Podcast
Questions and Answers
Which of the following best describes a felony?
Which of the following best describes a felony?
An intentional tort is defined as accidental harm to a patient.
An intentional tort is defined as accidental harm to a patient.
False
What is whistle-blowing?
What is whistle-blowing?
A warning to the public concerning serious wrongdoing.
In the FDA process, the _____ phase involves testing a new drug on small groups of people.
In the FDA process, the _____ phase involves testing a new drug on small groups of people.
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Match the following roles in medication administration to their responsibilities:
Match the following roles in medication administration to their responsibilities:
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What is the purpose of medication reconciliation?
What is the purpose of medication reconciliation?
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The defendant is the person who brings a lawsuit against another party.
The defendant is the person who brings a lawsuit against another party.
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What role does the nurse have in the medication administration process?
What role does the nurse have in the medication administration process?
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What does the principle of nonmaleficence primarily focus on?
What does the principle of nonmaleficence primarily focus on?
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In deontologic ethics, the morality of an action is based solely on its consequences.
In deontologic ethics, the morality of an action is based solely on its consequences.
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What are the two primary principles of bioethics?
What are the two primary principles of bioethics?
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The principle that involves keeping promises and upholding RN standards is known as __________.
The principle that involves keeping promises and upholding RN standards is known as __________.
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Match the ethical principle with its description:
Match the ethical principle with its description:
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Which ethical principle requires a nurse to act in ways that promote a patient's well-being?
Which ethical principle requires a nurse to act in ways that promote a patient's well-being?
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Confidentiality in nursing ethics is primarily concerned with protecting the patient's privacy.
Confidentiality in nursing ethics is primarily concerned with protecting the patient's privacy.
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What does the principle of justice in nursing ethics require?
What does the principle of justice in nursing ethics require?
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What is the primary purpose of using a bar-code medication system?
What is the primary purpose of using a bar-code medication system?
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Ethics is solely the study of what is right or wrong without considering the consequences.
Ethics is solely the study of what is right or wrong without considering the consequences.
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What is one important action to take if a medication error has occurred?
What is one important action to take if a medication error has occurred?
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In the process of developing values, the step where one chooses options after considering consequences is called ______.
In the process of developing values, the step where one chooses options after considering consequences is called ______.
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Match the modes of value transmission with their descriptions:
Match the modes of value transmission with their descriptions:
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Which of the following describes the 'acting' process in developing values?
Which of the following describes the 'acting' process in developing values?
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It is permissible to leave prepared drugs unattended in a healthcare setting.
It is permissible to leave prepared drugs unattended in a healthcare setting.
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What should be done before administering medication to ensure patient understanding?
What should be done before administering medication to ensure patient understanding?
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The study of rights and wrong principles in relation to human conduct is known as ______.
The study of rights and wrong principles in relation to human conduct is known as ______.
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Which action is part of the prevention process for medication errors?
Which action is part of the prevention process for medication errors?
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What is the primary responsibility of a nurse in the medication administration process?
What is the primary responsibility of a nurse in the medication administration process?
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A misdemeanor is punishable by imprisonment for more than one year.
A misdemeanor is punishable by imprisonment for more than one year.
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What is the purpose of the clinical phase in the FDA drug approval process?
What is the purpose of the clinical phase in the FDA drug approval process?
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The _____ is the person or government bringing a lawsuit in a legal case.
The _____ is the person or government bringing a lawsuit in a legal case.
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Match the following phases in the FDA process with their descriptions:
Match the following phases in the FDA process with their descriptions:
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Which of the following is an example of an unintentional tort?
Which of the following is an example of an unintentional tort?
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The defendant is the person being accused in a legal case.
The defendant is the person being accused in a legal case.
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What does the principle of beneficence in nursing ethics primarily involve?
What does the principle of beneficence in nursing ethics primarily involve?
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What are the '7 rights' in medication administration?
What are the '7 rights' in medication administration?
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The principle of autonomy emphasizes the need for informed consent.
The principle of autonomy emphasizes the need for informed consent.
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Define nonmaleficence in the context of nursing ethics.
Define nonmaleficence in the context of nursing ethics.
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The principle that focuses on fairness and giving each individual their due is known as __________.
