According to the Department of Health(2019), the principles of the quality use of medicine are used to ensure the safe and wise use of medicines so that the risks of gaps, misuse, or overdose are managed. As per the principles it is required to monitor the patient for the outcomes of the drugs. During medication care of the patient, it is also necessary that the risks or benefits of the drug and its dosage are effectively maintained. Effective monitoring and evaluation by the nurse can ensure the safe delivery of the care to the patients (Davies et al., 2017). It is found that in some cases if the dosage is not appropriate or scheduled then it can impact the health of the patient. The following sections will discuss the key issues in the case study and their recommendations.
In this case study, it is found that the patient had a medical history of diabetes, rheumatoid heart disease, and pneumonia. The patient is prescribed with respective medications but it was found that without evaluating and monitoring the effects of the drugs the dosage was increased for the patient. The patient was even asked for the medications that she might have at her home or if she had any past surgery or medical care due to which she is prescribed with other medications or not. The patient was not informed and educated about her health status and she was also not told about her medications in brief. It was found that she did not use the medications prescribed at present for her health, but decided to use those medications or drugs that were available at her home due to her previous medical care. This showed that the patient had no education or information about her medicines. Each patient is prescribed with particular dosage as per the health condition, if in such cases the patient is not well informed about the types of dosage importance then he/she might mistake it with some look-alike or sound-alike drugs and take previously prescribed drugs that might negatively impact the health and prevent improved health conditions (Park et al., 2017).
The first issue is without the evaluation of the after-effects of the medication dosage on the health of the patient she was prescribed with high dose medicines. According to the National Institute on Aging(2019), there should be a safe and wise use of medications. This can be ensured if the monitoring is frequent and the patient’s condition and other therapies should also be considered. The first recommendation is the use of the Medication Administration Safety Assessment Tool and this tool is used for safe medication administration. According to the Department of Health(2019), the safe administration can be ensured by ensuring the following points: administration of the medication at right time and through the right route; monitoring of the vital signs after drug administration; the patient should be observed for the desired effects; the patient should be monitored for adverse drug reactions and contradiction cases; evaluation for allergic responses. It is found that in some cases few medicines show antagonistic effects, therefore frequent monitoring of the after-effects of the drugs is required. The second recommendation is educating the nurse and patient about the Rs of the medication. the right answer, the right way, right guidance, right dose, right time, right route, right medication, and right patient; these are the 9 Rs of the medicine administration (Edwards et al., 2015). This will ensure quality use of medicines and it is found that in some cases if the dosage is increased and evaluation is not performed then the side effects such as high blood pressure, anxiety, dizziness, headache, and vomiting can impact the health of the patient (Jose et al., 2018). If the patient is discharged without informing him/her about the time and route of administration then the efficiency will be reduced and expected results will not be received. If the Rs of medication are maintained then it will result in the appropriate use of medications with no chances of gaps or overdose; then there will be a safe and wise use of medications. These recommendations will ensure improved diagnostic, therapeutic, and professional medicine administrative care as well.
The second issue is poor knowledge of the patient about the medicines. It is important to educate the patient about the medication with their use and dosage. This will reduce the risks of chances in which the patient will mistake between similar medications. The first recommendation is educating the patient about the medicines. The patient should be educated about the difference in the effects of medicine when the dosage is changed. She should be asked open-ended questions about her health condition and knowledge about the medications as well. The nurses should ensure to provide knowledge on the refill of the medicines (Bowen et al., 2017). With information about the medication, the patient will be able to understand the sensitivity of the drug/medicine dosage and the ability to interact (Lucas et al., 2015). Moreover, the transfer of information will ensure informed consent of the patient as well to ensure patient-centered approach. The patient should also be informed about the different brand names of her medicine and the generic names as well so that the chances of misunderstanding or confusion are removed. The second recommendation is an assessment of the environment. In this case, it was found that the patient already had few previously prescribed medications and therefore thought not to use the presently prescribed medicines. If the environment is not assessed by the nurses then it can lead to medication errors (Cross et al., 2017). Moreover, effective communication can help in assessing the environment and reducing the risks that lead to poor use and management of medications. In this case, the patient was told that her recovery is complete but she was not informed that she still needs to continue the medication or not. Due to this inappropriate communication and incomplete information transfer, the risks to health may arise with the inappropriate use of medicines (National Institute on Aging, 2019). In this case study, the patient is a diabetic due to which her recovery is slow and if she is not well informed and educated about the quality use of medicines then her recovery rate will get negatively affected or she might also get infection risks if the right dosage and correct medicines are not taken by the patient.
It is concluded that if there unprofessional use of medicines then the health of the patient might get affected. Without the transfer of the complete information between the nurses and the patient then the miscommunication and poor knowledge about the use of medicines can result in unexpected results. With the use of a medicine safety assessment tool, the risks can be reduced. The patient should be assessed for the vital signs, after the effects of medicine, and health status. With the quality use of medicines, medicinal errors can be reduced, and the diagnostic and therapeutic care can be improved. All these factors will ensure safety and quality care delivery as well. The nurse and patient should be provided with knowledge of 9 Rs of safe medication.
Bowen, J. F., Rotz, M. E., Patterson, B. J., &Sen, S. (2017). Nurses' attitudes and behaviors on patient medication education. Pharmacy Practice, 15(2), 930.https://doi.org/10.18549/PharmPract.2017.02.930
Cross, R., Bennett, P. N., Ockerby, C., Wang, W. C., &Currey, J. (2017).Nurses’ attitudes toward the single checking of medications. Worldviews on Evidence‐Based Nursing, 14(4), 274-281.https://doi.org/10.1111/wvn.12201
Davies, K. M., Coombes, I. D., Keogh, S., & Whitfield, K. M. (2019). Medication administration evaluation tool design: An expert panel review. Collegian, 26(1), 118-124.https://doi.org/10.1016/j.colegn.2018.05.001
Department of Health.(2019).Quality use of medicines (QUM).Retrieved from:https://www1.health.gov.au/internet/main/publishing.nsf/Content/nmp-quality.htm
Department of Health.(2019).The National strategy for quality use of medicines.Retrieved from:https://www1.health.gov.au/internet/main/publishing.nsf/Content/EEA5B39AA0A63F18CA257BF0001DAE08/$File/National-Strategy-for-Quality-Use-of-Medicines-Executive-Summary-Brochure.pdf
Edwards, Sharon & Axe, S. (2015). The 10 ‘R's of safe multidisciplinary drug administration.Nurse Prescribing, 13, 398-406. https://doi.org/10.12968/npre.2015.13.8.398
Jose, J., &AlHajri, L. (2018). Potential negative impact of informing patients about medication side effects: A systematic review. International Journal of Clinical Pharmacy, 40(4), 806-822.https://doi.org/10.1007/s11096-018-0716-7
Lucas, M., Loh, R. K., & Smith, W. B. (2018).Improving drug allergy management in Australia: Education, communication and accurate information. The Medical Journal of Australia, 210(2), 62-64.https://doi.org/10.5694/mja18.00467
National Institute on Aging (NIA).(2019). Safe use of medicines for older adults. Retrieved from:https://www.nia.nih.gov/health/safe-use-medicines-older-adults
Park, C., Meghani, N. M., Amin, H. H., Nguyen, V. H., & Lee, B. J. (2017). Patient-centered drug delivery and its potential applications for unmet medical needs. Therapeutic Delivery, 8(9), 775-790. https://doi.org/10.4155/tde-2017-0039
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