Nursing Responsibilities in Medication Management

Section A:

1. The role of the nurses in medication management are as follows:

Nurses are to be involved in accessing medication history from the patients during the administration time in care. This is required for the nurses to be aware of any allergies of the patients related with the medication and take prior action to prevent their occurrence during administration of medication (Mardani et al., 2020).

Nurses are to review the overall medications and collect data to identify any discrepancy with the medication and ensure safe disposal and administration of medication (Mardani et al., 2020).

Nurses are to understand the specific mode of medication administration suitable for the patient and know the dose of the medication to the delivered to the patient (Mardani et al., 2020)

Nurses are to work in collaboration with the multidisciplinary to deliver safe and effective medicines to the patients (Mardani et al., 2020)

Nurses are to minimise the harm and side-effects to be caused by medication to the patients by implementing appropriate measures during the administration of medication (Mardani et al., 2020).

Nurses are to maintain the confidentiality of the patient’s medication and keep record of the medication delivered (Mardani et al., 2020).

2. In case of a part of the prescription is illegible, the nurse is to act by contacting the doctor responsible for prescribing the medication directly to resolve the issue. This is because the doctor is able to provide the right information to resolve the doubts against the medication nature or name or other raised out of illegible handwriting (Brits et al., 2017).

3. In the UK, the Medicines and Healthcare Regulatory Agency (MHRA) is the regulator of medicine, blood components and medical devices used in care. The role of MHRA is to monitor and review new as well as existing drugs and medical devices to ensure they are safe to be used as well as meeting the required standards and quality (Gov, 2021).

Section B:

1. The factors to be considered for making patients prepared to manage medication at home after discharge are their level of knowledge regarding medication, self-administration ability, understanding of dose of medication and medication needs. This is because based on education of the patients regarding medication to be used after discharged, the nurse would further impart information to the individuals in making them capable to use and administer medication without error. Moreover, determining the self-administration ability of medication by the patients would make nurse determine the way administration of medication are to be arranged for the patients (Ozavci et al., 2021). the process of discharging patients with medication in making the individual well-aware of all the medication doses to be followed with a prescription and chart indicating the medication name, dose and when to take them (Ozavci et al., 2021).

2. The five rights of medication administration are right patient, right medication, right dose, right route and right time. The right patient is important to avoid the risk of administering medication who does not require the drug and has different ailments which cannot be resolved through it (IHI, 2021). The right medication identification is important as it avoids the risk of unnecessary or wrong medication to be administered that has depleting health impact on the patient (IHI, 2021). The right dose of medication is important for avoiding the risk of over or underdose of the drug that is harmful to the patient’s health and creates unnecessary side effects (IHI, 2021). The right route of medication delivery is important to avoid the risk of lack of effect of the medication on the person’s body after being administered (IHI, 2021). The right time of medication delivery avoids the risk of hindered health control of the patient (IHI, 2021).

3. The nurses on detecting medicine discrepancy is to immediately reassess and compare the counts to ensure no human errors are made by them in counting. The incidence is to be immediately reported to the nursing manager and authorities regarding the discrepancy. This is because the nursing manager and authorities is able to take actions required to identify the cause and person responsible for the discrepancy (CQC, 2009). The nurses are to share personal records and proof of medication use for patients during audit by authorities to provide if they are responsible or innocent for the discrepancy (CQC, 2009).

Section C:

1. Medication error is referred to any preventable actions that might cause or lead towards development of any inappropriate medication use for the patients that may harm them while the medication is delivered under the control of the health professional or nurses (Al‐Jumaili and Doucette, 2018). The medication error may be caused due to hindered communication of the nurses with the physicians which leads the nurses remain unaware of the exact medication name or dose to be delivered to the patients, in turn, making them execute error out of lack of effective information been shared (Alomari et al., 2018). The medication error is also caused by hindered understanding of the handwritten prescription of the doctors by the nurses where they are unclear of the specific medication to be administered leading them to make error (Hammoudi et al., 2018). The medication error is caused by nurses due to their lack of ability in differentiating between alike name and looks of medication which leads them to cause error out of confusion (Jember et al., 2018).