The principle that focuses on fairness and giving each individual their due is known as __________.
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Match the bioethical principles with their descriptions:
Match the bioethical principles with their descriptions:
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Which of the following statements best describes deontologic ethics?
Which of the following statements best describes deontologic ethics?
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Fidelity in nursing ethics includes keeping promises and maintaining professional standards.
Fidelity in nursing ethics includes keeping promises and maintaining professional standards.
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Explain the concept of utilitarianism in nursing ethics.
Explain the concept of utilitarianism in nursing ethics.
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Which of the following is a common medical error that should be prevented?
Which of the following is a common medical error that should be prevented?
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The bar-code medication system allows nursing staff to administer medications without scanning patient's identifiers.
The bar-code medication system allows nursing staff to administer medications without scanning patient's identifiers.
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What should be done if a medication error is identified?
What should be done if a medication error is identified?
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A witness is required ________ when counting and wasting a narcotic.
A witness is required ________ when counting and wasting a narcotic.
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Match the steps in the process of developing values with their descriptions:
Match the steps in the process of developing values with their descriptions:
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Which topic should be included in patient teaching regarding medication?
Which topic should be included in patient teaching regarding medication?
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Modeling is a way of transmitting values that involves direct instruction.
Modeling is a way of transmitting values that involves direct instruction.
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What is the role of bar-code medication systems in healthcare?
What is the role of bar-code medication systems in healthcare?
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Inappropriate ___________ of a drug is a common medical error.
Inappropriate ___________ of a drug is a common medical error.
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What does bioethics primarily focus on?
What does bioethics primarily focus on?
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What is the primary responsibility of a pharmacist in the medication administration process?
What is the primary responsibility of a pharmacist in the medication administration process?
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An intentional tort is defined as harm that is meant to occur to a patient.
An intentional tort is defined as harm that is meant to occur to a patient.
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What is the purpose of the Investigational Phase in the FDA process?
What is the purpose of the Investigational Phase in the FDA process?
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The process of asking a patient about their current medications to avoid errors is known as __________.
The process of asking a patient about their current medications to avoid errors is known as __________.
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Match the following legal terms with their definitions:
Match the following legal terms with their definitions:
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Which phase of drug development involves testing on the largest group of patients?
Which phase of drug development involves testing on the largest group of patients?
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Name one key responsibility of a nurse during medication administration.
Name one key responsibility of a nurse during medication administration.
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The defendant is the individual or entity bringing a lawsuit to court.
The defendant is the individual or entity bringing a lawsuit to court.
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Which principle of bioethics emphasizes the importance of respect for patients' rights to make their own healthcare decisions?
Which principle of bioethics emphasizes the importance of respect for patients' rights to make their own healthcare decisions?
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Deontologic ethics assess the rightness or wrongness of an action based on its consequences.
Deontologic ethics assess the rightness or wrongness of an action based on its consequences.
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What is the principle that requires nurses to avoid causing harm or to prevent harm during care?
What is the principle that requires nurses to avoid causing harm or to prevent harm during care?
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The ethical principle that focuses on doing good and promoting patient well-being is called __________.
The ethical principle that focuses on doing good and promoting patient well-being is called __________.
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Match each ethical principle with its description.
Match each ethical principle with its description.
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Which of the following best describes utilitarianism in the context of nursing?
Which of the following best describes utilitarianism in the context of nursing?
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Justice in nursing ethics ensures that all patients get equal access to care regardless of their background.
Justice in nursing ethics ensures that all patients get equal access to care regardless of their background.
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What term describes the obligation for nurses to keep promises made to patients?
What term describes the obligation for nurses to keep promises made to patients?
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Which of the following is a common medical error that can be made during drug administration?
Which of the following is a common medical error that can be made during drug administration?
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A nurse can leave prepared drugs unattended while attending to other duties.
A nurse can leave prepared drugs unattended while attending to other duties.
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What must be checked daily regarding controlled substances?
What must be checked daily regarding controlled substances?
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The process of administering medication without thorough checks can lead to __________ errors.
The process of administering medication without thorough checks can lead to __________ errors.
