Making Mistakes and Incident Forms

You are an FY2 doctor on your 4-month cardiology rotation. You are coming to the end of a long day shift on the ward. One of your patients, Taz, is a diabetic suffering from heart failure. As listed on the drug chart, you give Taz his evening dose of insulin, but you forget to record this on the drug chart. You hand over to the night team. During the night shift the patient receives another insulin dose as the night staff thought this had not been done. The following day Taz complains to you that he had a terrible night. He explains how he sweated profusely, felt dizzy and endured headaches, all of which are signs of hypoglycemia. You realize your error when you look at the drug chart. You tell your consultant, who advises that you should fill out an incident form.

• What should you tell Taz?
• Are NHS trusts under any obligations to be open and honest when mistakes are made?
• What is the purpose of an incident form?
• What happens to the form once it has been completed?

Apply Theory (Specific Professional Healthcare Competencies + Clinical Medical Ethical Principles) to Practice in order to provide Optimal Patient-Centered Care (OPCC)

Source – Ethics Case Studies from Clinical Ethics and Law (Second Edition), Carolyn Johnston Penelope Bradbury