Introduction to Medicines Management in Nursing

Alison Spires,Martina O?Brien,Kirsty Andrews,Martina O?Brien,Martina O?Brien

• Publisher: Learning Matters
• Year: 2011
• ISBN:
  9781844458462
• Edition: 1
• Topic: Medicine
• Subtopic: Nursing Skills

Managing medicines can seem a daunting prospect for new nursing students, but is a crucial skill they must develop from day one to provide safe care to their patients. This book specifically supports first-year, pre-registration students in meeting the required competencies for medicines management needed for progression into the second year. It is structured around the NMC Essential Skills Clusters, providing a clear introduction to law, calculations, administration, introductory pharmacology, patient communication and contextual issues applied to medicines management. The book is written in user-friendly language and uses patient scenarios to explain concepts and apply theory to practice.

Chapter 1
Medicines calculations for nursing students

NMC Standards for Pre-registration Nursing Education

This chapter will address the following competencies:

Domain 1: Professional values

8. All nurses must practise independently, recognising the limits of their competence and knowledge. They must reflect on these limits and seek advice from, or refer to, other professionals where necessary.

Domain 3: Nursing practice and decision-making

6. All nurses must practise safely by being aware of the correct use, limitations and hazards of common interventions, including nursing activities, treatments, and the use of medical devices and equipment. The nurse must be able to evaluate their use, report any concerns promptly through appropriate channels and modify care where necessary to maintain safety. They must contribute to the collection of local and national data and formulation of policy on risks, hazards and adverse outcomes.

Domain 4: Leadership, management and team working

6. All nurses must work independently as well as in teams. They must be able to take the lead in coordinating, delegating and supervising care safely, managing risk and remaining accountable for the care given.

NMC Essential Skills Clusters

This chapter will address the following ESCs:

Cluster: Medicines management

33. Patients/clients can trust the newly qualified graduate nurse to correctly and safely undertake medicines calculations.

By the first progression point:

1. Is competent in basic medicines calculations relating to:
   • tablets and capsules
   • liquid medicines
   • injections including:
     • unit dose
     • sub and multiple unit dose
     • SI unit conversion.

Chapter aims

By the end of this chapter, you should be able to:

• understand the mathematical principles that underpin the accurate calculation and administration of medicines;
• discuss the consequences to the patient of receiving inaccurate dosages of medicines;
• demonstrate competence in calculating a variety of medicine dosages.

Introduction

According to the National Patient Safety Agency (NSPA, 2009), 72,482 medication incidents were reported in 2007. Of these, 73 per cent were reported in acute adult care and 76 per cent in acute paediatric care settings; primary care settings reported 14 per cent, while mental health settings reported 9 per cent. While the majority of such incidents resulted in little or no harm to the patients involved, 100 resulted in death or serious harm to patients. The most serious incidents occurred at the administration stage of medicines management (41 per cent). This report highlighted that 3,674 (5 per cent) of incidents were as a result of the wrong dose of medication being administered to patients.

An essential requirement for entry on to all pre-registration nursing programmes is the ability to demonstrate proficiency in numeracy skills. This is a requirement for all entrants by the NMC, in the interests of public protection.

While the whole process of medicines management is a responsibility of a variety of members of the interprofessional team (for example, doctors and pharmacists), it is generally the nurse who has the responsibility for actually giving the medicines to the patient. The administration of medicines is a task nurses perform many times each day. It is therefore essential that nurses are able to calculate medicine dosages accurately.

While only registered nurses can independently administer medicines, it is a skill that takes a lot of time, practice and experience to develop. So, as a nursing student you need to use every opportunity to practise the skills involved in the administration of medicines under the direct supervision of a registered nurse.

When performing calculations, it is important that you understand what you are doing. If you are unable to perform medicine calculations accurately and consequently give the wrong dose of medication, this could have dire consequences for your patients. Becoming familiar with some common formulas to calculate medicine dosages will help you i...