GCNCP3 Clinical Project Assignment Sample 1

Introduction to Medicines

Medicines are one of the common means of treatment modality, commonly practiced and used in healthcare settings (Gyasi, 2017). The main aim to use medication is to bring about a relive in the ongoing signs and symptoms of the patient. It although, in multiple incidences has been associated with harm as well. There is also an increased incidence of adverse reactions with administration of these drugs and also multiple errors are observed with their administration, during various interventions. Some of these incidences have caused more harm to an individual than carrying out good to them. Australian community on safety and quality in healthcare has therefore developed medication safety standards to regularize and monitor the same (Gilbert, 2017).The main target of this standard is to ensure that utter safety is observed by the clinicians, during prescribing medications, dispersing these medications to the patient population and administering these drugs through proper channels. The use of these drugs is also monitored through the means of this standard. The standard also ensures that the consumers are well aware about the risks and harms of medications taken by them and are dully infirmed about the details of the same, before being administered to them. The following research will analyse for the various points if strength and weakness faced by the medical staff in managing this standard in patient population. The study will also reflect in the various fruitful gals and strategies that can be implemented to ensure that the medication safety standard is followed and implemented in its full capacity.

Learning Objectives of Clinical Project 

The main objectives that will be pondered upon in this study will include:

• Having an overall insight about the medication safety and its importance.
• To encourage the staff involved in the process to learn and improve on the existing practises on drug safety.
• To develop better and enhanced means of ensuring safety while administering the medications to the patients.

The above-mentioned goals can be attained by the help of following measures:

• Having a complete and comprehensive knowledge about the standard of medication safety and its guidelines to be followed by the medical staff.
• Understanding and evaluating the incidences of medication error in healthcare settings.
• Understanding the attitudes of the patients in respect with the medication administration and the adherence and non-adherence of the medication. Analysing for the factors that control the adherence and non-adherence in patients regarding their medication.
• Helping in identifying the errors and duly reporting it to the authorities involved in the process.
• Understanding the means by which medication administration can be made safe for the patient population.
• Evaluating the role of multidisciplinary approach in ensuring medication safety is maintained at all times (Copeland, 2018).

Medication Safety Problem

Medications is the most common form of treatment means used commonly in healthcare practises, all around the world. Wherever these interventions are used in a methodical approach they can contribute largely in fetching better healthcare outcomes in patients (Pevnick, 2016). Safety assurance while drug administration can contribute significantly to the overall improvement in the healthcare status of an individual. Despite best efforts from the various healthcare professionals there has been an increase in the number of incidents reported, due to unsafe administration of drugs to the patients. Medication safety is however, a means to prevent these incidences from occurring and ensuring no harm caused during administration of the drug. It also ensures to keep the patient and their family in close loop, before administration of drug, so that they are well aware, not only about the drug but about the various contraindications that can be caused by intake of the same (Roughead, 2016).

The standards of medication safety also ensure that the healthcare outcomes are not impacted and there is a drastic reduction in length of stay in the hospitals, reduced re-admissions to the hospital facilities and thus, decreasing the overall cost involved in management of these diseases (Mickelson, 2018). The main issue regarding medication safety is the misunderstanding of the use of different terms used to define the same. Medication safety may comprise of both factors of medication errors and adverse drug reactions, but these two terms don’t make a clear distinction in explaining the term of medication safety cumulatively. There is however, a direct link between the errors in medications, as it may lead to adverse drug reaction in individuals.

Reflection on Medication Safety

Providing patients with medications to the patients is integral part of the daily routine of nurses. Before giving any medication to the patient it is the responsibility of the nursing professional to understand as to why the patient is being given the particular drug. The medications prescribed should be in sync with the patient’s diagnosis and clinical signs and symptoms as well. There is also a dire need of prior assessment, before prescribing medication to the patient as it enables a nurse to know for the potential harms it can cause to the patient. It is also imperative to note for any side-effects post administration of drug to report the same within the given window time, so that the same can be dealt with appropriately. Studies have show that to minimize this error the use of electronic medicines dispensers have fetched great results (Nakrem, 2018). However, the system that manages the same needs to be closely monitored in order to reduce any chance of medication error. Identification of the patient as per the doctor’s prescription is also important to make sure that accuracy is maintained while drug prescription. The patient should also be informed about the side-effects, uses and harm of the drug that is to be provided to them for the purpose of their treatment.

