Medicine management is the practice of managing the routine in which medications are selected, purchased, transported, administered, prescribed, and reviewed, while incorporating agreed withdrawal and appropriate safety in order for the medicines to have the greatest impact in advancing treatment and healthcare (DH). According to Fullbrook-Scanlon, a nurse consultant, nurses are expected to dispense prescribed medications properly and to examine medications as part of the multidisciplinary panel. As a result, nurses are not involved in the practice of selecting, purchasing, or transporting drugs (Edwards and Axe 398). This essay shall hence delve in particularly discussing the responsibility and accountability of a registered nurse as pertains to medical management in order that a nurse transits to a registered nurse.
Aim of the Transition
The NMC (Nursing and Midwifery Council) identifies medicine management to be a significant aspect of the nurse’s task. Therefore, they have published a distinct guidance on the ethics which nurses are obliged to adhere to when occupied with the administration and management of medications (NMC). Administering medication comprises of the nurse’s professional and thoughtful judgement and is not merely a mechanical undertaking executed in accord to the commands on an inscribed prescription. A registered nurse, therefore, is necessitated to possess a certain level of skills and knowledge in correlation to medication management. The NMC issued medication management standards in 2008 that reminded the nurses of their responsibility to offer effective and safe care established in the best practice, current evidence and, where appropriate, a validated research.
Considerations for the Transition
In 2009, the Care Quality Commission presented the crucial standards of safety and quality. The presentation outlined the prerequisites for a nurse prescriber to achieve the necessities of the regulated activities depicted in the Health and Social Care Act of 2008 when overseeing medications (NMC). The standards entailed a necessity that the medications offered to service the patients be person-centred and relevant. Additionally, a nurse when administering and prescribing medication has to consider the patient’s lifestyle, allergies, age, conditions, disabilities and choice (Griffith 45). Consequently, annual or regular nurse updates should verify that the nurses occupy adequate medication administration competency, possess skills in drug calculation and pertinent theoretical knowledge (Edward and Axe, 403).
Analysis of Nurse Registration
Nurses have the task to safeguard the service users from risks accompanying the management of medications since managing medication is a standardised undertaking within the 2008 Health and Social Care Act (Griffith 45). Thus, the nurses have to monitor undesirable drug reactions experienced by the service users in their care. In 2008, the European Commission re-counted that undesirable drug reactions have become the fifth most widespread source of death in the hospital within the European Union (Griffith 45). Moreover, studies in the UK insinuate that 5% of the hospital admissions emerge from severe harmful drug reactions (Pirmohamed 460).
The National Prescribing Centre’s (NPC) outline exhibit competencies that are appropriate to every non-medical and medical prescriber. The medication is assigned with noble intention, yet the drugs are toxic to the user’s body and could be hazardous if oversights are made. The NPSA’s (National Patient Safety Authority) report illustrated that medication related oversights are experienced by every 1 in 10 patients. The NPSA also realised that 71% of the deadly and the severe detriment from medication events ensue from unclear prescriptions, drug omission, delayed medication, prescription of the wrong dosage, and prescription of the incorrect medication frequency
Registered nurses have well-defined professional standards which they have to adhere to as pertains to their occupational convention of conduct and medication management (NMC). Besides, there exist four fundamental areas of medication management where nurses have strategic responsibilities. These areas are prescription, dispensing and supply monitoring and administering, and medication review (Wright). Since the nurse is not supposed to thoughtlessly obey directives, they possess the right to reject a prescription, which integrates the right to decline to administer a prescribed drug. When a prescription is confusing, or has been inscribed incorrectly, or raises the nurse’s doubts regarding its legitimacy, then the nurse retains the right to decline or accept to administer the drug to the service user (Edwards and Axe 402).
