Question

One of each nursing exemplars, please, thank you!

1. Implements principles of safety in the administrations of medication/parenteral fluid therapy.(Provide a specific example of how you maintained safety in medication administration (in addition to and including the 6 rights). Provide a specific example of how you maintained safety in parenteral fluid therapy administration (in addition to and including the 6 rights))

2. Demonstrates organizational and time management skills. (How do you organize your care? Give an example of how you managed time in providing patient care. This objective should be addressed in an area in which YOU, the student, are working somewhat independently (such as a med-surg unit). ONLY 1 exemplar required).

3. Identify cultural variances related to communication, space, social organization time, environmental control and biological variations for select clients. (What did your assessment reveal?)

4. Implement individualized nursing interventions to preserve the client’s unique cultural beliefs and culturally influenced ways of life. (What nursing interventions did you implement? How did these interventions preserve and demonstrate value to the client’s culture/beliefs/way of life?)

5. Identify cultural variances related to communication, space, social organization time, environmental control and biological variations for select clients. (What did your assessment reveal?)

Answer 1

1.Safety principles in the administration of medications

• The safe and accurate administration is the most important responsibility of nurse. Improper administration can cause harmful effects.
• If the dugs administerd with with out considering the principles of medicine administration it can produce harmful effects to the patient
• Nurses must know generic and trade names of drugs to be administered, classification, average dose, route of administration, use, side and adverse effects, contraindications, and nursing implications in administration befor administering a drug to the patient

Principles

• Princiiples include assessment of medications by nurse and 10 Rights

a)Assessment

1. Check when obtaining the container of medicine.

2. Check when removing the medicine from the container.

3. Check when replacing the container.

b) Rights of medication administrartion

1. Right Patient:

• Correct identification of the client be ensured before any drug administration
• This can be done by asking the client to mention his/her full name which should be compared with that on the identification bracelet or the patient’s folder and medication/treatment chart for confirmation.

2. Right Medication

• Read the physician’s orders to study the correct name of the drug
• If the order is not clear consult the physician
• Beware of same and similar first and surnames to prevent the error of administering one person’s medication to another
• Before administering any medicine, compare name on medication chart/medication order with that on the medication at least 3 times-checking
• Compare medication label with that on treatment chart and medication label and name on treatment chart with patient’s name tag.

3. Right Time

• Drug timing is very especially with some drugs like antibiotics, antimalaria drugs etc. to achieve cure and prevents resistance.
• Drug should be administered the drug as per physician’s orders
• The nurse must know why a medication is ordered for certain times of the day and whether the time schedule can be altered
• Medication that must act at certain times are given priority
• Know the common approved abbreviation in administering drugs as per intuitional policy.
• Give the medicine as ordered in relation to the food intake (a.c(before meals), p.c( after meals))• Give the medicines according to the action expected
• The interval of administration of drugs should also be adhered to because drug concentration level increse in the blood

4. Right Dose

• Consider the age and weight of the patient.
• Know the minimum and maximum dose of the medicine administered.
• Calculate the fraction dosage correctly.
• Have the medicine card or written order before you preparing drug.
• Know the abbreviations and symbols used Careful and correct calculation is important to prevent over or under dosage of the medication.

5. Right Route

• The drug can be administered through different methods, like orally, intreavenous, anal, sublingual etc
• Read the Physician’s orders to determine the route of administration
• Dilute the drug if indicated
• Know the abbreviations used to designate the route of administration
• Review the available forms of drug to make sure the drug can be given according to the order.
• Make sure the patient is able to take the drug by the route indicated or ordered.

6. Right to information on drug/client education

• •The patient has the right to know the drug he/she is taking, desired and adverse effects and all there is to know about the medication.

7. Right to Refuse Medication

• The patient has the right to refuse any medication.
• Eventhough after rejection nurese is obliged to explain to patients why the drug is prescribed and the consequences refusing medication.
• Record the medicine refused by the patient and those drugs that are not administered to the patient and the reason for not giving the medication.

