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Medication Error: The Error Administration of Phytonadione
Nhu L. Vicente
El Camino College

Medication Error: The Error Administration of Phytonadione
Medication error is a problematic event in all healthcare facility. Many scholars have conducted researches to rule out the cause of, and find the solution for, medication error. In their study of neonatal medication error, Sauberan, Dean, Fiedelak, and Abraham (2010) found that the major reason of medication error in their neonatal intensive care units is the mixing up between “look-alike” adult and neonatal strengths (p. 49). In their first case study, the adult strength of Phytonadione (also known as vitamin K1) is incorrectly administered into the neonate at three hours of life. Although the infant is finally discharged in good condition, the mistake is a hard lesson for all healthcare workers. Let’s take a closer look at how the error had happened.
Phytonadione, an antidote of Coumadin, is frequently used in the prevention of blood thinning in the newborn. The common brand name in the United States includes AquaMephyton and Mephyton. According to Schull’s drug handbook (2006), Phytonadione acts on the liver to promote the production of active prothrombin, proconvertin, plasma thromboplastin component, and Stuart factor. In other words, it promotes blood clotting. The safe dose for neonate is 0.5 to 1 mg injected intramuscularly within one hour of birth. Adverse reactions include: hyperbilirubinemia, pain, swelling, tenderness at injection site, and anaphylactoid reactions. Because neonates in the first few hours of life usually don’t have adequate vitamin K in their blood stream, physician often prescribes Phytonadione to prevent hemorrhaging of the newborn.
However, the patient in the case study was given too much vitamin K. This medication error puts the patient at risk of hemolytic anemia and hyperbilirubinemia (Sauberan et al., 2010). The error involves a chain of healthcare personnel from the...

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