Standard of Care - Assignment Example

?STANDARD OF CARE Standard of Care Word Count 850 (7 pages Identify the regulations concerning venipuncture, drug administration, and IV medication and how these standards in your field. Explain the possible repercussions that could arise when these standards are violated. How do the standards apply to ancillary health care professionals? ? Possible repercussions that could arise when standards are violated include: wrongly punctured veins, in venipuncture; overdoses in medication levels; and improper drip rates on the IV medications. The standards apply to ancillary health care professionals as well, because, even if they are simply a support system, these people too also need to know how to properly draw blood, administer drugs (if applicable), and start and maintain an IV drip. (2) Explain the repercussions that could arise from violating these standards. The repercussions that could arise from violating these standards include, for venipuncture: the patient could bleed to death; the needle might introduce a fatal bubble into the bloodstream; and the needle could be contaminated with a virus like MRSA or HIV. Other repercussions, from poor medication management, could include: overdoses; possible drug interactions;?the patient finding out he or she is allergic to something; and other various medication issues stemming from mismanagement of the prescription drugs. Also, someone who does not properly know how to hook up a canula for an IV may be putting the patient at risk. Also, the drip of the IV must be on a specific timing so that too much medicine does not enter the patient’s body at once. Also, another possible IV issue is that the patient could have a bubble introduced into his or her bloodstream. (3) What are the responsibilities of a person in your health care position during a code arrest? The responsibilities of the person in my health care position during a code arrest would be to respond to the code in an appropriate manner. For example, it is common knowledge that “Code Blue,” for example, means there is a patient who is having a cardiac arrest. It is important for codes to be uniform across hospitals because, if staff happen to transfer from one hospital to another, it is important that a Code Blue in one hospital would mean the same thing even in a totally different hospital. (4) Discuss the repercussions that could arise, both for the patient and you, in regards to injection of contrast media. ?? Repercussions with the advent of contrast media could be severe for the patient. The patient might begin to have an interaction should he or she be receiving ink within the blood to have the patient’s innards show up on an imaging technology. The injections could not only prove to be only annoying or beginning a reaction, but the injections could also prove fatal if the patient had a very severe reaction and the injection was not stopped before the interaction progressed to the point where the patient was having a very bad reaction—whether it be due to certain medications the patient was on or other concomitant factors. (5) Explain the organization of the information supplied in the Physicians Desk Reference (PDR). ?? The Physicians’ Desk Reference, or PDR, is basically a book that lists all of the medications that are administered today. One must, however, have the most recent copy of it, which is most relevant—because new medications are put on the market every year. The organization of the information in the PDR is generally just placed in alphabetical order. Usually, the generic and brand names are both listed in the book, but you just might have to look up the generic name instead of the brand name. It really depends upon what year of the PDR one is looking at, per se. (6) What are the benefits of physicians using PDRs in ordering prescriptions for their patients? ?? The benefit of physicians using PDRs in ordering prescriptions for their patients is helpful, but not necessarily recommended. When a doctor is making out a prescription, he or she should carefully note if he or she has to use the PDR while actually making out prescriptions. The doctor should already know potential drug interactions and should not have to look at his or her copy of the PDR unless prescribing a new drug to see if it would interact with any particular medication that the patient is already taking now. (7) Compare the ratings of addictive drugs on the controlled drug standard. Give an example of each category. ?? Some addictive drugs include: prescription narcotics, cough medications, tranquilizers, sedatives, soma, amphetamines, OTC (over-the-counter) meds, and oxycontin. There are five schedules of addictive drugs (Schedule I, II, III, IV, and V) in the U.S. Schedule I are the drugs that have the most highly-addictive attributes—and these drugs are most likely often the ones being abused. Schedule I includes the illegal substance of heroin, which is very addictive. A controlled substance in Schedule I includes GHB and weak opioids. A Schedule II drug would be morphine. A Schedule III drug would be Marinol. Schedule IV includes Benodiazepines. A Schedule V drugs include codeine. These are just examples to demonstrate the type of dependency that could result from these medications. (8) What are some reasons the imaging professional should chart carefully? In which ways is charting accomplished? ?? Imaging professionals should chart carefully because, if it is not done correctly, it could potentially affect the health—and ultimately life—of the patient. Ways in which charting is accomplished include: either physically writing down items on the patient’s chart; or also alternatively, doing the charting by computer and then having a printout put on the clipboard at the end of the patient’s bed. Some charting is done completely by computer nowadays, so it really depends upon the hospital or the health care organization. (9) Which examinations require charting and how is this done? ? All examinations require some form of charting. This is done either manually by the doctors, staff, and/or nurses. Most times, charting is completed on EMRs, or electronic medical records, which are basically electronic forms of charting. This is kept online in databases within a hospital’s other online records, usually only accessible by reliable and authorized medical personnel. ii) Topic: There are many ethical and moral decisions to be made when drugs are available in a health care facility. As a department manager, develop a set of procedures and protocols regarding the handling, storing, and monitoring of drugs. Be sure to include generic drugs, controlled