CNP 5 2019 – Assessment: Critical Self-Reflection

Key Principles:

1. Be careful when preparing medicines. Avoid distractions. Some agencies have an uninterrupted area (NIZ), where health care providers can administer medication without interruption.
2. Examine allergies. Always ask the patient about allergies, types of reactions, and magnitude of reactions.
3. Always use two patient identifiers. Always follow patient policy identification policy. Use at least two patient identifiers before administration and compare with MAR.
4. Testing comes before medication. All medications need to be tested (laboratory reviews, pain, respiratory tests, heart tests, etc.) before taking medication to ensure that the patient is receiving the right medication for the right reason.
5. Be diligent in all drug statistics. Medication errors errors have contributed to dose errors, especially when adjusting or removing doses.
6. Avoid relying on memory; use checklists and memory aids. Memory slips are caused by a lack of attention, fatigue, confusion. Mistakes are often called attention-grabbing behaviors when a lack of training or knowledge is the cause of a mistake. Slips cause a lot of mistakes in heath care. If possible, follow a general list of steps for every patient.
7. Consult your patient before and after administration. Provide information to the patient about the medication before giving it. Answer questions about usage, dosage, and special considerations. Give the patient a chance to ask questions. Include family members if appropriate.
8. Avoid workarounds. Workaround is a process that goes beyond a process, policy, or problem in a system. For example, a nurse may “borrow” medicine from another patient while waiting for an order to be completed at a pharmacy. These practices fail to follow agency policy to ensure safe drug procedures.
9. Make sure the medicine is not out of date. Medication may not work if it expires.
10. Always specify a vague order or procedure. Always ask for help whenever you are unsure or uncertain about an order. Contact a pharmacist, nurse, or other health care provider and make sure you resolve all questions before continuing with medication.
11. Use available technology to provide medication. Barcode scanning (eMAR) decreased handling errors by 51%, and computer prescription instructions decreased errors by 81%. Technology has the power to help reduce mistakes. Use technology when giving medicines but be aware of technological mistakes.
12. Report all missed missions, errors, and negative reactions. Reporting allows for the analysis and identification of potential errors, which can lead to the development and sharing of secure patient information.
13. Be aware of situations that are prone to side effects and caution medications. Cautionary medications are those that can cause serious harm, even when used as intended. The most common over-the-counter medications are anticoagulants, narcotics and opiates, insulin, and sedatives. The types of injuries commonly associated with these medications include hypotension, delirium, bleeding, hypoglycemia, bradycardia, and fatigue.
14. If a patient asks or expresses concern about a drug, stop and do not give it. If the patient asks for medication, stop and check the patient’s concerns, review the doctor’s instructions, and, if necessary, inform the physician in charge.

Medication Errors: Some of the factors associated with medication errors include the following:

Medicines with the same names or packages

Rarely used or prescribed drugs

The most commonly used medications for most patients with allergies (e.g., antibiotics, opiates, and anti-inflammatory drugs)

Medications that need to be tested to ensure appropriate treatment levels (i.e., non-toxic) are maintained (e.g., lithium, warfarin, theophylline, and digoxin).

Conclusion:

There is a large and growing body of research that discusses the safety of medicines in health care. These books cover the severity of the drug side effects and adverse drug reactions, the stages of the drug risk-taking process, and the threats all that causes patients. As this list goes on, the fact that there are important places that we know very little about becomes clear. Nurses are heavily involved in the administration of medicine, although they provide an important function in detecting and preventing errors that occur in the determining, recording, and distribution stages. Management errors cover a large portion of all errors but, apart from that fact, little is known about the causes or effectiveness of the proposed solutions. Research dealing with the complex process of drug use in hospitals is desperately needed and requires a new way to generate factual information from studies conducted in the field with minimal control over confusing factors.

Reference:Patient Safety Competency Framework (PSCF) Standards (2017).