Drug administration is one of the major roles of nurses.However,as I found out in the objective structured clinical examination given to us,it entails much more than simply giving a patient a pill.It is an aggregate of all the principles and skills we learn as nursing students…
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Drug administration is one of the major roles of nurses. However, as I found out in the objective structured clinical examination (OSCE) given to us, it entails much more than simply giving a patient a pill. It is an aggregate of all the principles and skills we learn as nursing students, and the application of theories into practice. In drug administration, we have to remember and practice patient safety, provide holistic and individualized patient care, have a solid foundation on knowledge about drugs and medication safety, and perform administration checks and documentation at all times. Much about the role of nurses in hospital can be learned from something as seemingly simple as a drug administration OSCE. Patient safety practices Patient safety is a crucial part of patient care. At all times, all health professionals should keep the safety of the patient in mind. Patient safety practices for drug administration begin at the first contact, from patient identification, patient education and information, patient contact, performance of procedures, to leaving the patient comfortable. One of the important principles in patient safety is infection control. Nosocomial or hospital-acquired infections are the most common complications affecting hospitalized patients today, and one of the major sources of infection is cross-infection by health care workers (Burke, 2003). Meaning, most patient obtain infection from the hands of those that are treating and caring for them. Most incidents that lead to infection can be prevented and one of the simplest ways to prevent this is by hand-washing. In the Guideline for Hand Hygiene in Health-Care Settings released by the Centres for Disease Control and Prevention (Boyce and Pittet, 2002), it is recommended that hand washing and hand antisepsis be done if hands are visibly dirty or contaminated. It should also be done before having direct contact with patients, before donning sterile gloves, after contact with a patient’s skin, after contact with body fluids or excretion and wound dressings, and before eating or after using the restroom. In all aspects of contact with the patient, hand hygiene must be done. The guideline further recommends that health care personnel should not wear artificial fingernails, should keep nail tips short, and should remove gloves after caring for a patient. Thus, before drug administration, and even before handling drugs and preparing them, hand washing must always be done. It should also be done after patient contact, and in between interaction with different patients. Verifying patient identity is another important aspect of patient safety, and not being able to do this could lead to adverse results. Omitting verbal verification of patients’ identity prior to administering medications may lead to a potential adverse event 20% of the time in worst case scenarios (Lisby, Nielsen, and Mainz, 2005). Even with the use of medication administration technologies such as bar code verification, effectiveness in preventing errors is largely dependent on how practitioners use the technology to verify patient identity and drug identity (Englebright and Franklin, 2005). Remediable causes of having the wrong patient include absent or misused protocols for patient identification and informed consent, faulty exchange of information among caregivers, and poorly functioning teams (Chassin and Becher, 2002). During my OSCE, I failed to check the identity of the patient with my mentor. I understand that failing to properly verify my patient’s identity could lead to adverse consequences, and will make sure to keep it in mind in future patient interactions. Doing a brief clinical history can also contribute to patient safety. It allows nurses and other medical personnel to be aware of the patient’s condition, comorbidities, present symptoms and level of comfort. Particularly relevant in drug administration is asking the patient about other drugs being taken and for any personal history or family history of
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