Administering Medications

Administering medications are most often times done by the nurse. The practice of administering medication involves providing the patient with the right medication that is intended for the diagnosis, treatment, or prevention of a medical illness or condition. The purpose of this paper is to look at the medication administration policy of Sanford Health.

Assessing the policy is via Intranet. Intranet is found on all computers located at Sanford Health. The main page of the intranet pops up after clicking on internet explorer and then there is a menu button that populates a heading that states policy and procedures. Click on the hyperlink and different categorizes of policies and procedures will populate. There is a category for general nursing. Click on hyperlink and it will bring up on the policies and procedures related to nursing. Also on the main page of the policies and procedure page is a search engine which allows the person searching to type in the policy or procedure they are looking for on the intranet. The medication administration policy was originally initiated on February 8th, 2006 and last revised on September 9th, 2009.

Through clinical error, such as wrong medication to right patient and wrong patient and right medication, have evolved a policy and procedure for medication administration(Ulanimo, O'Leary-Kelley & Connelly, 2007). The policy of medication administration was put in affect to describe a uniform system to safely administer medications. Trial and error helps ensure the correct policy and procedures needed to make certain a successful delivery of medication.

According to Polit and Beck (2012) inductive reasoning is the process of developing generalizations from specific observations. For example when giving a medication that is PRN for a patient in pain. According to the Sanford's policy the nurse must have two identifiers such as name and birth date to ensure it is the right medication for the patient. Assemble information is to bring together information and fit it together. According to Polit and Beck (2012) quality improvement and risk data such as medication error reports, can be used to assess the need for practice changes. This is a good example of how policies can be affected by assembled information. This error reports can also be broke down into more specific reporting such as the done by Johanna Westbrook and partners. The study broke down medication errors into association of interruptions with an increase risk and severity of medication administrations errors. According to Westbrook et al (2010) the conclusion was among nurses at 2 hospitals, the occurrence and frequency of interruptions were significantly associated with the incidence of procedural failures and clinical errors. This is a great example of how assemble of information is so important. Disciplined research is very important to the world of nursing. The aim of disciplined research is to gain understanding about a phenomenon. According to Polit and Beck (2012) the current emphasis on EBP requires nurses to base their clinical practice to the greatest extent possible on research-based finding rather than on tradition, authority, intuition, or personal experience.

Within research, there is a recognized hierarchy of reliability which can be used as a guide when considering the effectiveness of evidence. On this particular policy and procedure obtained from Sanford Health provided no specific references. It did reference that medication will be ordered, handled, stored appropriately, according to each clinic site procedure and per OSHA, MSDS and manufacturer guidelines. The hierarchy of evidence for this policy and procedure would be placed at a 6 because there are no references to on the policy and procedure itself. There is however great references throughout research that provides great support to the policy. According to MacDonald (2010) eludes to the fact of patient safety and the five rights saves more than 29 billion each year in hospitals alone by using the five rights. The 5 rights are talked about through the policy and procedure of Sanford Health.

Observation of a RN was done. Noted was the following. Before the RN gave the medication of Levaquin she made sure she had the right medication, patient, dosage, route and time. RN washed hands before entering room. RN then placed medication in medication cup and asked patient to verify his name and birth date and she check his name band. RN gave patient the water cup and he proceeded to take medication as RN watched. RN then washed her hands as she walked out of room. She then signed off medication outside of patient's room. RN should have signed medication in room instead of signing outside of room but the RN did a very good job of following the procedure.

The measurement of quality of the policy and procedure of medication administration effectiveness is by patient survey. The survey asks the patient if they were ask their name and birth date prior to medication being given. Sanford health has a PI committee that does chart audits to make sure VORB'S and TORB'S are being written within the standards of the policy and procedure. Sanford also has pharmacy on staff 24 hours a day and enters all medication on the MAR this is then double checked by a RN before giving medication to patient. Sanford also has a medication phone number to call. All variances are tracked and they are able to find a pattern in variances and correct it if they need arises. No name of individual causing the variance is needed or the name of the person calling. The Institute for Safe Medication practices (2003) has a started the National Medication Errors Reporting Program, operated is a confidential voluntary program that provides expert analysis of system-based causes of medication errors. Through various media outlets, the Institute for Safe Medication Practices (ISMP)