Professional Responsibility in Drug Administration

Disucss about the Nursing Health Care Ethics in your Chosen Case Study.

The ethical issue in case three is the issue of drug administration to patients and the issue of reporting child abuse cases. In the healthcare profession, there are ethical standards that need to be followed when administering drugs and not just any approach that the practitioner takes. Hodgson (2016) suggests that practitioners are legally limited on the decisions that they can make in  a situation thus the need to rely on other professionals in handling different situations that arise within healthcare. The healthcare practitioner needs to understand the professional responsibilities associated with the medication, the drug order and the delivery system that needs to be used.  According to the Australian Institute of Family Studies (2018), there are guidelines for reporting child abuse and neglect cases that practitioners need to follow. In reporting, the paramedics were supposed to document the incidence at the scene and handover the file to Beth was supposed to report the issue to the doctor for analysis. However, none of this happened since the situation of the child was not documented which is a violation of the mandatory policy requirements. Every drug has its own indications on dosage and the mode of administration to be used in patients in the case study the urgency nurse draws the prescribed dose of morphine and then draws the rest of the ampoule in another syringe and asks whether the administration should be halves. In the healthcare setting, the practitioner is supposed to determine the mode of administration and the type of administration of the drug and not the patient. The patient is not informed of the healthcare process and thus requires the professional opinion of the practitioner in issues that relate to healthcare.

Ignorance or negligence of the nurse can result in delays or other complications to the patient. Since nurses proactive under a professional license, they need to understand the responsibilities that relate to the role that they play and must seek to develop relevant competencies that meet the requirements of the profession (Salari, et al., 2013).  This means that the patient is entitled to the right drug, dosage and route. Even though the patient may not be aware of the rights that apply in a particular context, the practitioner is not supposed to infringe these rights by abusing them but rather needs to focus on ensuring that the patient receives the right dosage. On the other hand, the paramedics and the nurse needed to take all the clinical notes of the child to be used in reporting and filing of criminal charges against the parents.  The Australian Institute of Family Studies (2018) requires documentation and reporting of any abuse and neglect aginst children to ensure that they are protected by the state. when practitioners fail to document and report the issues, then they compromising the rights of the child and violating the legal requirements that define the profession. By observing ethical values in handling patient related issues, the practitioner ensures that the patient receives the right dose leading to the intended outcomes (Soleymani, Shalviri, & Abdollahi, 2011). Since the nurse is responsible and accountable for individual nursing practice, then there is need to ensure that the approach used in medication meets the required standards and upholds the needs and rights of the patient.

Guidelines for Reporting Child Abuse

Human dignity is a philosophy that requires treating people in a humane way and ensuring that conditions are put in place to make the approach meaningful. Borhani, Abbaszadeh, & Roghayeh Mehdipour Rabori (2016) suggests that patients are vulnerable to the practitioners since they are ignorant in some situations or they can be in a state that cannot allow them to raise certain concerns about the healthcare process. This means that the practitioner has to uphold patient dignity at all times by ensuring that they are exposed to the required conditions that will not dehumanize them in any way. In the case of Milly she is entitled to the right morphine dose to reduce the pain that she felt before any other analysis can be done on her. By reducing the pain and trying to restore her to the normal state, the practitioner has observed the concept of human dignity to the patient. Human dignity requires that the agency nurse adheres to the right dosage requirements and mode of administration regardless of the views of the patient. Further, she is legally entitled to protection by the state like any other child from abusive parents.

Human rights form the moral norms or principles that define the standards of human behavior that are protected by the law. In a healthcare setting, patients are entitled to the right drug that meets the medical condition they are facing, right dose, right route and administered at the right time. Filik, Purdy, Gale, & Gerrett (2014) suggests these rights ensure that the patient is protected against any harm that can arise from practitioner errors thus compromising the healing process. Since practitioners are accountable for the healthcare decsionsons and outcomes that they engage in, then it means that infringing the rights of the patient can lead greater implication (Seidling, et al., 2013). In the case of Milly, the practitioner was not supposed to ask whether the administration was to be done in halves since the dose had been prescribed. To treat her with dignity, the practitioners were supposed to report the issue immediately to the doctor who was to involve the law administration team to investigate and open criminal proceedings against the parents.

The nurses in Australia are bound by a professional code of ethics that requires quality of care and informed decision making as major areas that focus on the administration of drugs (Nursing and Midwifery Board of Australia, 2017). This code is relevant to all nurses and nurses are required to ensure that they observe the code of ethics in every process that they engage in to avoid ethical dilemmas. The requirements are documentation of any clinical outcomes in the patient and reporting any issue like the case of abuse to higher authorities. By observing the set standards, Beth and the nurse can achieve quality outcome for the patient through following the right administration process and focusing on quality of outcomes and informed decision making. The board requires all practicing nurses to be licensed as a way of ensuring that they compy with the regulations of the industry. Nurses who do not comply are deregistered thus making it difficult for them to work in Australia. This code of ethics ensures that nurses meet the ethical standards when dealing with patients.

Importance of Observing Ethical Values in Healthcare

When dealing with patients, principles of healthcare are applied to ensure that the patient gets the best of care in the process. The principles of  beneficience, justice, and non-maleficence apply to the case situation above. Justice requires that the right procedure is followed in dealing with the patient situation and administering of drugs. The principle of beneficence requires that the health practitioner approaches the administration process with the intention of doing good for the patient (Lawal, et al., 2014). This means that the dosage should meet its intended requirement of relieving the patient from the pain. By administering a proper dosage, the practitioner ensures that the patient can enjoy the health benefits of the drug being administered to her. On the other hand, the principle of non-maleficence requires that no harm should be done to the patient. The practitioner puts proper mechanisms in place to ensure that the patient receives the intended benefits  of the medical process.