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Match the following modes of value transmission with their descriptions:
Match the following modes of value transmission with their descriptions:
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Which step in the medication administration process ensures proper identification of the patient?
Which step in the medication administration process ensures proper identification of the patient?
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The action of 'prizing' in the development of values involves public affirmation and happiness.
The action of 'prizing' in the development of values involves public affirmation and happiness.
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Describe the importance of patient teaching regarding medication.
Describe the importance of patient teaching regarding medication.
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The study of ethics in healthcare specifically related to the principles of rights and wrongs is known as __________.
The study of ethics in healthcare specifically related to the principles of rights and wrongs is known as __________.
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If a medication error occurs, what should be documented?
If a medication error occurs, what should be documented?
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What is the correct order of responsibilities in medication administration?
What is the correct order of responsibilities in medication administration?
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An intentional tort is characterized by accidental harm to the patient.
An intentional tort is characterized by accidental harm to the patient.
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What is the main purpose of medication reconciliation?
What is the main purpose of medication reconciliation?
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In the FDA process, the __________ phase involves further studying the effectiveness and safety of drugs.
In the FDA process, the __________ phase involves further studying the effectiveness and safety of drugs.
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Match the following legal terms with their definitions:
Match the following legal terms with their definitions:
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Which of the following is a responsibility of the nurse in medication administration?
Which of the following is a responsibility of the nurse in medication administration?
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The New Drug Review Application process is the final step before a medication can be marketed.
The New Drug Review Application process is the final step before a medication can be marketed.
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Describe what a felony is in legal terms.
Describe what a felony is in legal terms.
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Which principle focuses on the obligation to avoid causing harm to patients?
Which principle focuses on the obligation to avoid causing harm to patients?
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Utilitarian ethics focus on the act being right or wrong regardless of its consequences.
Utilitarian ethics focus on the act being right or wrong regardless of its consequences.
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What does the principle of beneficence require from nurses?
What does the principle of beneficence require from nurses?
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The principle that requires respect for patients' rights to make their own health care decisions is known as __________.
The principle that requires respect for patients' rights to make their own health care decisions is known as __________.
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Match the following ethical principles with their definitions:
Match the following ethical principles with their definitions:
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Which of the following best describes the principle of justice in nursing ethics?
Which of the following best describes the principle of justice in nursing ethics?
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Fidelity in nursing ethics involves upholding professional standards and keeping promises.
Fidelity in nursing ethics involves upholding professional standards and keeping promises.
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Explain the principle of nonmaleficence in nursing ethics.
Explain the principle of nonmaleficence in nursing ethics.
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Which of the following is NOT a common medical error?
Which of the following is NOT a common medical error?
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A witness is required only when administering medication.
A witness is required only when administering medication.
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What should be done if a medication error occurs?
What should be done if a medication error occurs?
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The principle of __________ in nursing ethics is focused on doing no harm.
The principle of __________ in nursing ethics is focused on doing no harm.
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Match the common medical errors with their descriptions:
Match the common medical errors with their descriptions:
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What is a key part of the bar-code medication system?
What is a key part of the bar-code medication system?
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Patient education about medication should occur after administration.
Patient education about medication should occur after administration.
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What is essential to be checked daily for controlled substances?
What is essential to be checked daily for controlled substances?
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In the process of developing values, the step where one treasures the value is called __________.
In the process of developing values, the step where one treasures the value is called __________.
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Match the modes of value transmission with their descriptions:
Match the modes of value transmission with their descriptions:
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Study Notes
Drug Administration in New Jersey
- Prescriber: Orders the medication (prescription).
- Pharmacist: Responsible for preparing the medications.
- Nurse: Responsible for administering the medications.
-
Checks and balances: Help prevent errors.
- If an error is made, the pharmacist and nurse have time to note it.
- If the pharmacy makes the error, the nurse can note it using the 7 rights of medication administration.
FDA Drug Approval Process
-
Pre-Clinical Phase:
- Development of the drug includes:
- Animal testing (to check for toxicity)
- Sponsoring the drug
- Development of the drug includes:
-
Investigational Phase:
- New Drug Application (NDA) is sent to the FDA if the criteria are met.
-
Clinical Phase:
- New drug tested on small groups of people.
