Nurse Prescribing V150 a Case Study

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

Whiles weighing Ella, I observed that Ella had red and inflamed rash on her face and in the creases of both hands. According to Beckwith and Franklin (2011), to prescribe safely a holistic assessment of the patient has to be completed and the seven steps of the prescribing pyramid was used which are ,examining the patient’s holistic needs, considering an appropriate strategy, considering a choice of product, negotiating a ‘contract’ and achieve concordance with the patient, reviewing the patients on a regular basis, ensuring all record keeping is both accurate and up to date and reflecting on your prescribing for future reference.(NPC, 1999) were used as a decision making

Maria Niceforo, a 75-year-old woman receiving in-home nursing care, had died of infection due to numerous pressure wounds (Le May, 2016). She was admitted to the hospital presenting with a bleeding pressure wound across her back and legs that had penetrated through the bone (Le May, 2016). It was also observed that the wounds were soiled with urine and dried faeces (Le May, 2016). She was receiving in-home support from registered nurses, who according to her son, were not consistent nor reliable in their care of Mrs. Niceforo (Le May, 2016). Another contributing factor to her death was inadequate communication and documentation of her treatment (Menagh, 2016). For example, one of the nurses had reported not providing treatment to Mrs. Niceforo's bottom as she was not aware of it (Menagh, 2016). I was quite

The negligence of this incident had a negative impact on the patient’s family members. Approximately 25% of cases involving medical negligence involve poor nursing care. Another negative aspect was patient’s family follow up was poor resulting in lack of importance highlighted on the pressure wounds. Ashley (2003) states nurses can be sued for malpractice, this means he or she is being sued for “negligence”. Furthermore, the nursing health professionals can lose its credibility among a community as they failed to provide a holistic care for the patient. However, a positive outcome was nurses were able to reflect among this evidence based practice to assist in better quality in patient

Jane presented with a wound to her lower left leg which, following a holistic assessment (appendix 2), was diagnosed as a venous leg ulcer. The assessment was conducted in accordance with Local PCT Leg Ulcer Guidelines (appendix 3) as well as RCN Guidelines (RCN 2006) to rule out other possible aetiology such as arterial ulceration, diabetes or malignancy (Moloney and Grace 2004). Although traditionally considered uncommon, recent studies suggest that malignant ulcers are more prevalent than previously thought (Miller et al 2003, Taylor 1998) therefore even though initial assessment suggests an uncomplicated venous ulcer, if Jane’s wound fails to heal following appropriate treatment then specialist advice will be sought. Between 17% and 65% of people with a leg ulcer experience severe or continuous pain with a major impact on quality of life (Briggs and Nelson, 2003) and effective pain relief is important to maximise quality of life, to enable mobilisation and improve appetite to facilitate wound healing. Fortunately, Jane experienced no pain from the leg ulcer prior to or at the time of assessment. However, careful review and monitoring of any pain will be important throughout the treatment process as the first line of treatment for uncomplicated venous leg ulcers are compression systems (RCN 2006) and although compression counteracts the harmful effects of venous hypertension and

I am a second year nursing student in my third week of the practicum placement on a surgical ward with my co-student and the morning shift registered nurses. We had just finished analysing the patients handover report (Levett-Jones & Bourgeois, 2015) and I had been assigned to work with the registered nurse. I was looking after Mrs. Brown (pseudonym) is 82 years old New Zealander was admitted to surgical ward on the 08/06/16 for multiple SCC removals from L) hand and L) foot with skin grafts.

2. Review Mrs. Checketts home medications - which medications increase her risk for complications during her hospitalization and what are those complications?

Client continues to reports she suffers from, hypertension, Dyslipidemia, Psoriasis, H/O stroke, chest pain. She takes the following medications: Lisinopril 5mg, and Hydrocortisone Cream

Mr. J.’s daughter noticed a red mark on her father who then reported this to the nursing assistant and her concerns were immediately dismissed. If the nursing assistant was properly trained in the use of restraints and had knowledge of patient outcomes, this patient would not have developed a pressure ulcer. The nursing assistant should have immediately informed the nurse and measurements should have been taken to prevent further breakdown of the patient’s skin which was not done. It is evident in reading this case that Mr. J developed a Stage I pressure ulcer from being retrained in one position with no assessment or release for an undetermined amount of time.

Francesca, thank you for your discussion. I enjoyed how you described what Jane is experiencing with her medication. What I would try to explain to her would be that each of our bodies operate in different ways. That some individual respond differently to all forms of medications and why some have allergic reactions. Therefore, it makes sense that the gentlemen that she met in the lobby has a different response than she does with a different medication. However, it in no way means that the medication that he is taking would be affective. Furthermore, I would explain that I would not recommend her to change the medication because right now it appears to be working. It appears that her system has reached complete equilibrium (Preston,

Therefore, the aim of this literature review is to explore issues in relation to patient concordance in their leg ulcer care in the

Historically prescribing has taken many years to occur as in the early 1980s nurses began to explore the potential for prescribing, beginning with dress packs. The nursing profession then claimed for authority of prescribing in 1978 when the Royal College of Nursing proposed that nurses should have authority to prescribe dressings and topical treatments. In 1986 the government considered the claim and acknowledged that it was an opportunity to highlight the argument for legislation to allow nurse to prescribe. The amendments were finally made in 1992, fourteen years after the first written report in support of nurse prescribing. Over the following eight years the Labour government embarked upon a programme of prescribing policy growth (mheducation,

A nursing diagnosis specific to the patient would be at risk for infection related to impaired skin integrity as evidence by ulcer on foot. It is important that the client understand that wearing heels increases the risk of infection. The client states “I like to wear heels” shows her knowledge about wound care is not met. Tight fitting shoes can generate an ulcer by rubbing on a part of the foot that has become numb as well as increase the risk of infection, prolong the duration, and increase depth of the ulcer. (“A nurse’s guide,” 2015). It could even create new ulcers. Also, understanding that standing all day will cause the ulcer to heal slower and increase the risk of a possible infection which could potentially lead to more serve problems.

A diabetic foot ulcer is an infuriating condition that arises from the unmanageable progression of diabetes. Significantly, its occurrence can impact each patient physiological appearance and psychological state. The patients that are living with diabetic foot ulcers are faced with the possibility of encountering severe infections from the foot due to presenting multi-factors that initiate its development. Like many other foot conditions, foot ulcerations are in compliance with the evidence base practice of nursing as a whole. As a result of this practice, diabetic foot ulcers can be treated with the use of clinical expertise and scientific knowledge to provide the most safe and effective care to patients who are at risk for limb amputation. In short, this paper will discuss the pathophysiology, etiology, and risk factors of diabetic foot ulcers, while reviewing nurse’s perspectives on how valuable evidence based nursing is to their practice and to managing diabetic foot ulcers. The interventions listed, will be evaluated within the paper to ensure that they are appropriate in preventing the early onset of diabetic foot ulcers.

During my second week of placement, when I was working with the home visiting nurse, I was working under supervision of my preceptor, caring for a fifty four year old Samoan gentlemen, Mr.Li (pseudonym). When we went to his place in Mt. Albert, he was sitting on the chair and his wife was there as well. Mr Li had left leg ulcer and he developed this in February 2016. According to Mr. Li, it started off with a blister and lead to left leg cellulitis.