2. The “near miss” incident in medication error is referred to as the act of omission or commission which could have caused harm to the patient but was avoided as the result of the mitigation or prevention of the action through active support or awareness (Aseeri et al., 2020).

3. The nurse on suspecting they have executed any medication error are to take ownership of the error and take immediate measures to inform the patient regarding the error as mentioned in the NMC Code of Conduct where patients are to be informed of any error in care (NMC, 2018). Further, they are to inform the doctor of the error and take effective course of action as early as possible to counteract the impact of the medication. The nurses are to inform regarding their error to the supervisor of the hospital and provide a written report explaining the action that led to the error in concise manner where cause name of the medication provided, dose and other details are clearly mentioned (Dyab et al., 2018).

Section D:

Scenario 1:

1. The Co-Careldopa is used for people who suffers from Parkinson disease to control their tremors, stiffness and slowness related with the disease. The usual dose of the medication incudes taking tablets 3 or 4 times a day as prescribed by the doctor before 30-60 minutes of eating a meal. The common side-effects of Co-Careldopa include loss of appetite, dizziness, insomnia and uncontrolled twisting and stitching. The serious side-effect includes strange and unusual thoughts, mood changes, sudden sleeping and others (NHS, 2021). The patient taking iron supplements, anti-sickness medication, pregnant and breastfeeding and others are to inform regarding the action to the physical before prescribing Co-Careldopa (NHS, 2021).

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2. The mechanism of action by Co-Careldopa includes supporting conversion of dopamine in the brain with the help of DOPA decarboxylase and enzyme. Dopamine is responsible for relaying messages to control the movement of the muscle. The slowing down of dopamine level in the brain leads to less active muscle movement which results in lowering tremor, stiffness and others (Kabra et al., 2018).

3. Debra is mentioned to show history for Parkinson’s disease and failure to provide the medication would lead to accelerate the symptoms regarding Parkinson’s disease that would hinder the well-being of the patient due to which it is to be provided in timely manner (Zahoor et al., 2018).

4. The nurse needs to make immediate arrangement of Co-Careldopa by consulting with the supervisor and pharmacist to ensure the medication reaches Debra as early as possible before the initiation of the tremors and hindered muscle movements.

Scenario 2:

1. The amoxycillin is used for preventing bacterial infection in the chest. The usual dose of the medication includes 250mg-500mg for 3 times a day for adults and it is be taken before or after the meal as prescribed by the physician. The common side-effects of the medication include nausea and diarrhoea and the serious side-effects that rarely occurs is skin discolouration, joint or muscle pain and others (NHS, 2021a). The patient taking blood thinning medication, gout medication, methotrexate and other antibiotics are to inform the physician before getting prescribed with amoxycillin as a part of caution as the antibiotics may interfere with the medication to cause hindered health effect (NHS, 2021a).

2. Amoxycillin is the medication from the bet-lactam antimicrobial class which acts by bonding with the penicillin-bindings proteins in the body to inhibit the process known as transpeptidation that causes activation of the autolytic enzyme on the bacterial wall. It leads to the destruction of the cell wall of the bacteria, in turn, destroying the bacterial cell (Al-Hasan and Al-Jaghbeer, 2020).

3. Charlie is mentioned to be suffering from COPD and administration of amoxycillin to him would help in lowering the exacerbation of the condition. Moreover, amoxycillin use on COPD patients helps them to fight against bacterial infection (bacterial pneumonia) in the lungs which ensures their better health (Moore, 2020).

4. The actions to be taken by the nurse in promoting concordance is that the nurse is to remain in effective communication with the patient as well as pharmacist to ensure the amoxycillin medication is available as per the patient’s needs at all times. Moreover, the nurse is to ensure keeping reminder of the need of amoxycillin use by reviewing the health of the patient in regular manner. A chart specifying the need of amoxycillin medication is to be mentioned for Charlie in the health records (Brack et al., 2013).

