Nursing Society Chemotherapy Administration

In New South Wales the poisons and therapeutic goods regulation 2002 controls the medicines and chemicals which are produced in the companies and distributed to the public for consumption. There are varieties which are formed to determine access to and use of drugs. These aspects include packaging and labeling of drugs as well as how the drugs are stored. For example, some medications must be stored at a specific temperature and medicines must be kept in an enclosed area where the general people do not have access (Kumari, Hanuja, Nagabhushanam, Reddy & Bonthagarala, 2016, p.2249). Prescription before giving any medication to the public is essential, and the dealer must be certified, and the order where the medicines are written and signed must be legal. The prescription process involves filling and picking up a prescription of drug which is complex. For healthcare professionals to ensure that the medication they administer to a client is active, they have to perform several things to ensure appropriate prescription. The prescription process gives a patient the information they need to find out if they are getting the medicine ordered by their doctors. The National Safety and Quality Health Standard (NSQHS) is an organization in Australia whose primary objective is to protect the public from harmful and hazardous effects which are associated with poor prescription and improve the quality of health care services which is given to patients by healthcare professionals (Brown, Hotham & Hotham, 2014, p.184). NSQHS provides a clear description of quality frameworks which are required in health care institutions to implement safe systems. Scheduled medication is a controlled drug and substance which is made for human consumption, and it is structurally similar to a schedule. To ensure appropriate supply of the medicine, the people working in the health industry as a nurse, doctor, and pharmacist must be certified by the APHRA to give out proper medications to the public.

The nurse administering the medication should refer to the prescribed ordered directly, and the order must be legible, clear, and it should not be open to any misinterpretation so that they may not end up making medication errors. If the nurse concludes that the order is not precise or is incorrect, they should ask the prescriber before administering the medication. The rules that are given through the telephone should be recorded in the patient’s medication records immediately at that time and then read back to the authorized prescriber (Davis & National Association of Medical Examiners and American College of Medical Toxicology Expert Panel on Evaluating and Reporting Opioid Deaths, 2013, p.62). The patient must be adequately identified, and the patient’s allergies and adverse drug reaction should also be checked before administration. The only person should select, prepare, administer and record the administration. Enrolled nurses need further training because healthcare sector is continually changing and evolving and therefore new training is essential for them to be able to stay with the current and latest development skills as well as the most recent technologies which are required in the world of nursing (Dégardin, Roggo & Margot, 2014, p.167). Nurses also need further training so that they can be able to comply with new laws and remain licensed and certified. Additional training for healthcare professionals is very significant as it helps to keep abreast with the field so that they do not lag behind.

There are various things which enrolled nurses need to complete before giving medications to clients.  Nurses have the right to demand to be complete and written. They have the right to require the drug, dose, and frequency written by the physician before completing a medication to a client. It is not right for enrolled nurses to accept an order I it is not written clearly because it is not a safe practice and can lead to medication errors. Nurses should ensure that they do not take the verbal order and that they only take telephone orders in cases where the physicians are not physically present. Before completing any medication enrolled nurses and other healthcare professionals should ensure that they have access to information so that they can be updated and have easy access to drug information. Which means that healthcare institutions should have a drug reference book available for nurses who administer medications to patients (Dégardin, Roggo & Margot, 2014, p.167). They also have the right to ask for information about drugs and medicines which they are supposed to apply to the patients. They should ask the pharmacist who is a specialist in drugs information regarding them. For healthcare professionals to be able to qualify for NMB NSW, the applicant must have successfully completed an assessment in medication management which includes administration of medicines which provides for drug calculations, pharmacokinetics which is the study of bodily absorption, distribution, and excretion of drugs and pharmacodynamics which is a study of physiological and biochemical effects of drugs.

