PHDN-601

FUNDAMENTALS OF PHILOSOPHY IN NURSING

Submitted by:

JOSEPH B. ABANG RN MN MAN

Submitted to:

NICOLO ANDREI AÑONUEVO, RN, MAN, PhD

October 15, 2022

 LEARNING ACTIVITY 2: PHILOSOPHY IN NURSING

This output is an application of the learnings after the discussion during the

scheduled class last week. It will focus on the topics of inquiry about medication variance

in the hospital and on the relevance of communication in preventing medication variance.

The following are the answers to the questions raised for this activity.

1. With regards to priority competency of nurses, look for practical interventions on

how to prevent medication variances in the hospital.

Nursing medication errors are at best regrettable occurrences. At worst, they could

negatively impact a patient's health and a nurse's professional standing. After the

discussion about priority competency of nurses regarding medication administration error,

the proponent of this paper is presenting the most practical interventions on preventing

medication variances in the hospital. For us to easily remember these practical

interventions, the proponent personally made a mnemonic, and this is the word

MEDICATION. These are the following:

M
Medication reconciliation procedures must be followed. When moving

a patient from one facility to another or from one unit within the same

facility, institutions must have procedures in place for medication

reconciliation. Compared to the transfer orders or the medications specified on the

transfer paperwork, review and confirm each medication for the correct patient, the

correct medication, the correct dosage, the correct route, and the correct time. The

medicine administration record must be compared by nurses to this. In order to avoid

potential errors related to improper reconciliation, it is imperative to verify with every

source possible, including the discharging or transferring institution/unit, the patient or

patient's family, and the physician, even though not all elements of a medication record

are frequently readily available for verification. Medication reconciliation forms are

available from all units and departments.

E
Ensure implementation of the main and specific rights of medication

administration. Nurses are responsible for ensuring adherence to institutional

policies regarding medication transcription. The five main rights of drug

administration or simply transcribing the prescription as given require that the proper

medication be provided for the right patient, in the right amount, with the right timing.

D
Double check or even triple check procedures. To verify that each

patient's order is noted and accurately typed on the doctor's order and the

drug administration record or treatment administration record, another nurse

on the same shift or an incoming shift verifies all new orders. Some organizations use a

chart flagging procedure to draw attention to charts that include recent orders that need

to be verified.

I
insure and consider always having a drug guide available. Whether it's printed

or digital depends on personal or institutional preference, but both are equally useful

in providing crucial details on most medication categories, such as trade and generic

names, therapeutic class, drug-to-drug interactions, dosing, nursing considerations, side

effects/adverse reactions, and drug cautionaries like "do not crush, or give with meals."

C
Consider using a name alert. To avoid the possibility of prescription mix-

ups between patients with names that sound similar, certain institutions utilize

name alerts. Name alerts displayed in front of the MAR can help reduce
medication mishaps because names like Johnson and Johnston can make it simple for

nursing staff to become confused.

A
allow a physician or another nurse read it back. To make sure the

prescribed drug was correctly typed, a nurse repeats back an order to the

prescribing doctor. A nurse can also relay an order to another nurse while the

Medication Administration Record (MAR) is being checked for accuracy, reading back the

order as it was transcribed to the physician's order form.

T
to consider placing a zero in front of the decimal point. Without the zero in

front of the decimal point, a dosage of 0.25 mg can easily be mistaken for a

dosage of 25 mg, which could have negative effects on the patient.

I
insure, assure, and guarantee proper storage of medications for proper

efficacy. To retain effectiveness, drugs that need to be kept chilled must be

maintained chilled, and vice versa for prescriptions that need to be stored at room

temperature. Most biologicals need to be refrigerated, and if a multidose vial is used, it

needs to be labeled so that its expiration date from the time it was opened is not

exceeded.

Observe proper documentation of and on everything. This includes

O accurate drug labeling, readable paperwork, or accurate logging of

medications taken. Any pharmaceutical error may be caused by improper

documentation. For instance, if a nurse forgets to record a drug as needed, another nurse

may provide another dosage because there is no record of the earlier administration.

Another best practice is to read the prescription label and the drug's expiration date. A
pharmaceutical error can also result from a correct drug having an inaccurate label or the

other way around.

need to learn your institution’s medication administration policies,

N regulations, and guidelines. Nurses must familiarize themselves with the

details of a medication policy before they may follow it. To address this, the

institution's educator or education department must instruct nurses on the details of their

drug policy. These regulations frequently include crucial details about the institution's

procedures for ordering, transcribing, administering, and documenting medications.

Additionally, nurses should become aware with standards like the Beers list, black box

warning labels, and look-alike/sound-alike medicine lists.

Medication mistakes can be avoided or reduced by implementing one or more of

the measures. Drug safety is important, and nurses must never forget that a medication

error could have a catastrophic result.

2. How are you going to incorporate communication in relevance to medication

variance?

Communication is a very relevant component in addressing medication variance

in the hospital. The transfer of information is the standard definition of communication.

