While conducting a chart audit, you find a number of patients with errors in their charts. What do you do?

"I would finish my audit and set all charts with errors to the side. After I completed the audit, I would look for patterns in the charts. For example, did the errors occur on the same shift or by the same person? It could be an opportunity to provide re-education and training if it's the same person making the mistake. I would also look at the severity of the errors. If it was the incorrect acronym over and over, that might not be as big of a deal as failing to document when pain medication was administered to a patient. Once I determined the staff involved in the errors, I would address them immediately. I would loop in my manager as well, so we could document it and also discuss with them the need to report the errors to proper authorities or to conduct disciplinary action with the employee."

"My course of action would depend on the severity of the situation. If a nurse were documenting giving a medication but writing the wrong medication name in the log each time, I would meet with the nurse immediately to review the medication prescribed and compare it to what was given and logged. Medication errors are serious and require special reporting to the director of nursing and sometimes the state. If the error was about a typo or a note in the patient file, that is not as serious but would still need to be addressed. I never sweep errors under the rug. I pride myself on integrity and would work to resolve the problem with whatever steps were necessary to prevent it from happening again."