The advice is given about storage of medicines

For appropriate medication, physicians should keep an updated list all drugs which are in the room. Physicians should use medication tracking worksheet to record medicines (Vellinga et al., 2014, p.98). Medicines and drugs should be stored in the safe place out of reach of children or anyone else who is capable of misusing them. This should be done especially or medicines which looks like water or any suitable fluid. For medicines and drugs which needs refrigeration should be stored in places where they cannot melt, and they should be stored separately with foodstuffs. Healthcare professional should ensure that medicines are stored in locations with light so that medicine labels can be seen clearly. Medicines should be stored in their original containers, and they should not be mixed with other drugs as this can bring confusion resulting in medication errors (Lang, Ford, John, Pollard & McCarthy, 2014, p.139). Medicines should be stored in dry and cool places. Medicines and drugs which are expired should be discarded in areas where children and animals cannot get them.

Potential risks which are associated with the use of medicines

Undertaken a risk assessment process is standard practice in just about every area of business or service, however, in healthcare, risk assessment also includes many potential risks and hazards that relate directly to the client, treatment, equipment, drugs and medicines, and other resources or circumstances. Illegal drugs have a range of harmful effects on the health of individuals. Medications are also drugs which are regulated various ways depending on the level of their health risk. All medicine are termed to have health risk even if healthcare professionals prescribe them. Medications which are sold over the counter possess a high risk especially if they are not taken as prescribed (Nauck, 2013). Taking some medicines can make patients have cravings for some foodstuffs. A patient receiving a particular type o medication may experience tiredness and lack of energy which can make it impossible for them to perform their daily operation. Patients under different types of medication can often feel angry and irritated in such a way that they cannot socialize well with other members of the community. Poor sleep is another potential risk which is associated with consumptions of medicines (Huybrechts et al., 2014, p.2397). Medication can bring depression to a patient which can contribute to other health hazards.

For healthcare professionals to ensure that they accurately follow the organization’s policies and procedure and the instruction given by various manufacturers on storage of medicine and blood they should ensure that they involve the leaders of each section in the organization. This is because policies are always created by someone within the organization and for healthcare professionals to be able to understand them must have a good relationship with them. Individuals and healthcare professional should determine the best way they can measure the understanding of policies and procedures which govern the storage of medicine, blood, and products (Dougherty & Lister, 2015). Organization leaders should ensure that policies and procedures are made available to all employees to ensure that the program used in the institution allow flexibility and it has permission controls which reduce clutters for end users. For employees to be able to follow organization procedures and policies accurately, they should set deadlines for each system and process which have to be acknowledged. This can be made possible by having programs which are capable of sending alerts to the right people in the institution. This notification should include task alerts and over-due notifications.

I would report it to my RN, the doctor and the pharmacy is necessary. After that, I will document everything in the patient’s progress notes.  I would also ensure that immediate advice is given to healthcare professionals in the health institution so that they cannot administer wrong medication to patients (Barbaud et al., 2013, p.555). I should also provide that healthcare professionals focus on the safeguarding process on these incidents where high chances of medication errors can occur.

  There are various ways and strategies which I can use to be able to deliver relevant information to the patient and his/her family members. The first way I will use to address them formally so that I can show respect. I should also be aware that aged patients have hearing problems so I should be very audible when delivering relevant information to them about the side effects which they may experience from use of specific medication and giving them advice on what they should do to prevent them (Agha et al., 2016, p.180).  I will also ensure that there is no distractions and background noise so that the patient and his/her family members can get the information more clearly and avoid making mistakes as they give out drugs to the patient. This is because distraction can hinder effective communication. I will also ensure that I don’t rush patients and their family members during the discussion because doing so I may create a wrong impression about myself and they may even feel am not respecting them.

I would do a pain assessment and try to identify the cause then I would report it to my RN and follow the procedures as per their order. I will use the PQRST pain assessment technique to describe, access and document the patient’s pain (Barr et al., 2013, p.263). I will use this technique because it can help me to be able to select the appropriate pain medication and treatment criteria.

It is essential to clarify the location and nature of pain or discomfort because it will help us to identify the cause of the pain and so that we can provide the proper treatment for their depression (Magee, 2013). It is also very significant because it makes it very easy for healthcare professionals to be sure on what kind of medication they should administer to the patient and have positive results without having any side effects which can be harmful to the health of the patient.