- Tested on larger groups:
- Patients with diseases for which the drug is intended.
- Usually includes a group who receives a placebo.
- Largest group: Patients take the medication and further study its effectiveness and safety.
- New Drug Review Application Process: FDA final review of the application and approval for marketing.
-
Testing on Human Beings:
- Approved for use by the FDA after the completion of all phases.
Nursing Process of Medication Administration
-
Assessment:
- Medication history
- Medication Reconciliation: A process to determine the medications the patient is taking, why, when, frequency, and when they started taking them.
Principles of Pharmacology
-
Principles:
- Autonomy: Respect the patient's right to make healthcare decisions and provide education.
- Nonmaleficence: Avoid causing harm or prevent harm. Intervention should not cause more harm than good.
-
Beneficence: Act in ways that promote patients' well-being.
- Examples: emotional support, ensuring medical needs are met, comforting a dying patient, and assisting with tasks they cannot perform independently.
- Justice: Give each patient their due and act fairly.
-
Nurses Add Principles:
- Fidelity: Keep promises, non-abandonment, upholding RN standards.
- Veracity: Tell the truth.
- Accountability: Taking responsibility for actions.
- Privacy: Maintaining patient privacy (HIPPA).
- Confidentiality: Keeping information private.
Non-maleficence Principles
-
Avoid causing harm or minimize harm (avoiding ACTUAL injury).
- Examples: Holding a medication due to adverse effects, ensuring a safe work environment, selecting interventions that cause the least amount of harm to a patient, reporting suicidal or homicidal ideations.
Ethics & Morals
-
Ethics: The study of right and wrong principles, virtue, good vs evil as they relate to conduct and human flourishing.
-
Bioethics (Medicine/Science): Asks questions such as:
- What kind of person should I be?
- What are my duties and obligations to other people?
- What do I owe the common good or the public?
- Nursing Ethics: A subset of bioethics, focuses on ethical issues that arise in the practice of nursing.
-
Bioethics (Medicine/Science): Asks questions such as:
- Morals: Personal or communal standards of right and wrong.
Principles of Bioethics
-
Utilitarian:
- Evaluating what is going to happen to this patient (personalized).
- Rightness or wrongness of an action depends on the consequences of the action.
- Action promotes greater good.
-
Deontological:
- An action is right or wrong independent of its consequences.
- We cannot do that across the board.
Beauchamp & Childress's Principle-Based Approach to Bioethics
- Autonomy: Respect the patient's right to make health care decisions and provide education.
- Nonmaleficence: Avoid causing or preventing harm. Intervention will NOT cause more harm than good.
-
Beneficence: Benefit the patient, weighing harms vs risk, prior research studies, “Do good”.
- Requires a nurse to act in ways that promote patients' well-being.
- Examples: emotional support, ensuring medical needs are met, comforting a dying pt, assisting with tasks they cannot perform independently.
- Justice: Give each their due and to act fairly.
- Fidelity: Keep promises, non-abandonment, upholding RN standards.
- Veracity: Tell the truth.
- Accountability: Nurses are responsible for their practices.
- Privacy: Maintaining patient privacy (HIPPA).
- Confidentiality: Keeping information private.
Common Modes of Value Transmission
- Modeling: Observation
- Moralizing: Instilled value system
- Laissez-faire: Child develops on their own, little or no guidance – possible confusion
- Rewarding & Punishing: Just what it is.
- Responsible choice: Encourages child to explore.
Process of Developing Values
- Choosing: Freely choosing from alternatives after careful consideration of the consequences of each alternative.
- Prizing (treasuring): Involves pride, happiness, and public affirmation.
- Acting: Combining choice into behavior with consistency and regularity on the value.
### Common Medical Errors & Prevention
-
Common Medical Errors:
- Inappropriate prescribing of the drug
- Extra, omitted, or wrong doses.
- Administration of the drug to the wrong patient
- Administration of the wrong route or rate.
- Failure to give medication within the prescribed time.
- Incorrect preparation of a drug.
- Improper technique when administering the drug.
- Giving a drug that has expired or deteriorated.
-
If an error occurs:
- Check the patient for adverse effects.
- Advise the nurse manager and physician.
