On your first day as an intern, a patient receives a bag of water instead of saline overnight. How would you deal with it?

On your first day as an intern, a patient receives a bag of water instead of saline overnight. How would you deal with it?

• A. Open disclosure: explaining to patient what has happened and what we doing to rectify it
• B. Ensuring patient stability - DRSABCD, continue monitoring for side effects
• C. Document it has happened, alerting team/nurses it has happened
• D. Make sure patient gets saline if they need it

Answer: (A)

Open disclosure after an adverse event is essential because it centers the patient’s right to know what happened and maintains trust in care. When a mistake occurs, acknowledging it, apologizing, and clearly explaining what happened and what will be done to correct it shows transparency and respect for the patient and family. It also lays out the immediate steps to protect the patient and the plan to prevent recurrence, which is critical for safety. In this situation, starting with open disclosure means you would calmly tell the patient (and family if appropriate) that a bag intended to be saline was not used, describe what happened, acknowledge the potential risks, and outline the concrete actions being taken to rectify the situation and monitor for any complications, along with how you will follow up. After the disclosure, you would ensure the patient’s safety is addressed—check stability, monitor for adverse effects, and implement measures to prevent a repeat error. Documentation and notifying the team are important parts of the overall response as well, but they support the disclosure and safety plan rather than replacing them. Choosing to focus first on open disclosure reflects the ethical obligation to be honest and proactive in communicating about patient safety, which helps protect the patient, supports trust, and aligns with standard practice in handling clinical errors.

Open disclosure after an adverse event is essential because it centers the patient’s right to know what happened and maintains trust in care. When a mistake occurs, acknowledging it, apologizing, and clearly explaining what happened and what will be done to correct it shows transparency and respect for the patient and family. It also lays out the immediate steps to protect the patient and the plan to prevent recurrence, which is critical for safety.

In this situation, starting with open disclosure means you would calmly tell the patient (and family if appropriate) that a bag intended to be saline was not used, describe what happened, acknowledge the potential risks, and outline the concrete actions being taken to rectify the situation and monitor for any complications, along with how you will follow up. After the disclosure, you would ensure the patient’s safety is addressed—check stability, monitor for adverse effects, and implement measures to prevent a repeat error. Documentation and notifying the team are important parts of the overall response as well, but they support the disclosure and safety plan rather than replacing them.

Choosing to focus first on open disclosure reflects the ethical obligation to be honest and proactive in communicating about patient safety, which helps protect the patient, supports trust, and aligns with standard practice in handling clinical errors.