Reflective Analysis of Medicine Management

Introduction:

This is a reflective essay that will use the Rolfe’s model of reflection in relation to discuss an episode of medicine management therefore discussing the seven rights of the medicine administration. Medicine management is the evidence-based approach that is performed by nurses to make the cost effective and safe use of different medicines (Baek et al. 2020). Royal College of Nursing (RCN) mentioned that all the newly graduate registered nurses must have the skill and understanding in performing safe as well as effective medicine management for ensuring safe administration of prescribed drugs into patients (Balogun & Ashafa,. 2019). All nursing professionals including student nurses as well as the registered nurses are obliged to follow and implement all the ethical, moral ana legislatives guidelines of medicine management set by RCN and NMC.

Self-reflection is crucial in nursing profession that assists student nurses to reflect on their work experiences, performances and work process. As mentioned by Ashton et al. (2019), reflection in nursing can be defined as the process in which nursing professionals can evaluate their past experience as well as performances to identify their professional strength and weakness. Reflection assists nurses to analyse what they learn on each nursing aspect and whether they comply with the standard set under NMC (2015) code throughout the practice [NMC, 2015]. Here the essay will make an in-depth discussion on the administration of subcutaneous insulin injection into patent’s body. Here the major impediments that are associated with effective administration of insulin infection will be analysed following a discussion on the major facets of medicine management. This essay has high scope in providing evidence-based information on medicine management and medicine administration that will improve the skill and abilities of student nurse in delivering safe care to patients in future workplace.

What:

While it comes to effective medicine management throughout the care delivery to patient, nurses are obliged to comply with all the standard and guidelines set by RCN and NMC for ensuring patient safety [RCN, 2019]. Student nurses must develop the clear understanding as well as professional knowledge on the seven rights of medicine administration in terms of meeting the standard set by RCN and NMC for effective medicine administration (NICE, 2019). These rights of medicine administration are right drug, right time, right dose, right patients, right reason, right route and right documentation. During the nursing practices student nurses need to develop in-depth knowledge and skill for incorporating all these rights of medicines administration into the practice (Baek et al. 2020). RNC (2019) mentioned that the seven rights of medicine administration are developed to assist the nursing professional to avoid the risk of any type of medication errors. PHE (2019) defined the medication error as the event or incident in which patients are administered with the wrong medicine or wrong dose of medicines which cause the health risks as well as the life risk of patients[PHE, 2019]. NMC (2015) mentioned that student nurses must ensure that they undertake proper training and the skill development program on safe medicine administration thereby developing the clear understanding on how the seven rights of medicine administration is implemented into the practice.

During my placement as a student nurse, I was assigned to perform the safe administration of the subcutaneous insulin injection in a patient under the guidance and instruction of my mentor. PHE (2019) mentioned that the administration of the subcutaneous insulin injection is a vital responsibility of nursing professionals. Nurses must have the clear as well as in-depth knowledge and the high level of competence on safe administration of the subcutaneous insulin injection into patient’s body. As mentioned by Berry et al. (2018) for developing the high-level of expertise as well as strong skill in performing the safe administration of subcutaneous insulin injection student nurses need to undertake repeated training and learning process. Student nurses must develop the clear knowledges on all the vital aspects of performing the safe administration of subcutaneous insulin injection, such as the guidelines as well as ethical aspects of medicine management, the process of administration, the risk factors associated with the administration on insulin and the safe measures that needed to be maintained while administering subcutaneous insulin injection [RCN, 2019].

While performing the administration of the subcutaneous insulin injection into patient’s body I had followed all the guidelines on safe medicine administration set by RCN and NMC (Cracowski and Mathieu Molimard, 2020). I had also complied with the all the four standards of NMC (2015) thereby not only ensuring the patient’s safety through effective medicine management and administration but also promote my professional integrity and the professional accountability during the process. Although I have prior practical knowledge on safe administration of subcutaneous injection into patient’s body, While I was asked to perform this process under the guidelines of my mentors, I was little nervous and had low self-confidence as I was confused whether the intravascular or the intravenous route need to be used here to administer the insulin (De Witt Jansen et al. 2017).

