Introduction to Pharmacology: The Nurse’s Role in Pharmacology

Medication errors

can cause morbidity and mortality.

Morbidity

estimated by prevalence or incidence, the state of being unhealthy or symptomatic related to a disease or condition

Mortality

deaths related to a specific health event

Nurses role in administration of medication

last safeguard in process prior to client contact with prescribed treatment

Medication administration process

providers prescription and transcription of the prescribed treatment —> meds then prepared, distributed, and administered to client

eMAR electronic medication administration and Bar coded medication administration BCMA

shown to reduce errors in provider prescriptions, doasage, and improving efficiency accuracy and client safety.

Medication giving process

prescribing —> record and review prescription —> BCMA and eMAR—> 10 rights of medication and administration —> monitor for effects of medicine —> continuity of care

10 rights of medication administration

client, medication, dose, time, route, education to refuse assessment, evaluation/response, documentation

Routes of medication

oral, peripheral intravenous, patient controlled analgesia, epidural, intramuscular, intrathecal, central venous catheter, subcutaneous, topical, or rectal

Efficacy

effectiveness of a treatment

Patient controlled analgesia

main management in which the client can dispense medication through the IV pump with the use of a button

Epidural

medication administered directly into epidural space along the spine

Intramuscular

injection of medication into the muscle such as deltoid muscle of the upper arm

Intrathecal

administration of medication into the spinal canal

Central venous catheter

catheter inserted into a vein to administer high volumes or high concentration of medications, such as a peripherally inserted central catheter (PICC) line

Subcutaneous (SUBQ)

administration of medication under the skin into the fatty tissue

Topical

administration of medication onto the surface of the skin

Side effects

generally unintended effects of the medication (for treatment) causing minor or non emergency manifestations

Adverse effects (ADR)

unexpected effects of a medication that can cause harm to clients, anaphylaxis, stomachache, diarrhea, IDRs

Medication reconciliation

improve client safety, listing and verifying clients meds to prevent errors and medication interactions

Sentinel event

medication error that causes client harm or death

Seven key elements in culture of client safety

teamwork, leadership, evidence based practice culture, client centered care, communication, and learning

Touchpoint

point of contact of interaction between individuals

Knowledge based errors

absence of learning about medications used in practice, client history, or admin of the medication

Rule based errors

failed adherence to appropriate standards of practice for medication administration

Activity based errors

multifaceted, occurring w. meds that sound alike or are spelled similarly or by becoming distracted during the medication administration process. Aka slip error

Slip error

occurs with look alike or sound alike meds

Anaphylaxis

severe life threatening allergic rxn causes extreme inflammation

Idiosyncratic drug reactions (IDRs)

unpredictable medication reactions, mild to severe, most target liver leading to liver failure, targets bone marrow

Anaphylactic shock

abrupt, severe, potentially fatal allergic rxn affects entire body, characterized by airways constriction causing breathing difficulties and airway obstruction by swelling of the throat

Agranulocytosis

inherited or acquired conditions in which severely low levels of neutrophils occurs leading to an increased risk of infection

Sepsis

overwhelming systemic and life threatening response to infection

Holistic approach

referring to the whole person

ISBARR

identify, situation, background, assessment, recommendations repeat

Five rights of nursing delegation

task, circumstance, person, supervision, direction and communication

Anticoagulants

meds administer to prevent blood clots

Pro re nata PRN

prescribe to administered based on clients individualized status and needs instead of scheduled intervals. Sedatives, hypnotics, analgesics, gastro meds, antipsychotics

Abc framework

airway, breathing, circulation

PICOT.

developing EBP research. Population, intervention, comparisons, outcomes, time

Cross sectional studies

pop data at an identified time and measure exposure and outcome

Case control

two diff groups who may or may not have disease and compare them with risk factors for the disease

Cohort studies

retrospective (looking back) and prospective (looking forward), groups of people who are exposed to disease and compare rates of disease development in both

Randomized controlled trials

compare a placebo with existing process in prospective manner. Randomly divided into treatment and placebo groups

Dissemination

distributing info to others