Patient safety is a nurse’s first concern and should never be assumed (Lundy & Janes, 2009). Usually, laxity, ignorance, and forgetfulness on the side of a nurse amount to negligence (Lucy and Locke, 2001). There are many issues that surround the day-to-day activities of a nurse. According to MarCathy (2009), these issues affect the interaction between the nurse and the patient. One of these issues and which is discussed in this essay is unsafe medicine use.
From a general perspective, unsafe medicine use relates to dispensation of the wrong prescription to a patient or the right medication in the wrong dosage (Lundy & Janes, 2009). This mishap may emanate from distinct anomalies on either the part of the nurse or the patient. One of the common mistakes is when a patient moves from one bed to another causing confusion. According to Lucy and Locke (2001), a nurse may get involved in unsafe medicine administration due to the wrong labeling of drugs. These could be drugs in basins, cups, syringes or other storage devices. They further assert that it may also result from brand confusion. This occurs due to the lofty number of medications in the market with an almost similar brand or generic names and packaging. To enhance patients’ safety, a nurse has the obligation to identify keenly every medication before administering it to the patient (MarCathy, 2009). This must include reading the labels keenly and seeking assistance when not sure, with a new patient, or upon taking over a new shift.
Another vital aspect of unsafe medication use involves a situation where a nurse gives additional medication that conflicts with the current ones (Lundy & Janes, 2009). This could be detrimental to the nurse’s career and sometimes may be fatal to the patient. This occurs when the patient deteriorates in sickness suddenly and the nurse has to give other medication to bring the patient’s condition under control. It also occurs when a nurse is not keen or the patient moves from one hospital to another and does not divulge the fact that he had been treated elsewhere (Lucy & Locke, 2001). The best thing for a nurse to do in such cases is to ask professional questions in order to get as much information as possible from the patient.
Unsafe use of medication also occurs when open communication is not fostered (Lundy & Janes, 2009). This is when there is a communication breakdown amongst the doctors, nurses, and other healthcare operatives. Doctors must give in-depth advice to nurses on specific patients’ prescriptions and conditions. This is what led the Institute of Medicine (USA) in 2004 to incorporate the Crew Resource Management (CRM) program into nursing, as used in the airline industry (MarCathy, 2009). This model emanated from the fact that good communication between the pilot and the crew members significantly reduced human-error-related airplane accidents by thirty percent. With such a line of thought, nurses are challenged yet empowered to transform their practice for the better. This in turn enhances patients’ safety.
To avert wrong medication use, it would be vital to have an efficient Rapid Response System (RRS) and team (MarCathy, 2009). This is called upon when emergencies occur and saving the patient’s life is non-negotiable. MarCathy underscores the need to operate the team by customizing a free toolkit he calls “TeamSTEPPS” (Team Strategies and Tools to Enhance Performance and Patient Safety). Regardless of the ward, a nurse operates in, whether Intensive Care Unit (ICU), general wards or community healthcare service centers, the toolkit can be customized to forge a way in which urgent information can be passed to the right people who must be ready to act quickly at that particular time. This ensures that there is always a doctor and a number of nurses, on or off duty, who have been alerted to remain ready for any emergency. It also ensures that that is the quickest way to inform them which they cannot ignore, for example, a line number which will signify emergency to the recipient medical practitioner.
It is also very significant to have excellent hospital design principles (MarCathy, 2009). This ensures that patients’ wards and washrooms are always observable by the nurses with ease. The nurses’ rooms should be decentralized meaning they should be located as close to the wards as possible. With such a hospital design, it is easy to reach patients and also be accessed by the doctors on duty. Where applicable, security cameras also play a key role so that patients can be observed to prevent them from taking overdose medication in suicide attempts or when trying to discard them (Lundy & Janes, 2009). These should not be spy cameras but should be observable by all including the patients-who should also be advised it is for their own safety not a restriction of privacy. They also play a supervisory role to the nurses. Nurses who know they are always under administrative observation tend to work more professionally. It instills discipline. In any case, the profession does not allow otherwise.
It is advisable to have customized hospital discharge of every patient (MarCathy, 2009). Nurses should ensure there is an easy plan to follow when the patient leaves the hospital. The information given to each patient should be in-depth but to the patient’s comprehension. It should include future medical visits to the hospital, a direct contact person in the hospital, and timely prescriptions of the medication given to the patient while leaving. Upon leaving the hospital, the nurse should have contacts of the patient for easy follow-up and names of other people who are responsible for the convalescent patient. This averts readmissions by a third (Lundy & Janes, 2009).
There are chances when the right medication is given to the right patient but fails to meet its intention. According to Lucy and Locke (2001), such cases may be brought in by nurses’ poor personal hygiene. Washing and sanitizing hands before coming into contact with the patient or touching his medication is paramount. There is a strong indication that health-care oriented infections have become serious medical complications in many hospitals. These infections have been associated with an annual death rate of about 100,000 with an estimated cost of not less than $20 billion globally (Lucy and Locke, 2001). The greatest infection is methicillin-resistant Staphylococcus aureus (MRSA). Hence ensuring proper personal hygiene near an already disease-weakened patient is most vital.
Nurses must be keen to eschew giving patients the leeway to access drugs that can be abused with time (Lundy & Janes, 2009). Many drug prescriptions fall in this category including some usually “non-harmful” ones like pain relievers. When some patients realize they can avoid pain by sleeping well after taking them, they become more susceptible to abusing the drugs. This may start as a correct medical step but when it extends to daily uncontrolled use, addiction may be the result. Nurses must ensure that such drugs are only given in the right dosage, at the right time and should never be left in a patient’s drawer because they are “un-harmful.”
Overall, unsafe medication use is not only a within-hospital ordeal but also an over-the-counter or chemist nightmare (Lundy & Janes, 2009). It has affected many patients and nurses universally to the extent it can no longer be overlooked. It costs both life and career hence affecting negatively the render and the recipient (MarCathy, 2009). Nurses fail by not being keen when giving drugs, giving medication at the wrong time, giving it to the wrong patient, general negligence and having poor personal hygiene. Patients fail by overdosing deliberately or otherwise, missing to take it when advised or missing to completely, self-prescription which -with some drugs- may turn addictive, and taking other patients’ medication after deducing that might be suffering from a similar malady. Though patients are to blame to some extent, every professional nurse must be keen and devise proficient ways to prevent or counter unsafe medication use to the most optimal level.
References
Lucy, C. & Locke, D.W. (2001). Contemporary challenges facing nurses; a look at nursing homes in the United States. New York: County Press.
Lundy, K. S., & Janes, S. (2009). Community health nursing: caring for the public’s health. Sudbury, Mass: Jones and Bartlett Publishers.
Marcathy M. (2009). Hospital Administration and its Challenges. Nursing Journal, 46, 15-32.