Question

You are a second year foundation doctor (F2 or FY2) working in general practice. At the baby clinic the nurse gives you a syringe with fluid already drawn up, an immunization (MMR), to give to a baby. After the parent and child have gone home you realise that the syringe contained only the diluent; the ampoule of active powder is intact.

Rank in order the following actions in response to this situation

(1= Most appropriate; 5= Least appropriate).

A. Contact the parent immediately and explain what has happened.

B. Inform the practice manager of the nurse’s mistake.

C. Fill in a critical incident form.

D. Send a further appointment for the baby.

E. Take no action.

Answer

A is the best answer. The parents should be informed of the mistake immediately so that they are aware the baby has not received the immunisation and can make appropriate arrangements. D is the next best answer. The need to repeat the immunisation is addressed, however this does not share with the parents what has happened or the reason for the appointment and so is not such a good answer. It is good to fill in a critical incident form so that the causes of the error are investigated but this does not address the need to repeat the immunisation so C is next best answer. B is not a good response because it does not address the baby’s need and it would be better to discuss the error directly with the nurse to find out what had happened. E is not a good response because you are the only person who knows the baby has not received the immunization and if you take no action this will not be redressed.

PLEASE NOTE: This is an example of how the question might be marked. The scoring framework will be piloted as part of the SJT development to explore the best way of scoring candidates in a granular way.