SolidBowtie

Medication error — high-risk infusion

Wrong dose of a high-risk IV medicine: look-alike drugs, pump programming and patient identity, recovered by monitoring and rapid response.

HazardAdministration of high-risk IV medication
Top eventWrong dose administered to a patient

4 threats 14 barriers 3 consequences safety-critical barriers marked

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Threats & preventive barriers

Each threat is a credible pathway to the top event; its barriers interrupt that pathway before control is lost.

Look-alike / sound-alike drug mix-up

  • Barcode medication verification ★ critical

    Active hardware · 90% effective · Owner: Pharmacy IT Lead

  • Tall-man lettering & segregated storage

    Passive (hardware) · 70% effective · Owner: Pharmacy Lead

  • Clinical pharmacist review

    Socio-technical · 85% effective · Owner: Chief Pharmacist

Infusion pump misprogramming

  • Smart-pump dose-limit library ★ critical

    Active hardware · 92% effective · Owner: Biomedical Engineering

    Drug library not kept up to date

    📅 Drug library update · quarterly keep-alive task

  • Independent double-check

    Behavioural (human) · 80% effective · Owner: Ward Nurse Manager

    Workload pressure skips the check

Prescribing error

  • CPOE with clinical decision support

    Active hardware · 85% effective · Owner: Clinical IT Lead

  • Weight-based dosing protocol

    Socio-technical · 80% effective · Owner: Clinical Lead

Wrong patient

  • Two-identifier check at the bedside ★ critical

    Behavioural (human) · 80% effective · Owner: Bedside Nurse

  • Wristband barcode scan

    Active hardware · 85% effective · Owner: Nursing Director

Consequences & recovery barriers

Once the top event happens, recovery barriers limit each consequence.

Patient harm

  • Continuous patient monitoring

    Active hardware · 80% effective · Owner: Nursing Director

  • Rapid response team & antidote protocol ★ critical

    Socio-technical · 85% effective · Owner: Critical Care Lead

    📅 Rapid response simulation · semiannual keep-alive task

Reportable adverse event

  • Incident reporting & review

    Socio-technical · 80% effective · Owner: Patient Safety Lead

  • Root-cause analysis with actions

    Socio-technical · 75% effective · Owner: Quality Director

Loss of trust & litigation

  • Open disclosure & duty of candour

    Behavioural (human) · 70% effective · Owner: Medical Director

Copying this template gives you a fully editable bowtie: barrier owners arrive as role suggestions, escalation factors sit on their barriers, and keep-alive activities are scheduled from the moment you copy. New to the notation? Read what the bowtie method is or browse the practical guides.

Use this template free. Copy “Medication error — high-risk infusion” into your own workspace and adapt every barrier — no credit card.

Start free with this template →