- Write a description of the error in the EMR and quality assurance documentation (incident report).
-
Prevention:
- Drug Regimen Process
- Avoid interruptions and distractions.
- Series of Checks:
- Nurse
- Patient
- Reporting Medication Errors
- NEVER LEAVE PREPARED DRUGS UNATTENDED
- Drug Regimen Process
### Bar-code Medication System
- Patient: Has own identifiers (ID, stickers).
- Nurse: Has a unique barcode (Omnicell, MAR, COW).
-
Drug: Has a unique barcode.
- Identifies the drug form, dosage, and NDC (National Drug Code).
-
Nurse Scans:
- Patient ID first, then the drug:
- If correct, the system allows administration of the medication.
- If wrong, the system will not allow the administration of the medication.
- Patient ID first, then the drug:
Patient Teaching
-
Medication:
- Describe the medication and what it does to the patient in an understanding language before administration.
-
Topics of Teaching:
- Name of the drug.
- Dose of the drug.
- Action of the drug.
- The frequency.
- How to store/prepare (discharge).
Comfort and Safety Measures
- Make sure the patients can restate the information perfectly to ensure they understand.
### Controlled Substance Handling
- Controlled substances on hand must be counted daily
- Each outgoing shift must complete a count of all controlled substances
- It should be done with another nurse witness
Common Medical Errors
- Inappropriate prescribing of medication
- Extra, omitted, or wrong doses
- Administering the medication to the wrong route
- Lack of administration, or wrong timely administration
- Incorrect preparation of medicine
- Improper techniques in drug administration
- Giving medicine that has expired or deteriorated
- If an error happens, the nurse must:
- Check the patient for adverse effects
- Advise the nurse manager and physician
- Write a description of the error in the Electronic Medical Record and quality assurance documentation
Medical Errors - Prevention
- Drug Regimen Process Avoid interruptions and distractions during medication administration
-
Series of Checks
- Nurse
- Patient
- Reporting Medication Errors
- Never Leave Prepared Drugs Unattended
Bar Code Medication System
- Patient has unique identifiers such as an ID band and sticker
- Nurse has a unique bar code
- For access to Omnicell, Medical Administration Record, and Controlled Substance Overage
- Drug has a unique bar code
- The barcode identifies the drug form and dosage
- NDC -> Natural Drug Code
- The Nurse scans the patient's ID first and then drug:
- If correct, the system allows the nurse to continue administration
- If incorrect, the system will alert the nurse and disallow the administration
Patient Teaching
- Explain the medication and how it impacts the patient in easy-to-understand language
- Teach before administration so the patient knows what they are receiving
- Topics of teaching include:
- Name
- Dosage
- Action
- Frequency
- Storage/preparation (discharge)
### Values & Ethics
-
Common Modes of Value Transmission
- Modeling
- Moralizing
- Laissez-faire
- Rewarding & Punishing
- Responsible choice
-
Process of Developing Values
- Choosing: Freely choosing from alternatives
- Prizing (treasuring): Involves pride, happiness, and public affirmation
- Acting: Combining choice into behaviors with consistency and regularity
-
Ethics and Morals
- Ethics: The study of right and wrong principles, virtue, good vs. evil as they relate to conduct and human flourishing
- Bioethics: asks questions such as:
- What kind of person should I be?
- What are my duties and obligations to other people?
- What do I owe the common good or the public?
- Bioethics: asks questions such as:
- Morals: Personal/ communal standards of right and wrong
- Ethics: The study of right and wrong principles, virtue, good vs. evil as they relate to conduct and human flourishing
### Bioethics Principles
- Utilitarian Principle: The rightness or wrongness of an action depends on the consequences of the action. This should promote the greater good
- Deontologic Principle: An action is right or wrong independent of its consequences
Beauchamp & Childress Principle Based Approach
- Autonomy: Respect the patient's rights to make decisions about their health care, provide education
- Nonmaleficence: Avoid causing/prevent harm; Intervention will NOT cause more harm than good
- Beneficence: Benefit the patient, harms vs risk, prior research studies, “Do good”
- Justice: Give each their due and act fairly
Nurse Specific Ethical Principles
- Fidelity (Keep promises, non-abandonment, upholding RN standards)
- Veracity (tell the truth)
- Accountability
- Privacy (HIPPA law- maintain patient privacy)
- Confidentiality
Non-Maleficence
- Avoid causing harm or minimize harm → Avoiding ACTUAL injury
- Examples:
- Holding a medication due to adverse effects
- Ensuring a safe work environment
- Selecting interventions that cause the LEAST amount of harm to a patient
- Reporting suicidal or homicidal ideations
### Principles of Pharmacology
-
Responsibilities in New Jersey
- Prescriber: Orders the medication (prescription)
- Pharmacist: Responsible for preparing the meds
- Nurse: Responsible for administration of the medication
-
Checks and balances are in place to prevent errors.