RCN (2019) mentioned that, student nurses as well as the registered nursing professionals must ensure that they work under their level of proficiency and expertise while administering any medicine to patient’s body thereby ensuring patient safety. In this context I discussed the matter with my mentor and got the valuable assistance from him which assisted me to choose the subcutaneous administration pathway of insulin administration (Doughty et al. 2017). NHS (2019) mentioned that student nurses must have the clear understanding on which route of the medicine administration would be best fit to patient’s current health needs. Here as the patient was diagnosed to the type 2 diabetes my mentor guided to use the subcutaneous route of medicine which would be more effective as the insulin will be slowly absorbed into the muscle as compared to vein thereby having more long-term effects of medicine.

I followed the systematic process of medicine management under the guidelines of RCN and NMC in terms of ensuring the appropriate procedures and techniques are used in administering the subcutaneous insulin injection in patient (Fang et al. 2017). Here I had followed and complied with the seven rights of medicine administration. Before performing the medicine administration, I checked the prescription to check the prescribed dose of insulin. Then I discussed with doctors and senior nurses regarding the right time on which the medicine needs to be administered to ensure high level of patient’s safety (Garg, & Wray, 2020). I also went through the health assessment report of the patient and the prescription in-detail to confirm that the prescribed as well as right dose of insulin is going to be administered in the patient’s body.

While administering the subcutaneous insulin injection I complied with the NMC (2015) code, preserving safety’ (Gupta & Dunn, 2018). Under this standard I had maintained effective communication with my mentors and other team members of MDT regarding the procedures that needed to be followed during the administration of insulin safely. Despite having the practical knowledge on this process of administration I confirmed with my mentors regarding the subcutaneous route insulin administration that needed to be used in this patient through which I had shown my professional accountability and concern towards the wellbeing and safety of patient [NMC, 2015]. I also followed another standard of NMC (2015), the prioritising people. Under this standard I ensured that the patient is administered with the right dose of insulin which was prescribed by the doctor, thereby eliminating risks of medication errors.

So, what:

The particular episode of medicine administration was proved to be highly informative as well as useful for me to develop the in-depth understanding and knowledge on the safe medicine administration (Hong et al. 2017). Moreover, during this episode, I have developed strong skill as well as expertise in managing and handling all the tasks that are associated with maintain safe medicine administration. During the process of administering subcutaneous medicined I have gathered knowledge on different important aspects of medicine management such as implement the seven right of medicine administration, check the prescription before carrying out the medicine administration, share up to date information regarding patient’s health condition before and after the administration and check the therapeutic usefulness of the medicine in improving patient’s health (Hosseinkhani et al. 2018). Through administering the subcutaneous insulin injection to the patient, I have learned the importance of maintaining the right times of administration and right dose of right medicine to ensure the health and safety of patients. I also learned that in case of diabetic patients, before administering the insulin infection through using the subcutaneous routine, nurses must check the health assessment report, prescription and the nutritional as well as dithery routine of the diabetic patient (Baek et al. 2020.). This is because, nurses must ensure that administration of the insulin would not interfere with the nutritional intake and digestive as we as metabolic function of the patient

By reflecting on this episode of medicine administration, now I am able to understand that, for ensuring that safe use of medicines in patients, nurses must follow the systematic process of the medicine administration. Nursing professionals need to first check the health condition of patient before administering a particular medicine (Hosseinkhani et al. 2018). Whie reflecting on my experiences on administering insulin injection to the diabetic patient, I understand the importance of checking blood glucose level, the cholesterol level, fasting and post prandial glucose and glomerular filtration rate before administering the subcutaneous insulin injection. Through these health assessments, nurses can ensure the right dose of the insulin is going to be administered to patients in terms of improving the therapeutic usefulness of this medicine.

