Legal, Ethical and Professional Practice Aspects of Nursing Drug Administration - Essay Example

Legal, Ethical and Professional Practice Aspects of Nursing Drug Administration The role of the professional nurse is to function autonomously and collaboratively in clinical settings geared towards achieving positive patient outcomes. The role of the nurse includes the assessment and management of patient using nursing knowledge and skills. Thus, the function of the nurse should be grounded in the nursing professional values, knowledge, theories and professional guidelines that determine the context within which the professional nurse should practice (Walsh , 2002; Guide to the Practical Legal Aspects for Nurse Practitioners, 2005:3). The safe and efficient administration of medication is one of the key responsibilities of the professional nurse. The practice of drug administration involves providing the patient with a substance prescribed and intended for the diagnosis, treatment, or prevention of a medical illness or condition (Hopkins, 1999). Although, effective drug administration involves the actual and complete conveyance of a prescribed medication to the patient, however, there is wider set of practices required to achieve safe, effective patient outcomes and to prepare for and evaluate the outcome of medication administration (Potter and Anne, 1997; Taylor et al, 1997). Because nurses administer prescribed drugs directly to patients, they happen to be the last link in the safe and effective drug prescription and administration sequence. Increased acuity of the patient nurses have to serve and the apparent reduction in the volume of resources available to nurses to ensure safe and effective practice, have greatly complicated the role of the nurse in drug administration (Cook, 2002). The purpose of this paper is therefore, to examine the legal, ethical and professional requirements of safe nursing drug administration. According to the NMC Guidelines for the Administration of Medicines, administration of medicines is a vital part of the professional duty of the nurse. It is not, however, a function that can be carried out ‘mechanically’ or following orders, but should be seen as a task that must be carried out in strict compliance with the written prescription of a medical practitioner. More importantly, it is task that requires thought and the exercise of professional judgement (NMC, 2002:3). Drug administration play a crucial role in achieving positive patient outcomes and despite the complexities involved with safely administering medications to patients, the professional nurse is duty-bound to do everything within her professional capacity to ensure this. The NMC code of professional conduct stipulates that the professional nurse should always act to identify and minimise risks to patients and clients. To ensure that this principle in upheld in drug administration, the nurse must act in accordance with, not only ethical and professional guidelines, but also be aware of the legal aspects of his/her actions (NMC, 2004). The NMC places great emphasis on accountable. It is a common saying that as a registered nurse, one is expected to give account and be accountable for every action or inaction (NMC, 2002: 4). In administering drug to patients and clients, therefore, the professional nurse is mandated to apply his/her knowledge and skills, as well as exercise professional judgement. The following sections examines the ethical, professional and legal scope of this professional judgement that the nurse must exercise in safely administering drugs to achieve positive patient outcomes and also to avoid medication errors that appears to be on the rise, lately (Dandry, 2004; Weston, 2002). Ethical Scope of Nurse Drug Administration To ensure safe and efficient administration of drugs to patients and clients, nurses must work in line with the guiding ethics of professional practice. First, the nurse must earn the trust and confidence of the patient, since they must respect the client as an individual, and seek consent before giving treatment or care (NMC, 2004). In this respect, communication is very important. Patients should be notified of the order for drug and also educated about the medication they are to receive (Potter and Anne, 1997; Dimond, 2005). With improved acuity of patients, effective communication between the nurse and the patient may aid the nurse in safe administration of drugs. Furthermore, before administering drugs on patients, five factors often referred to as the "Five Rights" of drug administration must be addressed. Right Patient: The professional nurse must be certain of the identity of the patient to whom the drug is to be administered. In this regard, it is important to definitely identify patients by name badge or bracelet. Simply asking the patients name or reading name on door may be insufficient Right Drug: The nurse should check records for the name of drug and compare with drug on hand, to ensure that what is been administered is the prescribed drug. Right Route: The drug labelling must be checked against the medication record for how to administer the drug, to ensure that the right route is followed. Right Dose: The ordered dose should be compared to dose on hand and when necessary, calculations should be done to ascertain the correct dose. Right Time: The nurse must ascertain that frequency or time ordered matches current time. Beside these five fundamental factors or "rights", the professional nurse is ethically bound to handle all medications in such a way that they do not come into contact with potentially contaminated objects or surfaces. Under no circumstances should medicines, of whatever sort, be left unattended. Also, patients should be observed when taking medications to ensure that the medications are actually taken and to prevent patient’s misdemeanour like: drug disposal, hoarding, abuse and/or misuse of medication, and to ensure the safety of the patient (NMC, 2002:4; Hauswirth, 2006). Professional Scope of Drug Administration Although, strictly working in accordance with the ethics and guidelines concerning drug administration is helpful, it cannot provide all the answers. Nurses still need to exercise their professional judgements. This use of professional judgements calls for responsibility and accountability on the part of the nurse (NMC, 2002). Responsibility refers to moral and professional obligation of the nurse to get a job done, and done properly. In this case, it implies safely administering drugs to the patient. Accountability, on the other hand, refers to being answerable and able to defend ones action, inactions and omissions (NMC, 2002; NMC 2004; Cook, 2002). Safe and efficient drug administration requires pre-administration preparation, aftercare and evaluation of medication effects. First, preparation for safe drug administration requires a background education. The patients should understand what they have to take and why. Earning the trust, confidence and cooperation of the patient/client will go along away in fostering professionalism on the part of the nurse. Furthermore, it is important to monitor and evaluate patients after drug administration for the desired effect and to document findings (Potter and Anne, 1997; Taylor et al, 1997). However, According to Cook (2002), the nurse also has to enforce certain rights to be able to uphold her professional responsibility when it comes to administering drugs. These include: The right to a complete and clearly written order. The drug, drug, dose, route and frequency are components of a safe and complete drug order and the nurse must demand that all these are written by the prescribing physician. The nurse also, must ensure that right and correct drug route and dose is dispensed by the pharmacist. Legal Scope of Drug Administration Accountability, records keeping and documentation are vital legal requirements. Each member of a healthcare team, specifically the nurse, in this sense, must be accountable for his/her actions. The nurse must be able to defend and offer explanations or rationalisations for her actions and inactions. Accountability also entails that nurse speak up when they observe situations that can potentially result in medication errors, such as wrong, incomplete or illegible drug orders or system glitches that might put the patients in danger. Furthermore, record keeping and documentation of drug administration is an important responsibility and also a legal requirement (NMC, 2002b). The medication record provides information about what substances the patient has received and when. Therefore, like other health records, it serves as a legal document. Although, the requirements for documentation varies from institutions to institutions, essentially, the initials of the administering nurse and the time and date should be documented on the record next to the appropriate order (Potter and Anne, 1997; Cook, 2002; Hauswirth, 2006). Conclusion Despite the fact that drug administration is often the responsibility of a single professional, the outcomes usually affect the objectives of a healthcare team. Thus, other members of the healthcare team play vital roles surrounding the medication administration process. For instance, doctors or other prescribing clinicians are responsible for writing clear, legible orders and for monitoring the response of the patient to medication. They are also responsible for responding to potential adverse effects and concerns by the patient or other clinicians. Pharmacists are responsible for evaluating the medication order for potential problems, correctly filling the order, and monitoring the medication supply. All health care professionals are responsible for complying with medication-related policies and guidelines designed to protect the patient and/or staff and for maintaining current knowledge regarding medication and medication administration. However, these guidelines relate most specifically to the nurse as she is the last link in the medication administration chance. Therefore, safe and effective drug administration entails working in strict accordance with professional, legal and ethical regulations guiding drug administration. 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