On a ward, you notice the intern charting the wrong amount of insulin; the patient develops a hypoglycaemic episode. What is your priority action?

On a ward, you notice the intern charting the wrong amount of insulin; the patient develops a hypoglycaemic episode. What is your priority action?

• A. Rectify the insulin regimen, discuss with senior medical staff regarding ensuring appropriate ongoing treatment and insulin regime
• B. Open disclosure: discuss with patient what has happened
• C. Discuss with patient what happened
• D. Emphasise doubling check dosing

Answer: (A)

The priority is to stop the ongoing harm and put the patient on a safe plan going forward. Rectifying the insulin regimen right away and involving a senior clinician ensures the correct dose is re-established, appropriate orders are in place, and monitoring is arranged to prevent further hypoglycemia. This immediate corrective action directly reduces the risk to the patient and provides authoritative oversight for the ongoing treatment. Open disclosure and discussing with the patient are important ethical steps, but they come after the patient’s safety has been addressed. Emphasising double-checking dosing is a good safety practice, yet it doesn’t fix the current error or ensure immediate safe management.

The priority is to stop the ongoing harm and put the patient on a safe plan going forward. Rectifying the insulin regimen right away and involving a senior clinician ensures the correct dose is re-established, appropriate orders are in place, and monitoring is arranged to prevent further hypoglycemia. This immediate corrective action directly reduces the risk to the patient and provides authoritative oversight for the ongoing treatment.

Open disclosure and discussing with the patient are important ethical steps, but they come after the patient’s safety has been addressed. Emphasising double-checking dosing is a good safety practice, yet it doesn’t fix the current error or ensure immediate safe management.