drugs, and all charting that may be necessary. Apply your policies to Deanna, an employer who takes anti-inflammatory drugs home for her personal use. ? Procedures and protocols which would be followed for generic drugs, controlled drugs, and charting for the application to Deanna’s case will follow. Rx Drug Procedure Protocol Application to Deanna’s Case Generic The drug is prescribed PRN for OTC medications—no prescription is needed for OTC drugs. Generic drugs need a prescription. There is no need for a prescription (Rx) if the drug is OTC; for any medications not OTC, a prescription is required for generics. Refills are optional. Deanna is to take the anti-inflammatory drug (most likely an NSAID), not requiring a prescription—unless it is for a specific strength not offered by OTC meds. Controlled The drug needs a prescription with a DEA number. Prescriptions are assigned by the doctor. n/a Charting Charting is needed to be fulfilled for every patient. The doctor reviews the charting and periodically makes updates once the patient is seen. The doctor will probably tell Deanna how many times to take the medication per day, and will write it down in her charting/medical records. Usually NSAIDs are not good to stay on for a prolonged period of time. I. Introduction It is so important that there are proper procedures and policies in place including controls concerning Deanna’s medications which are NSAIDs. II. Procedures Proper procedures for dispensing medications should be followed in a hospital setting. According to Pollack, Elling, and Elling (2008), “[One should] [m]onitor the patient's condition, and document the medication given, route, time of administration, and response…” (pp. 23). The procedures are important for establishing when medication can be given, how it is given, and what the patient’s response is to the medication. Basically, the procedures should always be followed to the letter every time in order to ensure the safety of each patient. According to Padesky and Greenberger (1995), “Nursing staff fulfill multiple roles in a hospital and meet with patients in community meetings, for medication dispensation, to encourage patients to attend daily scheduled activities, and for individual sessions” (pp. 237). Basically, nursing staff are responsible for following the same procedures that everyone else must follow when dispensing medication—“everyone else” being the doctors on staff. What is most important is that the medications be dispensed according to DEA guidelines, rules, and regulations. III. Policies Policies regarding medications should be the following. First of all, no medications can be dispensed without the express consent of the doctor’s orders. Thus, for example, a nurse may dispense any kind of medication as long as she knows it has been approved for dispensation (at some point) by the doctor in advance. For example, if a patient were to come to the nurse’s desk at night and ask for some Ativan, it is within the nurse’s power and control to dispense the Ativan as a sleep aid as long as it has been approved by the doctor in advance for sleeping aids. In Deanna’s particular case, the policies concerning the control of NSAIDs are special because prolonged use can be bad for the patient. In consideration of this, Deanna should be limited to various amounts of prescriptions or recommendations for taking NSAIDs such as Ibuprofen (one of the more common ones). IV. Controls Concerning Deanna Deanna basically needs to make sure that she doesn’t take too many NSAIDs within a short period of time. If she has COPD, she should make sure that the NSAID does not interact with her bronchodilator medications as these can interact negatively. Various medications can be used. Short-acting bronchodilators may be used—including the beta agonist and anticholergenic medications. Ther will relieve any shortness of breath that Deanna experiences. Deanna’s situation is special because sshe may have a worsening of her symptoms due to her extensive smoking habit every day. Thus, an inhaled corticosteroid will probably be prescribed for Deanna which will help relieve her symptoms considerably. From the provided scenario, some general information has been obtained about the client, however, further health assessment is need by the nurse practitioner in order to assess and evaluate the client's need as well as developing an appropriate care plan. Though the underlying causes of COPD are understood considerably well, there are some factors that might trigger a coughing fit in a COPD patient. The following factors are known to be triggers of COPD: viral infection, exercise, exposure to allergens (dust, pollens, mould spores, animal dander), irritants (such as tobacco smoke, air pollution, food additives), occupational exposure if irritants, and fumes and dust—and, in addition, very possibly NSAIDs. V. Conclusion In conclusion, the procedures, policies, and ultimate controls concerning Deanna have a lot to do with how well people manage patients’ medications. So, a lot of the important decisions fall on the shoulders of doctors as well as nurses. It is only with much careful consideration and contemplation that doctors and nurses must take into account what are the proper limitations that must be considered when prescribing or, respectively, dispensing medication to patients. It is only with the greatest of care that these decisions should be taken into account. Hopefully, with the guidance of good doctors and nurses, it only makes sense that patients should be able to feel secure in their own environments, knowing that substances are properly controlled around them. If patients feel insecure about their environments because drugs are not properly controlled, this will be the downfall of a healthcare organization. It is with the careful planning and proper controls on medication that these differing situations can be kept under control, of course by having rigorous and stringent policies in place which control such situations. It is very important that all of these elements work in conjunction with each other in order to form organized healthcare organizations. REFERENCES Jensen, S., & Peppers, M. (2006). Pharmacology and drug administration for imaging technologists (2nd ed.). St. Louis, MO: Mosby. ?? Padesky, C.A. & Greenberger, D. (1995). Clinician’s guide to mind over mood. US: Guilford Press. PDR Health. (2007). PDR family guide to prescription drugs. Retrieved 3 December 2011. Available: . Pollack, A.N., Elling, B., & Elling, K. (2008). Pharmacology applications. US: Jones & Bartlett Publishers. World class health care where you live. (2011). Available: . Read More