References

Al-Hasan, M.N. and Al-Jaghbeer, M.J., 2020. Use of Antibiotics in Chronic Obstructive Pulmonary Disease: What is Their Current Role in Older Patients?. Drugs & Aging, 37(9), pp.627-633.

Al‐Jumaili, A.A. and Doucette, W.R., 2018. A systems approach to identify factors influencing adverse drug events in nursing homes. Journal of the American Geriatrics Society, 66(7), pp.1420-1427.

Alomari, A., Wilson, V., Solman, A., Bajorek, B. and Tinsley, P., 2018. Pediatric nurses’ perceptions of medication safety and medication error: a mixed methods study. Comprehensive child and adolescent nursing, 41(2), pp.94-110.

Aseeri, M., Banasser, G., Baduhduh, O., Baksh, S. and Ghalibi, N., 2020. Evaluation of medication error incident reports at a tertiary care hospital. Pharmacy, 8(2), p.69.

Brack, G., Franklin, P. and Caldwell, J., 2013. Medicines Management for Nursing Practice: Pharmacology, Patient Safety, and Procedures. Oxford University Press.

CQC 2009, Reporting medicine related incidents, Available at: https://www.cqc.org.uk/guidance-providers/adult-social-care/reporting-medicine-related-incidents [Accessed on: 19 November 2021]

Dyab, E.A., Elkalmi, R.M., Bux, S.H. and Jamshed, S.Q., 2018. Exploration of nurses’ knowledge, attitudes, and perceived barriers towards medication error reporting in a tertiary health care facility: a qualitative approach. Pharmacy, 6(4), p.120.

Gov 2021, Medicines and Healthcare Regulatory Agency, Available at: https://www.gov.uk/government/organisations/medicines-and-healthcare-products-regulatory-agency [Accessed on: 19 November 2021]

Hammoudi, B.M., Ismaile, S. and Abu Yahya, O., 2018. Factors associated with medication administration errors and why nurses fail to report them. Scandinavian journal of caring sciences, 32(3), pp.1038-1046.

IHI 2021, Five Rights of Medication Administration, Available at: http://www.ihi.org/resources/Pages/ImprovementStories/FiveRightsofMedicationAdministration.aspx [Accessed on: 19 November 2021]

Jember, A., Hailu, M., Messele, A., Demeke, T. and Hassen, M., 2018. Proportion of medication error reporting and associated factors among nurses: a cross sectional study. BMC nursing, 17(1), pp.1-8.

Kabra, A., Thakur, S., Sharma, R., Garg, R. and Baghel, U.S., 2018. Parkinson’s Disease and Depression-Together or Apart: A Review. Asian Journal of Advanced Basic Sciences, 6(2), pp.27-34.

Mardani, A., Griffiths, P. and Vaismoradi, M., 2020. The role of the nurse in the management of medicines during transitional care: a systematic review. Journal of multidisciplinary healthcare, 13, p.1347.

Moore, D., 2020. Management of COPD exacerbations: pharmacotherapeutics of medications. British Journal of Nursing, 29(13), pp.738-743.

Brits, H., Botha, A., Niksch, L., Venter, K., Terblanché, R. and Joubert, G., 2017. Illegible handwriting and other prescription errors on prescriptions at National District Hospital, Bloemfontein. Professional Nursing Today, 21(2), pp.53-56.

NHS 2021, Co-Careldopa, Available at: https://www.nhs.uk/medicines/co-careldopa/ [Accessed on: 19 November 2021]

NHS 2021a, Amoxycillin, Available at: https://www.nhs.uk/medicines/amoxicillin/ [Accessed on: 19 November 2021]

NMC 2018, The Code, Available at: https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf [Accessed on: 19 November 2021]

Ozavci, G., Bucknall, T., Woodward-Kron, R., Hughes, C., Jorm, C., Joseph, K. and Manias, E., 2021. A systematic review of older patients’ experiences and perceptions of communication about managing medication across transitions of care. Research in Social and Administrative Pharmacy, 17(2), pp.273-291.

Zahoor, I., Shafi, A. and Haq, E., 2018. Pharmacological treatment of Parkinson’s disease. Exon Publications, pp.129-144.