Following the medicine administration, nurses need to conduct a follow up treatment process, in which they can check whether the patients suffer from any kind of side effects of the medicine that is injected into patient’s body (Hyde et al. 2017). RCN (2019) mentioned that after performing the safe medicine administration, nurses must make 48 hours observation of the patient to observe whether the is any abnormal change in the facial expression, activities and behavioural of patient [RCN, 2019]. If these abnormal changes are observed, then nurses need to immediately inform the doctors regarding theses side effects of medicine. Performing the safe administration of the subcutaneous insulin injection into the diabetic patients I have learned the importance of the early recognition and response system in the heartcare for ensuring patient’s safety. NMC (2019), mentioned that student nurses must develop the skill and abilities in determining the medication errors in patients [NMC, 2019]. This episode of medicine management enables me to learn how to detect whether the patient suffers from outcomes of medication error (Grammes et al. 2020). The episode of medicine administration assisted me to learn about the necessity of timely and fast determination and response to the health decline of patients while medication errors occur to provide immediate medical support to patients.

RCN (2019) mentioned that, for eliminating the risk of medication errors, nurses need to gather the clear information regarding the current health needs and health status of patients and the care plan developed for them [RCN, 2019]. During this practice, I have understood the importance of obtaining the clear information on patient’s medical history that is associated with maintaining the right time and the right dose of the prescribed medicine based on patient’s past and current medical status.

This reflection on the episode of safe medicine management assists me to focus on identifying the risks that are associated with effective medicine administration. PHE (2019) mentioned, there are many risk factors that pose potential impediments on the ability of nurses to conduct an effective medicine management and administration process [PHE, 2019]. These risk factors as the lack of skill and knowledge on medicine management of newly graduate nurses, poor infrastructure for arranging systematic and high-quality medicine management, lack of training and skill development opportunities on this process in the healthcare centre and poor communication between nurses and health professionals (Malick et al. 2020). This reflection enables to me to emphasize on learning the safe and effective process of injecting the subcutaneous insulin injection into the subcutaneous tissues of a diabetic patient. Throughout this reflection on the medicine management, I have understood that it is crucial for the student nurses to learn the right technique to perform the safe subcutaneous administration as the negligence and the lack of skill in performing this process leads to severe inflammation, skin infection, oedema and skin lesion in patients. I also understand and learn that on which sides of the patient the nurses will stand to inject the medicine and at which angle to the skin the syringe will be injected. As mentioned by Miotto et al. (2017), nursing professionals must have high level of ill and expertise on performing safe medicine administration and effective medicine management that will eliminate the risks of any type of healthcare infection such as the blood borne infection and needle stick infection. Here the reflection enables me to know about the standard and guidelines that I need to follow to perform the administration of subcutaneous insulin injection safely to eliminate chances of any needle stick injury in patients thereby ensuring patient’s safety.

Moreover, this reflection assists me to emphasize on how effectively the medicine management can be implemented into person centred care to improve the patient’s care experiences (Müller et al. 2017). The episode of medicine management taught me to prioritise the personalised needs of patients while administering any medicine to patient’s body. I have learned how to follow the two NMC (2015) standard, ‘prioritise people’ and ‘preserving safety’ for conducting the safe administration of the appropriate medicine to patient’s body.

Now what:

After considering the overall learning as a student nurse I have identified several areas of improvement which I need to work on to promote further professional skill development. The most important skill on which I need to work more is the clear and effective verbal and written communication skill for conducting safe medicine management (Ng et al. 2018). NMC (2019) mentioned that, student nurses must develop a strong verbal and written communication skill that will enable them to share all up-to-date information regarding the medicines type, dose of medicine, the times and date of medicine administration and risk factors assailed with the medicine administration. For developing the strong verbal communication skill, I will join the discussion between senior nurses and doctors in the ward in which I will take initiatives to share all the medicine related information to the health professionals (Benkhadra et al. 2017). For developing the written communication skill, I will practise writing different demo case studied of different patients which improve my grammatical and sentence formation skill. The written communication skill will help me to form clear and concise case study, health records and the medication history of patients

Throughout this reflection I identify that I need to develop my understanding on pharmacology which will assists me to better understand the importance and side effects of different types of medicines. Here I will use British National Formulary (BNF) to obtain good knowledge on the different types of medicines, their dose for the different health condition of patients, the risk factors that are associated with these medicines. On the other hand, I will also go through the online sources on the guidelines of National institute of care and Excellence (NICE), Royal College of Nursing (RNC) and Nursing Midwifery council (NMC). Through obtaining better knowledge and understanding on all these legislation and guidelines on medicine administration I can promote further development of my professional skill of maintaining safe medicine administration.

