Medicine Management Skills for Nurses. Claire Boyd
safer use of injectable medicines,
Safer practice with epidural injections and infusions.
The government department responsible for health regulation and policy in the United Kingdom.
Venous thromboembolism (VTE)
A medical condition including DVT, whereby a blood clot forms inside a vein, and pulmonary embolism (PE), whereby part of the DVT breaks off and travels to the lungs, blocking the blood flow.
Improving Medication Safety
The NPSA produced seven key actions to improve medication safety which are still relevant today (Table 1.3).
Question 1.5
Why do you think it is important that we know not just what medications the patients are allergic to, but also what foodstuffs?
Patient Self‐Administration of Medication
Health carers often take over the medication care of in‐patients with diabetes and mess up their blood sugars by not being able to deliver their insulin and other medications at the correct times. Patients with Parkinson's disease also have strict regimes and we may again fail to deliver their medications on time, with profound effects on their independence and wellbeing. Many hospitals now have secure boxes at the bedside for patients to store their medication and allow them to self‐medicate.
Table 1.3 Seven key actions to improve medication safety.
Source: Department of Health (2007).
| Increase reporting | Increase reporting and identify actions against local risks by way of an annual medication report: clinical risk. |
| Implement NPSA safer medication practice recommendations | Implement NPSA recommendations – audit safer medication practice – includes alerts on anticoagulants, injectable medications, and wrong‐route errors. |
| Improve staff skills and competencies | Improve skills: preceptorship competencies will help nurses to work towards the required level of competence. |
| Minimise dosing errors | Minimise errors: information, training, and tools to make calculations easier. |
| Ensure medicines are not omitted | It also can be linked with neglect when medications are not given. The NPSA reviews medicine storage and medication supply chains. |
| Ensure medicines are given to the correct patient | Ensure correct medications with correct patient – improve packaging and labelling of medicines – support local systems that make it harder for staff to select the wrong medicine. |
| Document patient's medicine allergy status | Document: improve recording of patient's allergy status. |
Remember that not all patients have the ability to do this; for example, patients with dementia or those too ill to administer their own medication. But please remember, patients with dementia may have windows of opportunity whereby they can self‐medicate. As with all health care, this aspect of their care must be monitored frequently. Many patients in the community have their medication distributed by their pharmacist into ‘dosset’ boxes, boxes that have timed sections or partitioned by morning, afternoon, or evening, in order for them to take their medication.
Focus on the Task in Hand: Do Not Get Distracted
Many wards and clinical areas have notices on drug trolleys stating Do Not Disturb While Administering Drugs. This enables the member of staff to concentrate on the task in hand. Some institutions have trialled the wearing of tabards in clinical areas for staff administering drugs, alerting others in the area not to disturb them.
Vicarious Liability
Question 1.6
What does vicarious liability mean?
We all need to comply with our Policies and Procedures, whether we work in a hospital, clinic, or the community setting.
Procedure for Administering Medication
So, when administering medications, what is the correct procedure? The person administering a drug before giving it will:
1 Check the identity of the patient,
2 Check for any recorded allergy/sensitivity,
3 Check the drug name, dose form, strength, date, and time,
4 Check the route of administration,
5 Check for any additional instructions, including safety considerations,
6 Check the drug has not already been administered,
7 Check the drug label against the prescription,
8 Check the expiry date of the drug on the label,
9 Calculate the dose if appropriate.
Prescriptions should be written in black pen, clearly, using no drug trade names, and the member of staff should not be distracted from the task in hand. Medical gases should also be prescribed (except in emergency situations).
When administering medications, we should adhere to the so‐called five rights:
Right medicine,
Right dose,
Right route,
Right patient,
Right time.
The procedure for checking the patient's name, name band, and prescription chart is referred to as the three‐point check.
Commonly Used Medicine Name Suffixes
As our knowledge of medicines increase, we will begin to see patterns of drug names related to their drug class, or medicine name suffixes. We can see some of these below in Table 1.4:
Table 1.4 Medicine name suffixes.
| Suffix | Medication family or class | Examples of drugs | Indications for use |
|---|---|---|---|
| mab | Monoclonal antibodies | Trastuzumab Pertvzumab Pembrolizumab | Breast cancer Breast cancer Melanoma |
| olol |
b‐Blockers
|