Subcutaneous heparin with a safety pause
RN OSCE practice station

The task

You are the RN in an emergency department. Mariam Saleh, aged 67, is boarding in ED with a signed prophylaxis order for heparin sodium 5000 units subcutaneously now. Check the order and safety history, calculate the volume and decide whether to proceed. Complete the supplied practice record. A second RN is available. You have eight minutes; describe and select physical actions in this online exercise. The prescriber can be reached by phone.

What this station tests

• Mariam’s reported HIT requires withholding even with normal platelets today.
• Use the Arabic interpreter to obtain a reliable technical reaction history.
• Record the unverified serious reaction as an alert with its source.
• Correct 0.5 mL arithmetic does not justify preparing or administering heparin.

Sources for the clinical content

• ACSQHC: High risk medicines and systems
• Healthdirect medicine information: heparin (InterPharma)
• TIS National: qualified interpreting services
• ACSQHC: Communicating for Safety Standard
• ACSQHC: Medication Safety Standard

An original practice scenario with invented patients. Not an exam question.

Practise next

• Oral paracetamol with an uncertain dose history
• Mealtime subcutaneous insulin safety check
• Intramuscular vitamin B12 with needle anxiety
• Checking an oral dose on a child medication record
• An S8 tablet and the controlled medicine register