Incident Log
Date of incident: 09/01/2018
Error type: dispensing error
Patient age: 9
Patient sex: female
Brief summary of incident: The dose of Trimethoprim suspension SF 50mg/5ml was written as "5ml QDS". I failed to realize the mistake as it is an inappropriate dose for UTI. The correct dose was supposed to be 4mg/kg twice daily ( max per dose 200mg).
Name of medication: ;
Level of harm that could have occurred: 5
The reason you think the potential harm is at the level you have chosen:
It is an overdose as it should have been given twice daily instead of four times a day
Possible cause/contributory factors: Nerves or just not reading the directions properly
Reasons why incident occurred and actions required to prevent reoccurence:
Ensure to read the everything fully. I will take my time to understand and try not to overthink.
Best description of this error/near miss:
wrong dose strength
wrong frequency
Error type: dispensing error
Patient age: 9
Patient sex: female
Brief summary of incident: The dose of Trimethoprim suspension SF 50mg/5ml was written as "5ml QDS". I failed to realize the mistake as it is an inappropriate dose for UTI. The correct dose was supposed to be 4mg/kg twice daily ( max per dose 200mg).
Name of medication: ;
Level of harm that could have occurred: 5
The reason you think the potential harm is at the level you have chosen:
It is an overdose as it should have been given twice daily instead of four times a day
Possible cause/contributory factors: Nerves or just not reading the directions properly
Reasons why incident occurred and actions required to prevent reoccurence:
Ensure to read the everything fully. I will take my time to understand and try not to overthink.
Best description of this error/near miss:
wrong dose strength
wrong frequency