Medication 6. 1

If a product does not comply with Health Canada's legislation or it is not safe for patients, that product is recalled. When we receive a recall from the manufacturer/ importer/ distributor I need to ensure that all products recalled are identified. I need to determine if other brands, lot numbers or sizes/ strengths are affected by this letter and then put everything away from the distribution to public. Also, I check to see if any of that product were given to our patients and then let them know about it. Then those products are either returned to the manufacturer or destroyed in an environmental manner.

The aim of this assignment is to demonstrate the use of safe and effective prescribing in practice. I will achieve this by presenting and analysing a prescribing scenario which I have encountered in my current area of practice within a District Nursing Team. During the case study the patient I have chosen will be referred to as Jean. This is to maintain her anonymity in line with the Nursing and Midwifery Council (2008) guidelines of confidentiality.

A physicians trained in pediatrics should be assigned and responsible for oversight of medication management.

Medications will be dispensed only when medically necessary (as determined by the administration staff ) and may include but are not limited to nebulizer EPL pens and inhalers. We do not dispense fever reducers pain relievers, cough suppressants antibiotics ear or eye drops or other medications which aid temporary conditions. One of the directors will administer medical lay necessary medications only upon written authorization from parents and proper health care treatment plan from and authorization from the child’s physician. Children are not allowed to keep medications in there backpacks or cubbies. It is at the discretion of the administration as to what is deemed medically necessary

Pediatric patients specifically have a propensity to be exceptionally soft to most medications, from this time they need to figure the bigger percentage of their pharmaceutical doses by weight. The minimum erroneous conclusion could prompt an unfriendly medication impact. More grown-up this is including the elderly, then again, are limited to, numerous doctor prescribed medications for their endless sicknesses which require examination to hold away from contraindications. On the other hand, paying little mind to whether the patient might be at danger of encountering a pharmaceutical mistake or not, all drug organizations should in a perfect world take after the "seven rights" which incorporate "the right patient, right prescription, right measurement, opportune time, right course, right reason, and right documentation". (Bonsall,

Negative reinforcement by instilling fear to comply is unethical and if a patient refuses treatment after information giving this must be accepted (Haynes et al. 2002:2881). Documentation is a vital tool to protect health professionals in this situation (Loveridge 2005:19). The promotion of concordance must be within a framework of health promotion as medication compliance is a learned response in health management and self-efficacy (Embrey 2006:510).

Dimond (2009) and NHS choices (2016) explained consent as the process involving a person giving their approval to accept or refuse a treatment or interventions, after receiving detailed information from a health care professional about the risk or benefits of the procedure. In order for consent to be deemed valid, it needs to be given voluntarily without any influence or pressure from either a family member or clinician. In addition, the capacity of the person is important when giving consent and the ability to process the given information and make a decision. Tingle &Cribb (2014) agree, emphasizing that the autonomy of the person giving

According to Kanneh, six “rights” of medication administration need to be implemented with every patient. Drugs are not always one hundred percent safe, but observing the six rights will make administration safer (Kanneh, 2011). These rights include the right person, drug, dosage, time, route, and documentation (Kanneh, 2011). It is more likely for an adverse reaction to occur if a drug is given to the wrong patient because of his or her own allergies and appropriate age of a child for a dose needs to be taken into consideration (Kanneh, 2011). A child’s age is important because metabolism of drugs is different for each year of childhood (Kanneh, 2011).

According to the Food and Drug Administration (FDA 2009), the wrong route of administrating medication accounts for 1.3 million injuries each year. An article published in September issue of the Journal of Patient Safety estimates there are between 210,000 and 400,000 deaths per year associated with medical errors. This makes medical errors the third leading cause of deaths in the United States, behind that comes heart disease and cancer. To prevent medical errors always follow the Three Checks and most importantly the Rights of Medication Administration. The “Rights of Medication Administration” helps to ensure accuracy when administering medication to a patient. When administering medication the administer should ensure they have the Right Medication, Right Patient, Right Dosage, Right Route, Right Time, Right Route, Right Reason, and Right Documentation. Also remember the patient has the right to refuse, assess patient for pain, and always assess the patient for signs of effects.

The problem that the community is experiencing related to medication administration is that there is no system that can be used to check the medication before administering except the RNs and LPNs themselves. Staff members are using picture of patients in the system as a way to identify patients before administering medications. They do not have barcode reader to alert them when they are about to administer wrong medications. The community is aware of this problem and started to use the same process except that the medication is checked by three nurses instead of two after entering the information into the system.

9) Administration and Control of Medicines in Care Homes and Children’s Services June 2003, and

In order for medications to be administered in school, the appropriate Medication Administration Form must be completed by the physician and parent. (i.e. Asthma, Allergies, Non-Asthma/Non-Allergy). Once the form is submitted and accepted, the parent may provide a NEW, UNOPENED bottle or package of medication with the pharmacy label attached. Open or used medications without labels will not be accepted. Medications submitted to the medical room will be kept in a locked drawer and cannot go back and forth between school and home. Please notify your child’s physician or pharmacist if you will need a supply of medication for in school and at home.

lives with her daughter, her daughter is able to supervise and remind her to take her medications at the correct times and at scheduled intervals. As a nurse, I suggested that they obtain a medication container that could be set up for the week and it would be easier for the patient and family to know that the medication was taken appropriately. Studies have shown that by using a medication organizer, it was easier to keep track of medications and reduce the chances of missing a dose (Modig, Kristensson, Troein, Brorsson, & Midlov, 2012). I explained to them it was like double checking each other as a safe-guard. The family agreed to purchase a medication container. I also informed Ms J.B. and her family of some of the side effects of her medications, such as dry mouth, possible dizziness, and chances of falls due to narcotics, to name a few. Although both the senior and her family knew of the risk of falls due to narcotic effects, they did not realize that dry mouth can occur with some of her medications, which she states she sometimes

While the confidentiality of the patients is important the privacy and dignity of patients still in the hospital is also of equal significance. The GOSH Privacy and confidentiality policy states that a patients treatment should be ‘based on the clinical, psychological and social needs of the individual child and young person. They should not be based on the constraints of the environment or the convenience of staff.’ This insures that staff listen to what the patient needs to say e.g. a child might feel more comfortable residing in a bed close to his/her own age group (6.2). Some patients might prefer the use of specific equipment that makes them feel more comfortable (6.6). In my case I respected a patient’s dignity when making my sample collection runs from SAFARI and THEARTE 2. This was done by always sticking to the provided routes through the hospital, preventing me from intruding into other wards which might contain distressed patients

The principles of confidentiality for children and young people apply the same as for adults. The respect for patient's confidentiality is the same regardless of the age and is highly important for patients, especially young people to have their information protected as they may not seek for help or may provide partly true or incorrect information. Patient's consent is vital prior disclosing information that could identify them; the disclosure of information must me minimum and if does occur needs to be only to achieve the purpose of the disclosure, otherwise the information must be anonymise before disclosing it; the patient must be informed that sharing information is for the care and treatment purposes.