There is an increased pressure on the nursing staff to ensure that drugs are administered to the patient with due safety. There are multiple factors that can cause medications errors in a healthcare setting. There can be a system error in dispensing wrong medication to the patient on time. The nurses also work in shift that are of longer durations and thus, chances of errors of drug administration in such incidences increases by multiple fold. There are patient related factors as well such as non-adherence to medication and overdosing of drugs. Non-adherence to drugs is manly observed in patients that are suffering from chronic illness. As these patients are having multiple comorbidities, they are on multiple drugs to take in a day to manage their diseases. This might cause reluctancy in these patients to take their drugs, prescribed for their particular illness. Some of the patients also don’t believe much in the effectiveness of the drug and thus, might not take their medications religiously. Drug overdosing can be observed mostly in patients effected from mental illness, as they have a constant perception of considering the drugs as a final resort to treat their ailments (Cochran, 2017). It the role of the nurse to minimize the myths and misconceptions related to drugs and their administration in the patient population. They should themselves be well-aware of the side-effects and effects of giving a particular medication to the patient. Before providing the concerning patient with the required dose, patient should be ensured about all the possible outcomes that can be derived from drug administration.

As a nursing professional, the staff should adhere to all guidelines before and after medication dispersion. The details of the patients should be reviewed and re-reviewed if and when required. The drug should be prescribed post-duly checking for all the required details. The administration should also be ensured to take place under guided supervision, especially for nurses who are new to this field of work and might have a little lesser knowledge regarding dosage and drug administration, in comparison to their counterparts. The process will largely make sure that accuracy is also maintained during medication administration. The drug dosage charts can also be provided to the medical professionals engaged in this field of work, in order to reduce the time required in analysing the dosage and promotion of effective medical management to the patient, attained at a higher speed. Patient prior medication history should also be closely monitored, especially in the cases where patient is suffering from multiple comorbidities. This will also help in reducing the instances of adverse drug reactions, due to overlapping of multiple drugs and its effects taken by the patient (Alomari, 2018).

It is also a part of nurse’s duty to handle the patient’s with respect with their cultural beliefs and practices. It is imperative for a nurse to be prepared before-hand before conducting for thorough evaluation before carrying out any intervention so that the chances of any potential errors can be minimized by multiple folds. There are certain modalities that can help the nursing professionals in ensuring medication safety. These include monitoring the dosages for medications as per standard doses mentioned in the chart. This check will ensure safety of drug administered to the patient. Check list can be used to monitor for any deviation of the clinical signs and symptoms of the patient, both before and after administration of the drug. Noting for all the medications in the chart will also help the nurse sin providing effective handovers and will thus, minimize the error chance and improve medication safety in individuals. The younger professionals can also take the assistance of senior staff in cross-checking of the drug before it’s administration to the patient. This will also help not only the nursing staff, but other healthcare workers involved in the process, to provide the patient with the holistic care, through multidisciplinary approach.

To have a successful medication process, it is crucial for the nurse to work in close coordination with the healthcare team members and should be encouraged to work in sync with doctors as well. Administration of the drug mainly requires confidence and courage to approach the patient to impart the required knowledge to him. The skills and knowledge sets should be groomed enough in order to provide the answers to all questions put up by the patients, regarding their ailment and the medication taken by them for the same. The effective medical management can be done only by following instruction closely and creating a communicative environment between the patient and the nursing staff (Huckels, 2017).

The action plan should include the following in order to make sure that medication safety is maintained at all times. While prescribing and administering drugs to the patients.

• A friendly and mutual environment should be created with the patients. This will promote the patient to not only have confidence in the care giving team, but will also ensure equal participation from the patient’s end.
• Making use of medication charts for reference ranges can be another method to regularize the medication administration, as standard values will be available to refer from (Pitkänen, 2017).
• observing the patients for side-effects and documenting the same in an appropriate manner.
• Following the rule of “5 Rs” for drug administration. That is ensuring right drug t be administered, right route of drug administration should be followed, medication should be dispersed at right time, the drug should be given in the right amount of dosage as required and lastly the drug should be given to right patient (Gibson, 2018).
• The nurses should also be taught about the high-risk medications that are prescribed to patients having chronic illness. It is important in such cases as the chances for adverse drug reactions are more in patients having chronic illness, due to multiple drug administration.
• Memory aids can be provided to the patients so that they strictly adhere to their medication routine. The patient can also be provided schedule to take medications tagged along with their activity of daily routine, such as breakfast, lunch, dinner. This will make sure that medications are not skipped and are taken on time. Use of digital aids and computerized prescription of medication can be carried out for the patient who are unable to get their medications renewed in person.
• In patients having medication overuse, multiple therapy in combination with medical management should be carried out. This will reduce the chances of addiction in the patient and will also help in complete cessation of medicines in these patients.

Strengths and Weaknesses of Clinical Project 

The main strength of this standard id ensuring safety while prescribing medications to the patients. However, there are certain underlying factors that hamper the smooth facilitation of this process. These factors can be either healthcare oriented or patient oriented in nature. The healthcare-oriented weaknesses can be identified as the faults on the part of healthcare professionals while providing medical management to the patient. Whereas, patient-oriented faults can be noted as non-adherence to drug and overdosing of the prescribed drugs to them.

