The most frequent acquired complication in healthcare setting is infection and third

The most frequent acquired complication in healthcare setting is infection and third standard of national safety and quality Health Services is all about the infection. This standard talks about prevention of infection and control of those infection if it is acquired by any circumstances or carelessness of patient or a worker. If we follow this standard properly then we can minimise most of the infections in the settings like by using proper personal protective equipment, doing proper wash and hand hygiene. But in case if there is infection then we must treat the infection accordingly by using evidence-based strategies. All the strategies should be approved by health regulation body and we must be updated all the time to prevent other infections to be spread. (Australian Commission on Safety and Quality in Health Care 2012)10. Whenever there is any insertion in veins then we must closely monitor the site to prevent the inflammation of the vein. It can be scored on basis of the appearance of the site from 0 to 5. 0 can be said healthy whereas 5 is the worst and needs immediate treatment. Basic signs are redness, swelling at the site and warmness. It is very important for every nurse to prevent any kind of infection and this in IV infusions are so common in healthcare facilities, so we must closely monitor the signs and symptoms of phlebitis by using VIPS. This can help to prevent the inflammation or encounter it at early stage so simple treatment can help to cure it.(Smith & nephew 2012)11.a. schedule 2- In this schedule the medicines are available to public through pharmacy and also through the licensed person who is allowed to sell these scheduled drugs if there is no pharmacy available. Examples cough and cold medicines, decongestant eye drops.b. schedule 3- drugs which falls in this schedule are only available in pharmacy. Also, can available from doctors in the clinic like dental, medical and veterinary clinics. These scheduled drugs don’t need any prescription, but professional advice is the way to use these drugs. Examples topical corticosteroids (low strength), adrenaline injections.c. schedule 4- these schedule drugs are distributed to public only with the doctor’s prescription. Dispensary is must for the storage of the drugs. Nurse practitioner, podiatrist and optometrist can also prescribe some limited number of schedule 4 drugs in some states of Australia. Example antibiotics and insulin.d. schedule 8- these are also known controlled drugs and precaution must be taken while prescribing or administering this drug. This drug make individual dependant and people can misuse it so its illegal to use this without authorities and prescription. Safety is very much important, so it is kept in locked cabinet. Validation of prescriptions are only up to 3 months. Examples opioids like morphine and CNS stimulant like dexamphetamine. (Gabrielle, Kate, Jodie 2017p572)12. The factors that needs to be considered while people are using dose administration aids are listed below:Patient should be provided with education and counselling about the medicines packed in the device, including a printed medicine list.Patient’s current medication regimen, type of device, which medicines are to be packed, packing interval and harm- benefit assessment must be documented. This document has to be shared between the packing pharmacy, prescriber’s and the patient, and should be updated whenever there are changes to the medicines or packing arrangements.Ensure the device is packed as close as possible to the date that it will be used, protect from direct light and heat during storage and use to minimise risks of drug degradation.Provide regular patient follow up and monitoring such as arranging home medicines review to ensure that the patient is successfully managing the device, and that ongoing information and education needs are met.Conduct regular medication reconciliation to ensure that the medication packed in the device match the prescriber’s intended regimen.Ensure good reciprocal communication system has been put in place between prescribers, the packaging pharmacy and the patient to ensure medication changes are implemented correctly and in timely manner.13.Rights of medication administration How an enrolled nurse should apply each of these rights?Right medication EN must always check the container and label with the medication chart 3 times before taking container, before taking medication from container, before putting container back. And after this EN should check with RN.Right dose Medication is ordered in SI unit. EN should always do the proper calculation by converting units if necessary. They should always use proper measuring devices according to dosage order. Before administration they should always approach RN.Right prescription (documentation) There must be proper documentation related to medication. It is our duty to check either order is correct or not. and always use acceptable abbreviation in medication chart. EN should do these under supervision of RN.Right route There is always mentioned route of administration by prescriber on the medication chart. We should check if route is suitable or not for the patient and then administer under supervision of RN. If route is not suitable then EN should consult with doctor or report to RN.Right time All the medication has different times for administration, and it is nurse’s duty to make sure the medication is administered on correct time intervals. Always cross check with RN to be safe.Right person It is most important to know that the prescribed medication administered to right person. So EN should always confirm the identity either by checking persons ID or asking them their name and date of birth.Right expiration date Every medication has their different expiration date and EN can make sure they are always on alert of the dates. If there is expired medication in drug room, then they can first notify RN and after that to pharmacist.Right to refuse It is every patient right to refuse for medication and every nurse must respect their decision but it’s also our responsibility to tell them the consequences that may arise and document that accordingly with correct abbreviation. EN should report this to RN or facilitator. (Gabrielle, Kate, Jodie 2017 p571)14.IV medication administration methods Identify an indication to use each of these methodsIv bolus This method is used when we must inject large volume of medication in short period of time like in emergency cases or when we cannot dilute the drug. It ensures that the medication is completely injected without blockage of line. (unknown 2019)Gravity or drip infusion It is used to make a portal of entry for the fluid’s administration like electrolytes or any other medication. (Joanne, Gayle, Eugenie, Karen 2016 p218)Electronic pump infusion This method is used when we must administer medication in controlled manner. like if there is ordered to administer critical fluids or medication having high risks then we use electronic pump infusion because they specially designed. (food and drug administration 2018).Via burette We administer medication via burette only when we have to control the volume of medication to the fluid container. Like if we must administer medication intermittently. (Joanne, Gayle, Eugenie, Karen 2016 p226)Via piggyback and tandem It is used when the patient already have an infusion line and we must administer medication intermittently without monitoring for any error. (Gabrielle, Kate, Jodie 2017 p604)Syringe driver through sub-cut lines It is used for those patients who are in palliative care and cannot take medications orally. It is also used for making the patient comfortable because there is better absorption. (BPAC 2019)15. Use of Metoprolol: Metoprolol can be used for hypertension, angina pectoris, cardiac arrhythmias, myocardial infarction, migraine prophylaxis, tachycardia. Action: Metoprolol works by blocking beta- adrenoreceptors (sympathetic nervous system), thereby reducing some of the responses of the body to adrenaline, noradrenaline and isoprenaline. (Adriana 2008)

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