Med Error Leads to Change in L&D Policy

A 30-year-old woman experiencing her first pregnancy, presented to
the Labor and Delivery unit. She was given the wrong drug and
required an emergent C-section. The “five rights” of medication
administration focuses on individual factors and not necessarily on
system flaws. Many organizations are also promoting just culture,
which encourages reporting near-misses and patient safety events,
and focuses on psychological safety and promoting a non-punitive
reporting culture.