The phrase can either be used to describe merely the message being transmitted or the

area of study looking into such transmissions. The multiple patient interactions that nurses

have throughout a typical workday depend heavily on communication. It is crucial to clarify

important medical and medication information with the patient at the time of prescription

pickup so that any potential inaccuracies can be caught in the early stages. As the last
chance for nursing professionals and/or staff members to identify any mistakes. To

guarantee that these encounters are productive, efficient, and safe, it is essential to know

the proper questions to ask and how to ask them. Although this might seem simple, a

hectic work atmosphere might make it simple to miss straightforward but crucial

communication topics. For us to easily remember this communication relevance, the

proponent personally made a mnemonic, and this is the word COMMUNICATE. These

are the following:

C
Confirm patient identity. This is because a variety of circumstances, such

as language hurdles, hearing issues, disorientation or altered states of

consciousness, and the potential for some identifiers such as patient names

to sound similar, may result in misinterpretation particularly among family members. In

the worst-case scenarios, such misunderstandings could result in the wrong patient

receiving the wrong drugs, including ones that could be high alert. Patients can vocally

reveal their information by being asked open-ended questions, which allows nurses to

accurately validate patient identity and guarantee that the proper medication is

administered to the correct patient.

O
Opportunity to asks questions. Another custom is to ask patients if they

have any other questions when the nurse and patient are wrapping up their

discussion. The patient should always be encouraged to ask questions of

their healthcare providers because they are an integral component of the circle of care.

M
Make use of and embrace technology. It has been demonstrated that

wise use of technology improves safety. Systems that are well-designed

enhance patient monitoring and surveillance capabilities. Platforms for

collaboration and communication help busy nurses streamline many aspects of patient

care. As a result, there is more time for more intimate contacts, such family and patient

participation. Additionally, with the use of instruments like easily readable electronic

whiteboards, patients themselves can take a more active role in their own care.

M
Make collaboration with colleagues open. Collaboration amongst

coworkers is crucial to intrahospital communication. To ensure that the

system runs as efficiently as possible, patients, lab technicians, doctors,

and employees must all be in regular contact. Working together across teams also entails

accurately entering data into databases, particularly shared ones. Inaccurate

departmental communication can result in database entry mistakes, which could

endanger patient safety.

U
Use common communication methods. Administrators and personnel

must be trained to use the various communication channels that each health

care system offers effectively. The safety of the patient may be at danger if

even one of these communication channels breaks down. A small typographical error

could result in wrong dosages, and missing information could prevent a doctor from being

aware of a serious allergy. For the benefit of the patients as well as the hospital, it is

important to have a basic understanding of how typical communication techniques

operate.

N
Need to focus on patient safety. Patient safety is one of the main reasons

to establish a strong communication structure in any healthcare business

when evaluating the significance of communication in healthcare. Despite the

serious repercussions that can result from communication errors, these problems are
frequently quite simple to resolve, making many patient fatalities brought on by these

mistakes avoidable. One of the main factors contributing to the need of communication

for patient safety is this fact.

I
Initiate sharing research findings. Research is essential to the development and

advancement of tools and practices in the healthcare sector. However, due to

pressure from competitors in their fields, some independent researchers, such as

those who work for private businesses or pharmaceutical labs, are hesitant to share their

findings with providers. In order for healthcare practices to advance, providers must put

in place communication platforms that make it simple and quick for researchers to work

together, both within and between organizations.

C
Coordinating hospital leadership. Hospitals must be run like companies,

whether they are publicly or privately funded. Doctors, workers, and patients

must all be regularly communicated with by hospital administrators and other

authorities. In addition to managing administrative personnel and responsibilities, all

hospital executives and managers have a significant impact on the personal health care

plans of their patients. They must keep lines of communication open with those around

them, encourage information sharing amongst hospital departments, and work with

outside organizations if they are to be effective.

A
Adopt a culture of safety. The leadership's complete commitment to

implementing a culture of safety is the vital first step in reducing medical

errors. Another crucial aspect of creating a safety culture is the idea of the

safety huddle. Safety huddles are multidisciplinary, cooperative processes that frequently

take place following a negative event. In order to create procedures that will stop negative
incidents from happening again, managers and front-line employees’ problem-solve. By

using this approach, numerous lives have been saved and medical blunders have been

avoided.

T
Teaching the fundamentals of communication. The essential skill of patient

care should be communication. We must include fundamental communication

abilities in our training sessions. The key to preserving seamless

communications is teaching providers how to deal with all that noise. It's no secret that

there are tense interactions between some nurses and emergency room personnel. The

first step is active listening, which entails pausing, concentrating, and truly calming down

the situation. The second is keeping a record of the communication interaction in some

way.

E
Evaluate patient hand-off processes. To ensure that crucial information is

communicated to other staff members, patient hand-offs are essential. The

consistency and organization of hand-offs is crucial components. Evidence

suggests that nurses in some settings speak very differently from one another.

Interactivity, enabling questions between the giver and receiver, limiting interruptions,

repeat-backs and read-backs when necessary, and an organized hand-off guide or

checklist to maintain uniformity for all patients are all key components of successful hand-

offs.

In summary, health care providers realize that maintaining high-quality care,

patient safety, and patient satisfaction will never be totally achieved in the spirit of

continual improvement. Nevertheless, these difficulties will never be insurmountable.