Eagle Eye Jaime Puchalski, CRNA, Corrects Medication Dosage Error

Jaime Puchalski, CRNA at Beaumont, Grosse Pointe believes nurses have the ultimate responsibility to advocate for patients to keep them safe. Working at Beaumont since 1999, Jaime has been assisting patients in the operating room for the past eight years.

As a Certified Registered Nurse Anesthetist, Jaime is an advanced practice nurse who specializes in anesthesia training. “CRNA’s have a heavy responsibility in the operative setting,” she said. “They’re tasked to safely administer more than 49 million anesthetics to patients each year in the U.S. in a variety of settings and collaborate with the entire health care team to keep patients safe during the operative period.”

CRNAs work in every setting where anesthesia is administered, such as the Operating Room, Endoscopy, Interventional Radiology, Obstetrics, MRI and CT Scan. On average, a CRNA can take care of three to four patients in an 8-hour shift.

One day during her shift, Jaime was about to start a Remifentanil infusion on a patient undergoing back surgery. Remifentanil is an ultra-short acting narcotic pain medication that is stronger than morphine by 100-200 times. “When programming the pump, I realized the pump was programmed to run this medication at 1,000 times the correct dose,” she said.

After discovering the error, she immediately notified the pharmacist and an investigation was conducted. An update was found, and it was sent to all Alaris pumps with the incorrect dosing units. “I had no hesitation to speak up,” Jaime said. “If this medication was given, it could have resulted in a very poor outcome for the patient.”

Jaime encourages others to speak up.

“I truly believe in teamwork and communication as being a priority for a culture of safety within the health care system,” she said. “This culture of safety is what patients deserve and expect from all of us in health care.”