First, we must identify the level of pain the patient is suffering from according to that we will have to administer medications. The World Health Organization has categorized pain medication as Non-opioids: acetaminophen, aspirin, and Adjuvants. Healthcare professionals can also use Anticonvulsants such as gabapentin, lamotrigine, and pregabalin. Local anesthetics such lidocaine 5% patch or gel can be applied for application in the areas with pain so that a patient can feel better. Opioids for mild to moderate depression:  tramadol, Hydrocodone in combination with acetaminophen, aspirin, or ibuprofen. Opioids for moderate to severe pain include Morphine and oxycodone. It is very significant or healthcare professionals to manage pain which the patient is going through. Pain management improves the quality of life, and it enables the patient to keep on doing the things he/she enjoys doing (Sturgeon & Zautra, 2013, p.317). When the pain a patient is going through is appropriately managed, patients can feel like part of the community because they can spend time with friends, family members and other members of the society talking and sharing information. Pain may lead to appetite and sleep which can result in more complex health condition which can lead to health deterioration of the patient. Therefore nurses and other healthcare professional’s needs to properly manage patient’s pain so that they can be able to take their meals and have a sound sleep which can help relieve distress. Use of medicine and drugs is the best strategy which healthcare professionals and nurses use to manage patient’s pain. Pain medicine works best to give positive results I they are used regularly and on a specific schedule (Hemingway et al., 2013, p.5595). Healthcare professionals should ensure that patients are using medicines immediately they experience pain before it gets severe which can be accompanied by other health complications.

We can assess the effectiveness of pain-relieving medications by adequately communicating with the patient. This can be made possible by establishing a strong therapeutic relationship between the patient and healthcare professional (Chou et al., 2016, p.131). This is very significant because healthcare professional can earn the trust of the patient and therefore been able to gather meaningful information regarding the patient health and the pain which they are going through. The patient also feels free to tell the nurse if the medication they are receiving can relieve the pain or not so that they can be able to change the medication to another. Healthcare professionals should also keep in their mind the rights of the patient so that they do not end up requiring some more confidential information from the patient who is against the law without their knowledge (Bannwarth & Kostine, 2014, p.619). This also helps them to be able to realize that they should treat all the patient equally regardless of their socio-economic backgrounds. Providing interventions based on the goals of the patient is another role which healthcare professionals are supposed to perform. Lastly, nurses should ensure frequent communication and re-evaluation of the interventions so that patients do not end up taking wrong dosages which can be very harmful to their health.

I would record the results of your observations of the client and your evaluation of the effectiveness of pain management in the patient’s progress notes and also to his care plan so that patient’s information can be assessed in the future in case need be (Calvert et al., 2013, p.814). It is handy and significant to keep patients information because it can be used by other healthcare professionals in the future to administer medication to the patient without making any mistake. Cases of a patient having side effects and allergies after using a particular medicine or drugs are recorded in which helps nurses to use alternative medicine to treat the patient in the future. Nurses and other healthcare professionals are charged with the role of continued assessment of the patient health status to gain information if the pain is reducing so that they can be able to determine the effectiveness of a particular medicine (Banaszkiewicz, 2014, p.13). There are various ways which healthcare professionals use to record information of their research of observation and evaluation of the patient according to organization policies and procedures. Nurses should report the results immediately after the evaluation and should be accurate.

List and explain the legal requirements for practice parameters of the enrolled nurse about the administration and documentation of medications, including legal requirements for each route of administration  

Enrolled nurses are the first people who should provide healthcare services to patients. So they are the first people who can reorganize when the patient is been assaulted or missing. Therefore the role of enrolled nurses in mandatory reporting policy is to report bad situations which occurs in the healthcare organization to local police authorities or Australian department of health. This is very significant as it helps reduce the harm and risks which a resident can be exposed to. Enrolled nurses should be able to identify the legal issues which are affecting patients and report them to the concerned parties (DeWit & O’Neill, 2013). Another legal requirement for enrolled nurses is that they identify and manage patient’s valuables according to the institutional policies (Neuss et al., 2013, p.5). It is a legal requirement that enrolled nurses should educate patients on legal issue which they are facing. Reporting the patient’s health condition is a requirement by the law as it enables the institutions to be able to determine the progress and effectiveness of medication they administer to patients.