Whie reflecting on the entire learning process, I realise that I have imitated understanding and knowledge on medication errors. Therefore, I need to improve my professional knowledge and skill in dealing with the medication errors and solving these issues by using the appropriate tools and techniques. PHE (2019) mentioned that there are many cases of inpatient deaths in the UK due to the medication error. For improving my knowledge on the pharmacology, I will maintain a clear and effective communication with pharmacovigilant in my workplace and will ask all the queries on the drug types, the usefulness of different drugs, the effectives management and administration of drugs.

Conclusion:

From the abovementioned discussion it can be concluded that, medicine management is the process of maintaining safe and useful administration of medicine to improve the therapeutic usefulness and cost effectiveness of medicines. Student nurses must be trained properly on developing good skill and knowledge on how to perform an effective as well as safe medicine administration and medicine management process. Self-reflection in nursing crucial in assisting student nurses to reflect on their activities, performances and past experience which enable them to determine their strength and weaknesses. Through reflecting on the episode of medicine administration, nursing professionals can improve their skill and abilities in conducting safe administration and management of medicine to promote positive health and wellbeing of patients

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Reference; list:

Abell, S.K., Suen, M., Pease, A., Boyle, J.A., Soldatos, G., Regan, J., Wallace, E.M. and Teede, H.J., 2017. Pregnancy outcomes and insulin requirements in women with type 1 diabetes treated with continuous subcutaneous insulin infusion and multiple daily injections: cohort study. Diabetes technology & therapeutics, 19(5), pp.280-287.

Ashton, J. J., Mossotto, E., Ennis, S., & Beattie, R. M. (2019). Personalising medicine in inflammatory bowel disease—current and future perspectives. Translational pediatrics, 8(1), 56.

Baek, S.Y., Lee, E.H., Oh, T.W., Do, H.J., Kim, K.Y., Park, K.I. and Kim, Y.W., 2020. Network pharmacology-based approaches of rheum undulatum linne and glycyrriza uralensis fischer imply their regulation of liver failure with hepatic encephalopathy in mice. Biomolecules, 10(3), p.437.

Balogun, F. O., & Ashafa, A. O. T. (2019). A review of plants used in South African Traditional Medicine for the management and treatment of hypertension. Planta medica, 85(04), 312-334.

Benkhadra, K., Alahdab, F., Tamhane, S.U., McCoy, R.G., Prokop, L.J. and Murad, M.H., 2017. Continuous subcutaneous insulin infusion versus multiple daily injections in individuals with type 1 diabetes: a systematic review and meta-analysis. Endocrine, 55(1), pp.77-84.

Berry, S.D., Rothbaum, R.R., Kiel, D.P., Lee, Y. and Mitchell, S.L., 2018. Association of clinical outcomes with surgical repair of hip fracture vs nonsurgical management in nursing home residents with advanced dementia. JAMA internal medicine, 178(6), pp.774-780.

Blair, J.C., McKay, A., Ridyard, C., Thornborough, K., Bedson, E., Peak, M., Didi, M., Annan, F., Gregory, J.W., Hughes, D.A. and Gamble, C., 2019. Continuous subcutaneous insulin infusion versus multiple daily injection regimens in children and young people at diagnosis of type 1 diabetes: pragmatic randomised controlled trial and economic evaluation. bmj, 365.

Cracowski, J.L. and Mathieu Molimard, V.R., 2020. Ultrafast response of the french society of pharmacology and therapeutics to the COVID-19 pandemic. Therapie, 75(4), p.317.

De Witt Jansen, B., Brazil, K., Passmore, P., Buchanan, H., Maxwell, D., McIlfactrick, S.J., Morgan, S.M., Watson, M. & Parsons, C., (2017). Nurses' experiences of pain management for people with advanced dementia approaching the end of life: a qualitative study. Journal of clinical nursing, 26(9-10),.1234-1244.

