In response to a VIM report
24-04-2023 -by general practitioner Maaike Blok and triage nurse Yvonne Janssen from the VIM committee
Recently, on a Sunday morning, a patient came to the HAP with complaints of small amounts of urination, a lot of urgency and pain when urinating. The patient was 33 weeks pregnant. The urine was sticked and she was found to have a urinary tract infection. A course of Nitrofurantoin was prescribed as a treatment.
In the second observation message, almost 2 hours after the first, it was mentioned “cure converted to Monuril”. The reason for this observation is unknown. It is not possible to find out why and by whom the medication was converted to Monuril. Patient is not known to have an allergy. Nothing is said about the pregnancy in this contact, it is unknown whether this information was included in the conversion of the medicine.
In the evening, the patient calls: she wants to take the Monuril and reads that this is not allowed for a pregnant woman.
The Monuril is converted to Nitrofurantoin (3rdobservation message).
In this case, both the assistant, the doctor who signed the contract and the pharmacy did not notice that the patient was not allowed to take Monuril because of her pregnancy.
In this case, we would like to draw attention to the importance of checking whether a medicine can be given with every prescription that is written and to note why a certain policy is chosen. In the 1st contact, it could be explicitly noted that Nitrofurantoin has been prescribed in connection with the pregnancy. In the second contact, it should be noted that in consultation with the directing physician <name> with reason <substantiation> it was decided to convert <name of drug 1> to another drug < name drug 2>.