Enrolled Nurse's Standards (NMBA)

Supplementary and independent nurse prescribing has taken some years to materialise; this movement was facilitated by Department of Health (DoH), nursing regulators, nursing professional bodies, and general practice (GP) supporters (RCN, 2012). Following the Medicines Act (1992) where only Health Visitors and District Nurses were allowed to prescribe from a limited formulary, over time legislations were subsequently amended allowing non community nurses to prescribe from an extended formulary. In 2003, supplementary prescribing was being recognised and by 2012 The Misuse of Drugs Regulations allowed the nursing formulary to access all of the British National Formulary including controlled drugs. In line with these changes and to ensure that

According to a cross-sectional study involving 237 nurses, approximately 65% of the nurses have made medication error. Only 31% of the participants reported medication errors. According to the study the most common type of reported errors were wrong dosage and infusion rate. The most common causes were using abbreviations of the drugs and similar names of the drugs. However, the study did not find any relationship between medication years and years of experience, age, and working shift. Yet study found association between intravenous injection and gender (Cheragi at al

rights, health, and safety of the patient.” This provision, identifying patients, medication safety are related because it is a nurse’s responsibility to protect the patient from harm and promote safety. Nurses are taught to use multiple checks before administering a drug and use two identifiers. These checks include checking the medication against the order when obtaining it, checking again when preparing the medication and the last check is done at the patient’s bedside prior to giving the medication. Also it is imperative to question any medication order that does not seem fit. The order should include a date, time, name of the medication, dosage strength, the route for

Non care setting - Medications are often stored and administered in a variety of non-health care settings. These settings include: primary and secondary schools, Child day care centres, Board and care homes, Jails and prisons. In all these settings, employees frequently are responsible for handling and administering prescription and over-the-counter medications to clients or residents. Some organizations may employ licensed health professionals to directly manage the medication administration process. However, many of these settings have no licensed health professionals involved. Where medications are stored and administered to individuals, written policies and procedures should address the following: Acquisition of medications (e.g., from parents, caregivers, pharmacies), Specification of which personnel are allowed access to medications and allowed to administer medications to students, clients or residents, Labelling and packaging of medications managed for students, clients

1. In the workplace there is a generic Medication Management Policy and Procedures for Adult Services (Issue 10, 2012) document. This is kept to hand in a locked cupboard, readily available to read. It requires that all Healthcare Staff are given mandatory training and refreshers are provided. Legislation which surrounds the administration of medication includes The Medicines Act 1968, The Misuse of Drugs Act 1971, The Data Protection Act 1998, The Care Standards Act 2000 and The Health and Social Care Act 2001

There are several legislations in place with protocols for the administration of medication which I have listed below. The main policy re admin of drugs and storing of drugs and medicines is the Control Of Substances Hazardous to Health or COSHH but along with this there are other policies in place as per the list below.

As clinical site co-ordinator with many years of clinical experience I feel competent in the drug administration via a variety of routes. Generally the patients I attend have become acutely unwell with most prescriptions not having the third eye of a pharmacist and most drugs being delivered intravenously. It is imperative therefore that the prescription and drugs always be thoroughly checked which relies on good communication throughout. Furthermore, most emergency drugs have a protocol for administration developed by the hospital. However within this situation the nurse is generally the last defence before any medication error actually occurs, therefore it is the nurses responsibility to ensure the prescription is correct and to challenge prescription written

The nurse must verify the physician’s medication order, including the dose and time, and then the pharmacy is responsible for their own checks and balances via the BCMA system in order to complete the dispensing phase of the medication (Gooder, 2011). The nurse enters the BCMA system with a login and password and is able then to see a list of the virtual due list for a specific patient. The computer on wheels is then taken to that patient’s room and the five rights of medication administration begin. As nurses, we are taught to use the five rights of drug administration are (1) right patient (2) right medication (3) right dose (4) right route and (5) right time. By scanning the barcode on the patient’s hospital identification band, the nurse then asks for the patient to verbally state their name and date of birth, which can be verified by the nurse on the virtual due list and then choses the medication that are due for administration at that time. The medication is dispensed and the nurse is able to scan the barcode on the medication, the scanning triggers the automatic documentation of the medication given (Kelly, 2012).