Describe the potential complications of blood transfusion

• Pain at IV site and arm: After blood transfusion high chances are that the patient may experience pain at the IV site and arm. It is, therefore, the role of healthcare professionals to stop the transfusion (Basques et al., 2015, p.1792).
• Loin pain: Patients can also experience loin pain which is a sensation of discomfort and distress in the part of the body below the rib and ilium during a blood transfusion.
• Urticaria (hives): a patient is likely to experience these complication depending on the interval between the start of blood transfusion and the onset of the allergic reaction.
• Nausea and vomiting: during blood transfusion patient skin feels sweaty and cold as well as feeling dizzy which makes them experience nausea and sometimes they can vomit.
• Headache: due to reversible constrictions of cerebral arteries, a patient may also experience a headache during a blood transfusion.
• Flushing, chills or fever: Blood transfusion is termed a crucial life-saving mechanism. However, the patient may experience transfusion fever which is a leading cause of morbidity
• Anxiety: Patients may also experience anxiety because they are eager to know what happens next which can make the situation more complicated.
• Tachycardia: during blood transfusion patients may experience this condition making their heart beat more than 100 times per minute.
• Wheezing, progressing to cyanosis: patients also experiences breathing problems making them have whistling and rattling sound in the chest as they breathe because their air passages are blocked.
• Haematuria: high chances are that a patient may have presence o blood in their urine during or after transfusion.
• Anaphylactic reaction or shock: it is an allergic reaction which can occur during blood transfusion and if healthcare professionals do not attend the patient immediately they can die (Low et al., 2015, p.286).
• Cardiac arrest: the patient’s heart can temporarily stop functioning during or after blood transfusion.
• Death: blood transfusion can lead to death it is done by inexperienced healthcare professional.

References

Agha, R.A., Fowler, A.J., Saeta, A., Barai, I., Rajmohan, S., Orgill, D.P., Afifi, R., Al-Ahmadi, R., Albrecht, J., Alsawadi, A. and Aronson, J., 2016. The SCARE statement: consensus-based surgical case report guidelines. International Journal of Surgery, 34, pp.180-186.

Banaszkiewicz, P.A., 2014. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty: an end-result study using a new method of result evaluation. In Classic Papers in Orthopaedics (pp. 13-17). Springer, London.

Bannwarth, B. and Kostine, M., 2014. Targeting nerve growth factor (NGF) for pain management: what does the future hold for NGF antagonists?. Drugs, 74(6), pp.619-626.

Barbaud, A., Collet, E., Milpied, B., Assier, H., Staumont, D., Avenel?Audran, M., Grange, A., Amarger, S., Girardin, P., Guinnepain, M.T. and Truchetet, F., 2013. A multicentre study to determine the value and safety of drug patch tests for the three main classes of severe cutaneous adverse drug reactions. British Journal of Dermatology, 168(3), pp.555-562.

Barr, J., Fraser, G.L., Puntillo, K., Ely, E.W., Gélinas, C., Dasta, J.F., Davidson, J.E., Devlin, J.W., Kress, J.P., Joffe, A.M. and Coursin, D.B., 2013. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Critical care medicine, 41(1), pp.263-306.

Basques, B.A., Anandasivam, N.S., Webb, M.L., Samuel, A.M., Lukasiewicz, A.M., Bohl, D.D. and Grauer, J.N., 2015. Risk factors for blood transfusion with primary posterior lumbar fusion. Spine, 40(22), pp.1792-1797.

Brown, E., Hotham, E. and Hotham, N., 2014. Views of obstetric practitioners and hospital pharmacists on Therapeutic Goods Administration approved Product Information for pregnancy and lactation. Australian and New Zealand Journal of Obstetrics and Gynaecology, 54(2), pp.184-188.

Calvert, M., Blazeby, J., Altman, D.G., Revicki, D.A., Moher, D., Brundage, M.D. and CONSORT PRO Group, 2013. Reporting of patient-reported outcomes in randomized trials: the CONSORT PRO extension. Jama, 309(8), pp.814-822.