Moreover, a nurse ought to carefully consider the 6 ‘R’s of administering drug when administering patient medication since these 6 R’s are still very vital (NMC). The 6 ‘R’s incorporate the right documentation, right medicine, right route and formulation, right dose, right time and right patient. Administering medication is a portion of the nurse’s task and has to be conducted in conformity to the 6 ‘R’s (Edwards and Axe 398). However, Elliott and Liu (303) maintain that the quality of administering medication or the manifestation of the medication oversights are not exclusively an issue of complying to the six ‘R’s. This is upheld by Jones (45) who affirms that utilisation of checklists like the six ‘R’s only partially addresses the issues linked to the sources of medication oversights.
Therefore, the six ‘R’s can thus be utilised in upholding medication management practices where they are appropriate. For instance, the occasions of medication insights conveyed to the NPSA reiterate many of the verdicts from the Francis article and they comprise of patients not receiving the correct medication, patients being aided in taking their medication, patients being unprogressively offered medication, inaccurate medication documentation, deficient keeping of medical records and the absence of a system to warrant best practice. Thus, the NMC urged the prescribing nurse that effective medication management is best achieved through effectual local and national procedures and policies, alongside a perpetual staff training within their area of occupation (Anguita 7).
In the article Standard for Competence by NMC (2015), it is specified that medicine administration should be evidence-based and nurses can decline or exclude a medication in accordance with the rigorous evidence-based practice. Yet, they can still be indicted of a medication oversight. Nonetheless, if a nurse excludes or forsakes to administer a drug or gives it at the imprecise time, then the nurse is positioned in a difficult setting since these incidences could constitute to a medication oversight. Besides, if the nurse declines to administer a medication on the basis of a misplaced prescription or if an unfitting preparation is to be provided then similarly a medication oversight could be constituted (Edwards and Axe, 403)
Action Plan
As a nurse who is transitioning to a registered nurse, it is vital to understand the situations that ensue to medication oversight and avoid them at all cost where applicable. In a scenario where I perceive that a medication oversight could occur, it would be wise to settle the matter by reporting any observed outcomes that could have ensued from medication oversight in order to protect the patient’s life on time. Additionally, I would ensure to put into practice that best nursing practice accompanied with the six ‘R’s where appropriate. Similarly, I could also attend continuous training to enable me to be ever competent in my duty as a registered nurse.
Conclusion
Drug administration is a sophisticated task and it necessitates clinical judgement prior to and during the preparation, instantaneously before and past administration. Thus, to transition to a registered nurse, one has to possess the pertinent drug calculation skills and theoretical knowledge which is core in medication management competencies.
Works Cited
Anguita, M. "Comments on The ESC Guidelines for The Management Of Acute Myocardial Infarction In Patients Presenting With ST-Segment Elevation." Revista Española de Cardiología (English Edition) 66.1 (2013): 5-11. Web.
DH. Department of health annual report 2007-2008. (2008). Web
Edwards, Sharon, and Sue Axe. "The 6 ‘R's of Safe Multidisciplinary Drug Administration." Nurse Prescribing 13.8 (2015): 398-406. Web.
Elliott, Malcolm, and Yisi Liu. "The Nine Rights of Medication Administration: An Overview." British Journal of Nursing 19.5 (2010): 300-305. Web.
Griffith, John R. Reaching Excellence in Healthcare Management. Chicago, Ill.: Health Administration Press, 2011. 45 Print.
Jones, Sara Wyn. "Reducing Medication Administration Errors in Nursing Practice." Nursing Standard 23.50 (2009): 40-46. Web.
Pirmohamed, M. "Adverse Drug Reactions as Cause of Admission To Hospital: Authors' Reply." BMJ 329.7463 (2004): 460-460. Web.
NMC Standard for Competence. (2015) Web
NPSA (National Patient Safety Authority). Safety in Doses: Medication incidences in the NHS. The Fourth report from the Patient Safety observatory. (2007). London: NPSA
Wright, Shelagh. Pain Management in Nursing Practice. Sage Publications Ltd, 2015. Print.