According to the Australian Nursing & Midwifery Federation (2017) the administration of medicines is a  function reserved for nurses and midwives whose role is to promote self-care and competent practices. Only nurses who are registered and required to hold  and administer medicines are allowed to administer medicines. This is the reason why the nurse asked Beth to confirm the mediation before she could administer. This indicates that she was not professionally allowed to prescribe or measure the dosage for patient medication (Athanasakis, 2015). The Poisons and Therapeutic Goods Act 1966 in Australia protects the health care community by imposing limitations on the use of medicines and their administration to ensure that they are used in the right standards and requirements to ensure that they meet the conditions that they are manufactured for. By ensuring that only qualified and authorized persons can handle or administer the medication, the policy protects the consumer against any breach that can affect the outcome of the medicine on the patient.

For proper administration of drugs by practitioners, facilities need to set standards and Policies that adheres to the legislations that have been put in place by relevant bodies on the procedures that practitioners follow. Standards are designed to ensure that the practitioner follow a certain course of action when handling and administering medication (Glavin, 2010). Nurses and practitioners who breach such Policies are liable for criminal charges against them. Through institutional medication Policies, management can regulate medical errors and ensures that nurses are familiarized with the institution administration processes. Policies ensure that proper standards are put in place for meeting professional requirements and achieving the intended outcomes. These policies are also used to determine the tripartite relationship between those who prescribe, dispense and administer to achieve improved care in the patient.

Analysis of the Ethical Issues

Another recommendation for reducing medical administration errors and addressing the ethical issues around it is the use of nursing education to equip nurses with proper skills in the area. Practitioners who are authorized to handle medications must have attained the minimum educational requirement to ensure that they understand the requirements (McMullan, 2010). Since medical administration is a multi-stage process that involves different disciplines, then management must be a joint effort of those who prescribe, dispense and administer. Nursing education ensure that the nurse is equipped with appropriate knowledge and skills required in the field.

Lastly, there is need to institute proper policies for reporting and recording of incidence reports for future reference. In cases of assault and abuse, the healthcare system plays a major role in justifying the extend of harm thus assisting in seeking justice for the victim. Proper reporting policies will ensure that nurses request for incidence reports from practitioners which can be used for protection or pressing of charges. In the case of Milly, there is no proper incidence report from the practitioners that indicates the effects that she suffered. Thus policies will ensure that such incidences are properly documented.

From the case study, ethical issues in the administration of medicines are important in ensuring that nurses can administer the right drugs and the right dosage to patients to minimize medical errors. Facilities need to put strategies in place to ensure that practitioners who handle medicines uphold the right standards of ethical care and uphold the Policies put in place by the organization. Although nurses are trained on medical processes and how to administer medications, there is need for organizational processes to be used in ensuring that patient’s dignity and rights are protected through following the right procedures and using the ethical principles of care required for all practitioners. Therefore, in the case of Milly, the practitioner nurse needed to have followed the right standards in administering the medication to achieve the required healthcare outcomes.

References

Athanasakis, E. (2015). Prevention of medication errors made by nurses in clinical practice. Health Science Journal, 10(5), 1-10.

Australian Institute of Family Studies. (2018). mandatory-reporting-child-abuse-and-neglect. Retrieved from Australian Institute of Family Studies: https://aifs.gov.au/cfca/publications/mandatory-reporting-child-abuse-and-neglect

AustralianNursing&MidwiferyFederation. (2017). Administration of medicines. Retrieved from Australian Nursing & Midwifery Federation.

Borhani, F., Abbaszadeh, A., & Roghayeh Mehdipour Rabori. (2016). Facilitators and Threats to the Patient Dignity in Hospitalized Patients with Heart Diseases: A Qualitative Study. International Journal of Community Based Nursing & Midwifery, 4(1).

Filik, R., Purdy, K., Gale, A., & Gerrett, D. (2014). Drug name confusion: evaluating the effectiveness of capital (‘tall man’) letters using eye movement data. Socilal Science Medicine, 59, 2597-2601.

Glavin, R. (2010). Drug errors: consequences, mechanisms, and avoidance. British Journal of Anaesthesia, 105(1), 76-82.

Hodgson, R. (2016). Legal and professional boundaries: a case study. Journal of Paramedic Practice, 8(2).

Lawal, A. K., Rotter, T., Kinsman, L., Sari, N., Harrison, L., Jeffery, C., . . . Flynn, R. (2014). Lean management in health care: definition, concepts, methodology and effects reported (systematic review protocol). Sytematic Reviews, 3(109).

McMullan, M. (2010). Exploring the numeracy skills of nurses and students when performing drug calculations. Nursing Times, 106(34), 10-12.

NursingandMidwiferyBoardofAustrlia. (2017). Code of Ethics for Nurses in Australia. Retrieved from Nursing and Midwifery Board of Austrlia.

Salari, P., Namazi, H., Abdollahi, M., Khansari, F., Nikfar, S., Larijani, B., & Araminia, B. (2013). Code of ethics for the national pharmaceutical system: Codifying and compilation. Journal of Research in Medical Sciences, 18(5), 442-448.

Seidling, H. M., Lampert, A., Lohmann, K., Schiel, J. T., Send, A. J., Witticke, D., & Haefeli, W. E. (2013). Safeguarding the process of drug administration with an emphasis on electronic support tools. British Journal of Clinical Pharmacology, 76(1), 25-36.

Soleymani, F., Shalviri, G., & A. M. (2011). Pattern of use and adverse drug reactions of tramadol; a review of 336,610,664 insured prescriptions during 5 years. International Journal of Pharmacology, 7, 757-760