Chou, R., Gordon, D.B., de Leon-Casasola, O.A., Rosenberg, J.M., Bickler, S., Brennan, T., Carter, T., Cassidy, C.L., Chittenden, E.H., Degenhardt, E. and Griffith, S., 2016. Management of Postoperative Pain: a clinical practice guideline from the American pain society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists’ committee on regional anesthesia, executive committee, and administrative council. The Journal of Pain, 17(2), pp.131-157.

Davis, G.G. and National Association of Medical Examiners and American College of Medical Toxicology Expert Panel on Evaluating and Reporting Opioid Deaths, 2013. Recommendations for the investigation, diagnosis, and certification of deaths related to opioid drugs. Academic Forensic Pathology, 3(1), pp.62-76.

Dégardin, K., Roggo, Y. and Margot, P., 2014. Understanding and fighting the medicine counterfeit market. Journal of pharmaceutical and biomedical analysis, 87, pp.167-175.

DeWit, S.C. and O’Neill, P.A., 2013. Fundamental concepts and skills for nursing. Elsevier Health Sciences.

Dougherty, L. and Lister, S. eds., 2015. The Royal Marsden manual of clinical nursing procedures. John Wiley & Sons.

Hemingway, H., Croft, P., Perel, P., Hayden, J.A., Abrams, K., Timmis, A., Briggs, A., Udumyan, R., Moons, K.G., Steyerberg, E.W. and Roberts, I., 2013. Prognosis research strategy (PROGRESS) 1: a framework for researching clinical outcomes. Bmj, 346, p.e5595.

Huybrechts, K.F., Palmsten, K., Avorn, J., Cohen, L.S., Holmes, L.B., Franklin, J.M., Mogun, H., Levin, R., Kowal, M., Setoguchi, S. and Hernández-Díaz, S., 2014. Antidepressant use in pregnancy and the risk of cardiac defects. New England Journal of Medicine, 370(25), pp.2397-2407.

Kumari, B.S., Hanuja, G.S., Nagabhushanam, M.V., Reddy, D.N. and Bonthagarala, B., 2016. Current Regulatory Requirements for Registration of Medicines, Compilation and Submission of Dossier in Australian Therapeutic goods Administration. International Journal of Advanced Scientific and Technical Research, ISSN, pp.2249-9954.

Lang, S., Ford, K.J., John, T., Pollard, A.J. and McCarthy, N.D., 2014. Immunisation errors reported to a vaccine advice service: intelligence to improve practice. Quality in primary care, 22(3), pp.139-146.

Low, D.E., Alderson, D., Cecconello, I., Chang, A.C., Darling, G.E., D’journo, X.B., Griffin, S.M., Hölscher, A.H., Hofstetter, W.L., Jobe, B.A. and Kitagawa, Y., 2015. International consensus on standardization of data collection for complications associated with esophagectomy. Annals of surgery, 262(2), pp.286-294.

Magee, D.J., 2013. Orthopedic physical assessment. Elsevier Health Sciences.

Nauck, M.A., 2013. A Critical Analysis of the Clinical Use of Incretin-Based Therapies: Are the GLP-1 Therapies Safe?: The benefits by far outweigh the potential risks. Diabetes care, p.DC_122504.

Neuss, M.N., Polovich, M., McNiff, K., Esper, P., Gilmore, T.R., LeFebvre, K.B., Schulmeister, L. and Jacobson, J.O., 2013. 2013 updated American Society of Clinical Oncology/Oncology Nursing Society chemotherapy administration safety standards including standards for the safe administration and management of oral chemotherapy. Journal of Oncology Practice, 9(2S), pp.5s-13s.

Sturgeon, J.A. and Zautra, A.J., 2013. Psychological resilience, pain catastrophizing, and positive emotions: perspectives on comprehensive modeling of individual pain adaptation. Current Pain and Headache Reports, 17(3), p.317.

Vellinga, A., Cormican, S., Driscoll, J., Furey, M., O’Sullivan, M. and Cormican, M., 2014. Public practice regarding disposal of unused medicines in Ireland. Science of the Total Environment, 478, pp.98-102.