During a 24-hour chart revlew of a client in acute renal failure, the nurse notices that a prescription, written 12 hours ago for every 6 hours serum potassium levels, was not transcribed by the previous shift. Which is the best immediate action for the nurse to take?

During a 24-hour chart revlew of a client in acute renal failure, the nurse notices that a prescription, written 12 hours ago for every 6 hours serum potassium levels, was not transcribed by the previous shift. Which is the best immediate action for the nurse to take?

• A. Order the lab work as prescribed and follow procedures for completing an incident report.
• B. Telephone the nurse responsible for the error at home to report the omission of the transcription.
• C. Call the healthcare provider and ask if the prescription is still needed since 12 hours have elapsed since it was written.
• D. Notify the nursing supervisor of the previous shift's omission in not transcribing the prescription.

Answer: (A)

The key idea is ensuring patient safety by acting on existing orders and reporting system issues. For a patient with acute renal failure, potassium monitoring is critical because shifts in potassium can be dangerous. If a prescription for potassium level checks every six hours was written but not transcribed, the immediate step is to carry out the lab work as prescribed to prevent missing timely monitoring and to respond to results promptly. At the same time, follow your facility’s procedures to document the transcription error so the incident is recorded and can be reviewed to prevent recurrence. Delaying the labs while checking with the previous nurse or the physician delays essential monitoring, and simply notifying a supervisor without ensuring the immediate patient task is completed does not address the safety need.

The key idea is ensuring patient safety by acting on existing orders and reporting system issues. For a patient with acute renal failure, potassium monitoring is critical because shifts in potassium can be dangerous. If a prescription for potassium level checks every six hours was written but not transcribed, the immediate step is to carry out the lab work as prescribed to prevent missing timely monitoring and to respond to results promptly. At the same time, follow your facility’s procedures to document the transcription error so the incident is recorded and can be reviewed to prevent recurrence. Delaying the labs while checking with the previous nurse or the physician delays essential monitoring, and simply notifying a supervisor without ensuring the immediate patient task is completed does not address the safety need.