- If an error is made, the pharmacist or the nurse has time to note it with the 7 "rights"
-
FDA Process
-
Pre-Clinical Phase: Development of the drug
- Animal testing
- Toxicity evaluation
- Sponsoring of the drug
-
Investigational Phase: New Drug Application
- Application is sent to the FDA if the drug meets the criteria
-
Clinical Phase
- New Drug Tested on small groups of people
- Larger groups: People with diseases for that drug, and usually some placebos
- Largest group: Patients will be taking the med and further studying effectiveness and safety
-
New Drug Review Application Process: FDA Final Review application process and marketing
- Testing on Human Beings
- Approvals:
-
Pre-Clinical Phase: Development of the drug
-
Nursing Process of Med Administration
-
Assessment
- Med History
- Medication Reconciliation - it's a process of questions to know what meds the pt is on, why, when they are taken, when did pt start taking it.
- Med History
-
Assessment
- Nursing Ethics: A subset of bioethics; The formal study of ethical issues that arise in the practice of nursing
### Drug Administration Responsibilities
- Prescriber orders medication
- Pharmacist prepares the medication
- Nurse administers the medication
FDA Drug Review Application
- Pre-Clinical Phase: Drug development, animal testing and toxicity analysis
- Investigational Phase: Drug application submitted to FDA once criteria are met
- Clinical Phase: Drug testing on small groups of people, progressively larger groups with placebo groups, and the largest group involves further study of effectiveness and safety
### Nursing Process of Medication Administration
- Assessment includes medication history and medication reconciliation
- Nursing ethics a subset of bioethics which focuses on ethical issues arising in nursing practice
### Bioethics Principles
- Utilitarian: Rightness or wrongness of an action is determined by its consequences, action promotes the greater good
- Deontologic: An action is right or wrong regardless of its consequences
### Beauchamp & Childress Principle Based Approach
- Autonomy: Respecting patients' rights to make healthcare decisions, providing education
- Nonmaleficence: Avoid causing harm, intervention shouldn't cause more harm than good
- Beneficence: Benefit the patient, weighing harms vs risks, prior research studies, "Do good"
- Justice: Giving each their due and acting fairly
- Fidelity: Keeping promises, Non-abandonment, upholding RN standards
- Veracity: Telling the truth
- Accountability: Being responsible for one's actions
- Privacy: Maintaining patient privacy, upholding HIPPA law
- Confidentiality: Protecting sensitive patient information
### Non-Maleficence
- Avoid causing harm or minimize harm
- Examples: holding medication due to potential adverse effects, ensuring a safe work environment, selecting interventions that cause the least amount of harm
Medication Administration Responsibilities
- Prescriber: Orders medication.
- Pharmacist: Prepares medications.
- Nurse: Administers medications.
-
Checks and Balances: To prevent errors.
- If an error is made, both the Pharmacist & Nurse should note this error using the "7 rights" of medication administration.
FDA Process Overview
-
Pre Clinical Phase:
- Develops the drug.
- Includes animal testing (toxicity) and sponsoring of the drug.
-
Investigational Phase:
- New Drug Application (NDA) submitted once the criteria are met.
-
Clinical Phase:
- New drug tested on small groups of people.
- Larger groups:
- People with the disease the drug is intended to treat, and often include placebos.
- Largest groups:
- Patients take the medication while effectiveness and safety are studied further.
-
New Drug Review Application Process:
- FDA reviews the final application and approves marketing.
- Includes testing on human beings.
