Sources must me peer-reviewed only. Please include on my reference the attached sources.
Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins. Please access the link for ​the ebook: https://we.tl/4HwfU5Nx3i
Incident: Day shift nurse forgot to include on the report that the patient will be initiated on Tikosyn loading. Tikosyn is an antiarrhythmic medication mainly used by our cardiologist to treat Atrial Fibrillation. Patients need to stay a minimum of 3 days in the hospital when initiating this medication due to close monitoring of kidney function and heart rhythm.
There are steps that need to be done prior to giving the first dose of medication including baseline EKG, Labs to check potassium and magnesium and creatinine clearance. Patient’s potassium level needs to be greater then 4 and magnesium level needs to be greater than 2 due to the risk of Torsades when the electrolyte level is abnormal. Therefore, an electrolyte replacement is necessary prior to administration of the Tikosyn.
Giving the medication on time is critical because the medication if given exactly every 12 hours. The cardiologist wants the medication to be given at 7 pm and 7 am. Failure by the day shift nurse to handoff that critical information and lacking to complete the necessary test caused a delay in patient’s therapy and prolonged the patient’s stay in the hospital.
Patient’s satisfaction was also affected along with a very unhappy cardiologist. Patient could have possibly had a deadly arrhythmia due to the delay in administering the medication. ISHAPED was utilized by our department to prevent important information from being omitted.

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