Doughty, K. N., Del Pilar, N. X., Audette, A., & Katz, D. L. (2017). Lifestyle medicine and the management of cardiovascular disease. Current cardiology reports, 19(11), 1-10.

Fang, J., Wang, L., Wu, T., Yang, C., Gao, L., Cai, H., Liu, J., Fang, S., Chen, Y., Tan, W. &Wang, Q., (2017). Network pharmacology-based study on the mechanism of action for herbal medicines in Alzheimer treatment. Journal of ethnopharmacology, 196,.281-292.

Garg, M., & Wray, C. M. (2020). Hospital medicine management in the time of COVID-19: preparing for a sprint and a marathon. J Hosp Med, 15(2020-05), 305-307.

Grammes, J., Küstner, E., Dapp, A., Hummel, M., Kämmer, J.C., Kubiak, T., Schütz‐Fuhrmann, I., Zimny, S., Bollow, E., Holl, R.W. and DPV initiative, 2020. Comparative characteristics of older people with type 1 diabetes treated with continuous subcutaneous insulin infusion or insulin injection therapy: data from the German/Austrian DPV registry. Diabetic Medicine, 37(5), pp.856-862.

Gupta, S., Bi, W. L., & Dunn, I. F. (2018). Medical management of meningioma in the era of precision medicine. Neurosurgical focus, 44(4), E3.

hong Sun, J., Sun, F., Yan, B., yi Li, J. & Li Xin, D., (2020). Data mining and systematic pharmacology to reveal the mechanisms of traditional Chinese medicine in Mycoplasma pneumoniae pneumonia treatment. Biomedicine & Pharmacotherapy, 125,.109900.

Hong, M., Li, S., Wang, N., Tan, H.Y., Cheung, F. & Feng, Y., (2017). A biomedical investigation of the hepatoprotective effect of radix salviae miltiorrhizae and network pharmacology-based prediction of the active compounds and molecular targets. International Journal of Molecular Sciences, 18(3),.620.

Hosseinkhani, A., Asadi, N., Pasalar, M., & Zarshenas, M. M. (2018). Traditional Persian Medicine and management of metabolic dysfunction in polycystic ovary syndrome. Journal of traditional and complementary medicine, 8(1), 17-23.

Hyde, A. J., May, B. H., Dong, L., Feng, M., Liu, S., Guo, X., ... & Xue, C. C. (2017). Herbal medicine for management of the behavioural and psychological symptoms of dementia (BPSD): a systematic review and meta-analysis. Journal of Psychopharmacology, 31(2), 169-183.

Malick, D., Baba, M.M.M.S. & Ziba, F.A., 2020. Performance of Pharmacist Pharmacologist versus Nurse Pharmacologist in teaching Nursing Pharmacology at the University for Development Studies, Tamale, Ghana: Nursing Students Perceptions.

Miotto, K., Cho, A.K., Khalil, M.A., Blanco, K., Sasaki, J.D. & Rawson, R., (2017). Trends in tramadol: pharmacology, metabolism, and misuse. Anesthesia & Analgesia, 124(1),.44-51.

Müller, T.D., Finan, B., Clemmensen, C., DiMarchi, R.D. & Tschöp, M.H., (2017). The new biology and pharmacology of glucagon. Physiological reviews, 97(2),.721-766.

Ng, P. C. Y., Long, B. J., Davis, W. T., Sessions, D. J., & Koyfman, A. (2018). Toxic alcohol diagnosis and management: an emergency medicine review. Internal and emergency medicine, 13(3), 375-383.

Pala, L., Dicembrini, I. and Mannucci, E., 2019. Continuous subcutaneous insulin infusion vs modern multiple injection regimens in type 1 diabetes: an updated meta-analysis of randomized clinical trials. Acta diabetologica, 56(9), pp.973-980.

Savoia, C., Volpe, M., Grassi, G., Borghi, C., Agabiti Rosei, E., & Touyz, R. M. (2017). Personalized medicine—a modern approach for the diagnosis and management of hypertension. Clinical Science, 131(22), 2671-2685.