the nurse's role in pharma

medication safety

• med admin process

• safety-related tech

  • electronic med admin record (eMAR)

  • barcode med admin

• rights of med admin

  • five original: client, med, dose, time, route

  • additional rights: education, refuse or autonomy, assessment, patient response, documentation

med reconciliation

• goals

  • prevent errors

  • prevent med interactions

    • ex: ozempic is being used for weightloss, not only diabetic people take it

• what to include

  • prescriptions medications

  • over the counter medications

  • supplements → herbal drugs can have affects on body too so you need to take that into consideration

med admin errors

med admin errors (MAE)

• sentinel errors: unexpected events that cause death, permanent harm, or severe temporary harm to a patient

  • ex: low K+ so you need to give the patient K+Cl-, but it was given to the wrong patients and caused them to have an elevated K+ level → cardiac arrhythmia (irregular heartbeat)

key elements in the culture of client safety

• elements: teamwork, leadership, evidence based practice, just culture, client centered care, communication, learning

  • ex: telephone orders may be hard to hear the med so you need to double check, bad handwriting can also make people perscrib the wrong thing

• benefits: orgs that promote a culture of a client safety have lower incidences of med errors

response to MAE

response

• asses the client, #1 priority

• notify the provider

• document the incident

• report the med error through the appropriate facility reporting channels

common factors associated with med errors

• lack of med knowledge

• language barrier

• increased workload

• distractions of interruptions

• inadequate communication with patients or provider

• deficiency of patient care records

• lack of standard procedures

med errors classifications

rule based errors

• standards not adhered to

knowledge based errors

• absence of med history

activity based errors

• “slip” errors due to distractions

role of the nurse

adverse drug reaction monitoring

• allergic reactions to meds

• idiosyncratic drug reactions

client education

• information to include (ex: if client pregnant)

• different approaches to teaching

• evaulation of client understanding

as a nurse, you need to know what/which medicine does what

interprofessional collaboration

benefits of interprofessional education

• each member can gather knowledge from one another and develop relationships to ultimately improve collab

• it strengthens teamwork

• it prevents fragmented care by focusing on holistic care

• it improves job satisfaction

best practices

• open communication

• team approach

• holistic care

• team based client rounding

effective communication

benefits

• increased patient safety, quality of care, and improved outcomes

• verbal communication: easily understood

• written communication: legible writing

• handoff communication: ISBARR tool

ISBARR

I: identify

S: situation

B: background

A: assessment

R: recommendation

R: read back orders

order of communication

health team members

• provider

• pharmacist

• nurse

• assistive personnel

prioritization

med tasks

• interruptions

• emergency situations

• medication timing

priority frameworks

• ABC’s: prioritize airway, then breathing, then circulation

• Maslows hierarchy of needs

  • focuses on addressing most basic needs first and then moving up the hierarchy

management of med tasks

• electronic task management systems

• management of nursing responsibilities

• organization of med tasks

  • nurses must be mindful of time sensitive meds

health care setting

inpatient care

• hospitals

outpatient or ambulatory care

• clinics, schools

out of hospital care

• skilled nursing facilities

evidence based practices

PICOT questions

• population, intervention, comparison, outcomes, time

locating evidence

• scholarly databases

evaluating evidence

• study designs

• levels of evidence

intergrating evidence

• interprofessional collab

• org support

evaluating outcomes

disseminating findings (through publications)

• journal articles

• conference presentations