-
Approvals:
- The safety and effectiveness of a medication is reviewed by the FDA before market approval.
Nursing Process of Medication Administration
-
Assessment:
- Medication history:
-
Medication reconciliation:
- A series of questions to determine what medications the patient is taking, why, when, and how long the patient has been taking the medication.
-
Nursing Diagnosis:
- Based on the assessment, the nurse identifies relevant nursing diagnoses related to the patient's medication needs, including any potential risks.
-
Planning:
- The nurse develops a plan of care for medication administration, including goals, interventions, and expected outcomes. This plan follows "The 7 Rights" of medication administration.
-
Implementation:
- The nurse administers the medication following the plan of care.
-
Documentation:
- Documentation is crucial and includes the medication administration time, dosage, route, and any patient reaction.
-
Evaluation:
- The nurse monitors the patient's response to the medication.
- Makes adjustments to the plan of care as needed and documents these changes.
Values & Ethics
-
Common Modes of Value Transmission:
- Modeling: Observing and learning from others' behavior.
- Moralizing: Being instilled with a specific value system (often from parents or religious leaders).
- Laissez-Faire: Freedom to develop values without much guidance.
- Rewarding & Punishing: Values are learned based on consequences.
- Responsible Choice: Encouraging the child to explore and make their own decisions.
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Process of Developing Values:
- Choosing: Selecting freely from alternatives after considering all consequences.
- Prizing: Showing pride, happiness, and public affirmation.
- Acting: Consistently and regularly performing actions based on values.
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Ethics & Morals:
- Ethics: Study of right and wrong principles, virtues, good vs. evil; how they relate to conduct and human flourishing.
- Bioethics: Focuses on ethical issues in medicine and science.
- Nursing Ethics: Subset of bioethics, a study of ethical issues that arise during the practice of nursing.
- Morals: Personal or communal standards of right and wrong.
Bioethics Principles
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Two Main Principles:
- Utilitarian: Rightness or wrongness of an action depends on its consequences and whether it promotes greater good.
- Deontologic: Right or wrong actions are independent of their consequences.
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Beauchamp & Childress Principle-Based Approach to Bioethics:
- Autonomy: Respecting patients' rights to make health care decisions; ensuring they receive education.
- Nonmaleficence: Avoiding causing or preventing harm. An intervention should not cause more harm than good.
- Beneficence: Acting in ways to benefit the patient. Harms vs. risks, prior research studies, "do good."
- Justice: Giving each their due and acting fairly.
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Nurses Add these Principles:
- Fidelity: Keeping promises, non-abandonment, upholding RN Standards.
- Veracity: Telling the truth.
- Accountability: Being responsible for actions.
- Privacy: Maintaining patient privacy, understanding the HIPAA law.
- Confidentiality: Protecting sensitive patient information.
Non-Maleficence Principles
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Avoiding Actual Injury:
- Holding a medication due to adverse effects.
- Ensuring a safe work environment.
- Selecting interventions that cause the least amount of harm to the patient.
- Reporting suicidal or homicidal ideations.
- An intervention should not be inherently negative.
- The action must be meant to have a beneficial impact.
- A positive result cannot be a consequence of an adverse effect.
Bar-code Medication System
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Unique Identifiers:
- Patients have their own ID number and stickers.
- Nurses also have unique barcodes for identification.
- Drugs have their own barcodes.
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Barcode identifies:
- Drug form
- Dosage
- NDC (National Drug Code)
- It's a number, and its unique to each product
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Scanning:
- Nurse first scans the patient ID.
- Then scans the medication.
- If correct, the system allows administering the medication.
- If incorrect, the system will alert the nurse and prevent the medication from being administered.
Patient Teaching
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What it does:
- Educates the patient about their medications in clear language.
- Teach before administering to ensure understanding.
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Topics of Teaching:
- Name of the drug
- Dosage
- Action of the drug
- Frequency
- Storage/Preparation instructions (for discharge)
Common Medical Errors & Prevention
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Common Errors:
- Inappropriate prescribing of the medication.
- Extra, omitted, or wrong doses.
- Administering the drug to the wrong patient.
- Administration of the drug through the wrong route or at the wrong rate.
