An 82-year-old man with advanced Alzheimer's disease is taken to the hospital by his daughter, who serves as his power of attorney and carer. Her father, she claims, is becoming increasingly disoriented and verbally hostile. He gets brought to the hospital after being diagnosed with a urinary tract infection. Intravenous antibiotics are started, and he seems less disoriented and agitated, but he is unable to recall nursing instructions and is mostly silent during the day. The antibiotic order expires three days into his treatment and is overlooked by the doctor, nurses, and pharmacy personnel. The patient is not given medicine for two days before the problem is discovered and fixed. This error has no consequences other than extending his hospital stay by 2 days Which of the following is the most appropriate course of action?

Question

Quizplus · Accepted Answer

Eductional Objective: Medication mistakes contribute significantly to patient morbidity and death, particularly in the hospital environment. These mistakes can be caused by health care providers (e.g., errors in inputting medicine, failure to renew prescription), drug-related variables (e.g., similar names, restricted therapeutic window), and patient-related factors (eg, poor renal function, polypharmacy). Checklists and medication reconciliation are examples of quality improvement strategies that aim to reduce these avoidable mistakes. 
It is sometimes difficult for physicians to reveal drug mistakes, especially when no major harm has happened to the patient. Fear of lawsuit or a loss of patient trust and confidence may be reasons for this hesitancy. Full disclosure of medical mistakes, on the other hand, should occur as soon as possible and has been linked to a neutral-to-positive influence on patient reaction and the physician-patient relationship. When an error is discovered, it should be disclosed in person and in a timely manner, along with an apology for what happened. Because this patient's changed mental condition and severe dementia prohibit him from understanding what happened, it would be more acceptable for the physician to inform his daughter about the error.

An 82-Year-Old Man with Advanced Alzheimer's Disease Is Taken to the Hospital