As a healthcare professional a therapeutic relationship is fundamental in providing quality patient care. The Nursing and Midwifery Board of Australia (NMBA) National Competency Standards for a Registered Nurse (2006) emphasises Collaborative and Therapeutic relationships as one of the four main domains which make up the standards. The assignment will explore one specific quality on establishing, maintaining and appropriately concluding a therapeutic relationship in relation to a Horizon Hospital and Health Service client, in this case Mary Young. The specific attribute chosen is ‘establishes rapport with individuals/groups that enhances they ability to express feelings, fosters an appropriate context for expression of feeling.’ This attribute is crucial in having the guiding principals for a safe professional practice.

Breeding, et al. (2013) states that there are a number of published documents addressing the quality, safety, and explicitly medication safety within ICUs worldwide. A large proportion of these studies focused on specific interventions such as: (1) creating “No interruption zones”; (2) addressing drug incompatibilities; (3) implementing automatic drug dispensing systems or electronic prescription of medications; or (4) implementing an ICU pharmacist role (Breeding, et al., 2013, p. 59). It is essential for multidisciplinary teams to be formed for medication safety promotion within this population. These teams would include physicians, pharmacists, and nurses (to also include advanced practicing nurses [APRN], such as nurse practitioners [NPs] or clinical nurse specialists

American Nurses Association (ANA) Standards of Professional Performance explains how all registered nurses do their work and activities consistently according to their professions that promote the wellbeing of their patients and communities (ANA, 2010a). The standards provide a mechanism to patients that they are been taken good care of and that the nurses know exactly what to do so as to provide high-quality care and the measures are in place to determine whether nursing care meets the standards. These activities are related to performance like ethics, quality of practice, education, communication, resources, leadership, environmental health, professional practice evaluation, and evidence-based practice and research. Registered nurses are responsible for their professional actions to themselves, their patients, their peers, and the community at large.

When I say this, however, most people would picture the nurse giving the wrong medication due to lack of focus on the tasks at hand. While this could happen, I have noticed during my time at hospitals that the doctor orders are still hand written for the most part. Consequently, they can be very hard to be read legibly much less correctly translated into proper medication dosages. The first suggestion I would give to an organization would be that they required all orders to be submitted securely, by the doctors, to the pharmacy be electronic means.

The national league for nurses defines critical thinking in the nursing process as “a discipline specific, reflective reasoning process that guides a nurse in generating, implementing, and evaluating approaches for dealing with client care and professional concerns” (Kozier, 2008). This definition is imperative to help a nursing student learn how to think in terms of nursing care. Nursing students must achieve a comprehensive understanding of critical thinking in order to understand the nursing process. The purpose for this paper is for nursing students to learn how to use the nursing process, how to properly document their findings and assessments, and correctly implement APA formatting in a formal paper.

Administration of medicines is a key element of nursing care. Every day some 7000 doses of medication are administered in a typical NHS hospital (Audit Commission 2002). So throughout this essay I will be evaluating and highlighting the learning that took place whilst on placement at a day unit.

In the early 1980s it came to light that while the supply of nurses had reached a record high, only 80% of hospitals nationwide had adequate nurse staffing levels (American Nurse Credentialing Center, 2011, p. 8). To address this issue a taskforce was formed within the American Academy of Nursing (AAN). Through an initial study of 165 hospitals, the AAN determined the characteristics of healthcare organizations that were magnetically attracting and retaining nurses as employees (American Nurse Credentialing Center, p. 9). In this study the AAN found “Forces of Magnetism” that contributed to the high level of job satisfaction amongst nurses, superior quality of care, low job turnover, and high level of nurse involvement in leadership, decision-making, and research. In the early 1990s, catapulted by the findings of this initial study, the American Nurses Credentialing Center (ANCC) developed the Magnet Recognition Program. The intention of the ANCC’s Magnet Recognition Program was threefold: To reward hospitals that demonstrated “excellence in the delivery of nursing services to patients;” to encourage quality in the nursing work environment to support practicing professional nurses; and to guide navigation for the dissemination of evidenced-based clinical nursing practice (American Nurse Credentialing Center, 2011, p. 14).