- Failure to give medication within the prescribed time frame.
- Incorrect preparation of the drug.
- Improper technique when administering the drug.
- Giving a drug that is expired or deteriorated.
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If this happens:
- Check the patient for adverse effects.
- Advise the nurse manager and physician.
- Write a description of the error in the EMR and quality assurance documentation (incident report).
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Prevention:
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Drug Regimen Process:
- Avoid interruptions and distractions.
- Use a series of checks:
- Nurse check
- Patient check
- Reporting Medication Errors:
- Never Leave Prepared Drugs Unattended.
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Drug Regimen Process:
Common Medical Errors & Prevention
- *Common Medical Errors:** - **Inappropriate prescribing of the drug:** The medication may not be suitable for the patient's condition or may interact with other medications they are taking. - **Extra, omitted, or wrong doses:** This can lead to overdosing, underdosing, or the wrong drug being administered, with potentially serious consequences for the patient’s health. - **Administration of drug to wrong patient:** This can happen when patient identifications are not verified correctly. - **Administration of the wrong route or rate:** Giving a medication orally when it should be injected or vice versa, or administering the wrong rate of intravenous fluids can have serious health implications. - **Failure to give medication within prescribed time frame:** This can affect medication efficacy and can impact the patient’s treatment. - **Incorrect preparation of a drug:** Mixing medications incorrectly or using the wrong diluent can lead to ineffective or dangerous medication doses. - **Improper technique when administering drug:** Incorrect injection technique or using the wrong equipment can lead to complications. - **Giving a drug that has expired or deteriorated:** Expired drugs may lose their effectiveness or become harmful. - *Prevention:** - **Drug Regimen Process:** - **Avoid interruptions & distraction:** Focus on medication administration and prioritize patient safety over other tasks. - **Series of Checks:** - **Nurse:** Verify the order, patient, medication, dose, route, and time before administration. - **Patient:** Ask the patient for their name and verify their date of birth against their identification bracelet. - **Reporting Medication Errors:** Immediately alert the nurse manager and physician if any medication errors occur. Document the error in the EMR and complete an incident report for quality assurance. - **NEVER LEAVE PREPARED DRUGS UNATTENDED:** This crucial step helps prevent accidental administration or tampering with the medication.
Bar-code Medication System
- Patient has own identifiers: Each patient has a unique identification number or stickers attached to their wristband.
- Nurse has a unique barcode: Nurses have their own barcode, typically worn as a badge.
- Drug has a unique barcode: Each medication container has a unique barcode that identifies the drug form, dosage, and National Drug Code (NDC).
- Nurse scans patient ID first, than the drug: This two-step process validates the patient's identity and confirms that the nurse is administering the correct medication to the right patient. If all the information matches, the system allows the nurse to continue.
- If it is right, it will allow you to continue administering the medication.
- If it is wrong, the system will tell you and not let you continue.
Patient Teaching
- Describe the medication and what it does to the patient in an understanding language: Use plain language that the patient can easily understand without using medical jargon, explaining the medication to the patient before administering it so they know what's being given.
- Topics of teaching:
- Name of the drug: Clearly identify the medication.
- Dose of the drug: Explain the amount of medication they are receiving.
- Action of the drug: Describe what the medication is intended to do and how it will help the patient.
- The frequency: Inform the patient how often they need to take the medication.
- How to store/prepare (discharge): Provide any necessary storage information or instructions for preparing the medication at home.
What OTC and holistic, alternative, therapies should be avoided
- This information is not included in the text provided. It is important to always consult with a healthcare professional before taking any over-the-counter medications or using holistic, alternative therapies, particularly if you are currently taking prescription medications or have any underlying health conditions. They can help advise on potential interactions and risks.
Comfort and Safety Measures
- Make sure the patient can restate the information perfectly to know that they understand: Reinforce patient education by asking them to repeat the information in their own words. This ensures they grasp the key points and can correctly follow medication instructions.
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Description
This quiz explores the roles of healthcare professionals in drug administration within New Jersey, including prescribers, pharmacists, and nurses. It also covers the FDA drug approval process from pre-clinical to clinical phases, focusing on the importance of checks and balances. Test your knowledge on these vital aspects of medication management.
