing medication correctly should include preparing
medications, administering, monitoring effectiveness of medicines and assessing for adverse
effects (OShea,1999). However, before any of these actions can be taken the nurse should first
be checking the patients orders and reviewing the six rights.

Identifying Allergy Medication Errors

In my opinion one of the most important things a nurse should review before
administering medication to a patient is the individuals allergies. Without this simple, but
crucial step, a nurse may send a patient into anaphylactic shock and maybe even death. There
are several ways a nurse can encounter medication errors with allergies. Errors can occur if a
nurse ignores allergy notices by scrolling through screens too quickly or exiting out of screens
too quickly. Another way errors can occur is when nurses rely on pharmacy to check the drug
and patients background for possible reactions (Koppeletal.,2005). This in my opinion is
laziness on the nurses part and is a simple step that they are excluding from the nursing process.
Lastly, I believe false allergy information can play a large role in medication errors. When
assessing your patient, you need to verify their allergies to make sure what they are saying is
correct, and matches their chart. Although these are examples of preventable medication errors,

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some errors with allergies cannot be avoided. Many patients are not aware of their allergies
before they have their first major reaction. This is why post medication administration
assessments of patients is so vital to catch errors quickly.

Interventions to Decrease Allergy Medication Errors

The most effective way to reduce allergy medication errors is to personally verify with
your patient what their allergies are, and what happens when they interact with the allergen.
Even though it seems basic, it is important to go through each group of allergies with your
patient, including asking about drug, environmental, food, latex and tape allergies. This can be
important because odd reactions may occur; such as iodine can aggravate someone if they have
an allergy to shellfish. It is also imperative that the nurse closely pay attention to the drugs being
prescribed to their patient, and double check that the prescribed medications do not contain
irritating allergens for the patient. Luckily for nurses in the last several years new computer
programs have been put in place to assist with identifying patient allergies (Bates, 2000). These
centralized computer systems also helped by retaining the allergy information for patients from
admission to admission, and from inpatient to outpatient (Bates, 2000). All in all, I believe the
biggest prevention method of allergy medication errors is to know your patient.

Medication Administration Fears

Although allergy medication errors are frightening, they are not my biggest fear for
medication administration. Currently, I think the error I am concerned about making is giving
the wrong dose of medication. I personally have seen a nurse make this mistake, and even
though the patient did not have an adverse effect, the outcome could have been life threatening. I

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watched the nurse set up the IV and hang a new bag of Cardizem for a patient who was
experiencing A.Fib RVR, and as she was programming the pump I could tell she was distracted.
The order was for the patient to receive a continuous infusion, however about thirty minutes later
we realized the nurse had accidently set the pump to bolus the entire medication into the patient.
Although this patient was not negatively effected, the nurse was a wreck. I think this experience
showed me how easy it is to make medication errors when you are distracted. This situation
constantly drives me, and will always remind me to pay close attention to every medication I
give.

Conclusion
Drug therapy can not be effective to patients if it is not performed correctly. In a study on
medication errors, it was found that approximately forty-four percent of errors occur during drug
administration. Results also show that medication errors are happening frequently, at a rate of
nearly one of every five doses given (Barker,Flynn,Pepper,Bates&Mikeal,2002). I believe
that if nurses used the interventions put in place to help them, and truly focused on their role
while at work this statistic could be greatly reduced.

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References
Barker, K., Flynn, E., Pepper, G., Bates, D., & Mikeal, R. (2002). Medication Errors Observed in
36 Health Care Facilities. Archives of Internal Medicine, 162(16), 1897-1897.
doi:10.1001/archinte.162.16.1897
Bates, D. (2000). Using information technology to reduce rates of medication errors in
hospitals. The British Medical Journal, 320(7237), 788-791.
Koppel, R., Metlay, J., Cohen, A., Abaluck, B., Localio, R., Kimmel, S., & Strom, B. (2005).
Role of Computerized Physician Order Entry Systems in Facilitating Medication
Errors. The Journal of the American Medical Association, 293(10), 1197-1197.
doi:10.1001/jama.293.10.1197
O'Shea, E. (1999). Factors contributing to medication errors: A literature review. Journal of
Clinical Nursing, 8, 496-504.