Goals and Objectives of Clinical Project 

The goals aim at not only reducing the errors but also reporting those errors on timely bases to be corrected. The goals of the study can be as follow:

• Establishing communication- There should be a good communication between the patient and the healthcare staff, as well as the whole healthcare team assigned to the patient. Inclusion of a multidisciplinary approach can make sure that not only a holistic care is provided to the patient but better healthcare outcomes are derived from the same.
• Reporting the errors and adverse drug events- This should be done to make sure that the adverse reaction was not only reported but was also taken care of. This will also be helpful for future inferences of any such reactions and will thus, help in controlling the signs and symptoms.
• Developing skills in nursing staff- The nursing staff should be taught on methods how to manage and prescribe the drug effectively. They can be taught on improving skills of reporting and documenting the details. The histories of allergies developed by the patients due to certain drugs can be noted and can be researched upon for future interventions to be planned accordingly. Inferences from previous medication errors can also be taken for the purpose of research.
• Developing checking habits- It can be done by making use of medication check list and noting for the vitals of the patients closely for the purpose of monitoring the same for any deflection from normal.

Conclusion on Clinical Project 

For any nursing professional drug prescription is a common clinical practise of the daily routine for patient care and coordination. There are greater chances of errors in the administration of the same due to many underlying factors. Although these errors are considered as a serious issue as it impacts the patients directly. This can result in direct implications on the patient and longer stay in hospital settings, which will hamper the recovery of the patient by greater extent. It is therefore, imperative to note and document any error in medication administration and the adverse reactions caused by the same, so that timely action can be taken on the same. It is duty of the physician as well as the patient to work collaboratively to ensure safe drug management is taking place to cure the underlying disease.

References for Clinical Project 

Alomari, A., Wilson, V., Solman, A., Bajorek, B., & Tinsley, P. (2018). Pediatric nurses’ perceptions of medication safety and medication error: a mixed methods study. Comprehensive child and adolescent nursing, 41(2), 94-110.

Cochran, G., Hruschak, V., Bacci, J. L., Hohmeier, K. C., & Tarter, R. (2017). Behavioral, mental, and physical health characteristics and opioid medication misuse among community pharmacy patients: A latent class analysis. Research in Social and Administrative Pharmacy, 13(6), 1055-1061.

Copeland, A., Mertel, K., Mohammadi, S., Steiner, C., Mannella, K., Sheetz, M., & Muthukrishnan, A. (2018). Lu-177 DOTATATE therapy for progressive metastatic neuroendocrine tumors: Multidisciplinary team work and role of technologists, nurses, physicists and physicians. Journal of Nuclear Medicine, 59(supplement 1), 1861-1861.

Gibson, E., Bretz, F., Looby, M., & Bornkamp, B. (2018). Key aspects of modern, quantitative drug development. Statistics in Biosciences, 10(2), 283-296.

Gilbert, A. V., Patel, B. K., Roberts, M. S., Williams, D. B., Crofton, J. H., Morris, N. M., ... & Gilbert, A. L. (2017). An audit of medicines information quality in electronically generated discharge summaries–evidence to meet the Australian National Safety and Quality Health Service Standards. Journal of Pharmacy Practice and Research, 47(5), 355-364.

Gyasi, R. M., Abass, K., Adu-Gyamfi, S., & Accam, B. T. (2017). Nurses' knowledge, clinical practice and attitude towards unconventional medicine: implications for intercultural healthcare. Complementary therapies in clinical practice, 29, 1-8.

Huckels?Baumgart, S., Niederberger, M., Manser, T., Meier, C. R., & Meyer?Massetti, C. (2017). A combined intervention to reduce interruptions during medication preparation and double?checking: a pilot?study evaluating the impact of staff training and safety vests. Journal of nursing management, 25(7), 539-548.

Mickelson, R. S., & Holden, R. J. (2018). Medication adherence: staying within the boundaries of safety. Ergonomics, 61(1), 82-103.

Nakrem, S., Solbjør, M., Pettersen, I. N., & Kleiven, H. H. (2018). Care relationships at stake? Home healthcare professionals’ experiences with digital medicine dispensers–a qualitative study. British Medical Journal of health services research, 18(1), 26.

Pevnick, J. M., Shane, R., & Schnipper, J. L. (2016). The problem with medication reconciliation. British Medical Journal of Quality and Safety, 25(9), 726-730.

Pitkänen, A., Teuho, S., Uusitalo, M., & Kaunonen, M. (2016). Improving medication safety based on reports in computerized patient safety systems. CIN: Computers, Informatics, Nursing, 34(3), 122-127.

Roughead, E. E., Semple, S. J., & Rosenfeld, E. (2016). The extent of medication errors and adverse drug reactions throughout the patient journey in acute care in Australia. International journal of evidence-based healthcare, 14(3-4), 113-122.

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