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A woman with a medical history of epilepsy was hospitalised and commenced on IV fluids for gastrointestinal complications. A jejunostomy was performed to facilitate feeding and administration of oral medications including oral liquid phenytoin. Complications developed and the patient was commenced on total parenteral nutrition. Her orders were changed to IV orders. About two weeks later a nurse who had previously administered oral medications to the patient prepared two IV medications and had these checked. The nurse then obtained the oral phenytoin liquid, measured 5mL into a cup and then drew it into a syringe. She administered the medications to the patient including the oral phenytoin liquid via central venous catheter (CVC). The patient complained of pain at the injection site and commenced dry retching before losing consciousness. Staff commenced resuscitation but the woman could not be revived.What you think might be contributing factors to error? Preventions for error?
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