8. Right Assessment

• Some medications require specific assessment before their administration e.g. checking of vital signs.
• Some medication orders may contain specific assessments to be done prior to medicat

9. Right Documentation

• Documentation should be done after medication and not before.
• Make sure you sign medication sheet immediately after administration of the drug.
• Record only that medicine which have administered.
• Never record a medication before it is giving to the patient
• Record the medications that are vomited by the patient, refused by the patient and those drugs that are not administered to the patient and the reason for not giving the medication.

10. Right Evaluation

Conduct assessment to ascertain drug action, both desired an side effect.

Example of providing safety in drug administration

When administering medication to the patient, for example while insulin administration, it should be administered at a precise time before mael at a certain dose.Overduse can result in hypoglycemia.Although the nurse should be aware of the drug reaction with each other.For example, if the patient is under sulfonylurea therapy for Diabetes ,use along with warfin, warfarin intensifies the effects of the sulfonylureas and cause blood sugar levels to plummet. The effect is that patients seem drunk, light-headed, and confused

Example of maintaing safety in parenteral fluid therapy administration

Prevention of infection ( Right route)

• Through administration of IV fluid , Infection can develop
• Before starting an iv line, aseptic technique must be maintained including initiation of IV therapy, preparing and maintaining equipment, and discontinuing an IV system.
• Perform hand hygiene before handling all IV equipment.
• If an administration set or solution becomes contaminated with a non-sterile surface, it must be replaced with a new one to prevent introducing bacteria or other contaminants into the system
• After starting an IV line , The set should be replaced every 72 to 96 hours to prevent infection and phlebitis in adults

2.TIME MANAGEMENT

• Time management is the act or process of planning and exercising conscious control over the amount of time spent on specific activities, especially to increase effectiveness, efficiency or productivity.

Ways for timemanagemnet in nursing care

1.Effective planning

• Planning should be based on goals to be achevied
• Draw an action plan
• Make a  list of things that need to be done to achieve your goals.

2. Setting goals and objectives

• Goals can be st as short term goal and long term goal basedd on the care to be given
• it will help to  reduce stress by preventing panic for people when confronted with multiple demands.

3.Setting deadlines

• As providers of care, nurses are expected to allocate their time to establish and maintain therapeutic nurse-patient relationships and implement the nursing process to maximize patient outcomes.

4.Delegation of responsibilities

• If the nurse is not able to carry out the work by herslf get some help or delegate the duty to other in busy situation
• It Involves assigning tasks , determining expected results and granting authority to the individual to accomplish these tasks

5. Prioritizing activities as per their importance

• Nurses not only have lots of things to do and also make quick and wise decisions. Time management allows the nurses to prioritize care, decide on outcomes, and perform the most important interventions first
• decide on outcomes, and perform the most important interventions first.

Example

• . In a hospital unit, a patient with apppendicitis and a patient with pulmonary edema with chest drainage is present.
• The nurse need to set priority care for her working area.
• Highlight those activities that must be completed during the shift or at specific times
• In the present case more focus should be given to patient with pulmonary edema, inspection of stoma and drainage should be checked thorougly for infection.

3.CULTURAL VARIATIONS IN NURSING CARE

• Culture refers to a set of beliefs, assumptions, values, and norms that a group of individuals largely observe and transfer across generations
• Culture affects an individual's concepts and approaches to health and illness

Communication

• A nurse should possess sufficient information about different cultural backgrounds and customs to be able to conduct holistic patient assessments
• A health care worker should consider patient's beliefs and heritage when developing a healthcare plan.
• Completion of a thorough assessment is particularly important when a patient comes from a different culture
• Communication has verbal and nonverbal dimensions, occurs in different culturl backgrounds
• It reflects similarities and beliefs in provider and patient cultural values, beliefs, and behaviors in health care
• It act as a bridge between health care provider and the patient
• Communication should be based on the cultuarl values of the client

Space

• Space is known as the distance between individuals when they are interacting with each other.
• Maintaing personal space is different in various cultural
• The nurse should respect the cultural factors related to maintaing a personal space according toc onvienece of the patient

Social organization

• It is the manner of people of different culture gather themselves around as a family
• The members in a social organization relate to each other in a different way
• The care should be based on notifying the charecteristics of client with in the family subunit

Time

• Most of the culture focuses on the traditional path, and some focus on the present culture
• The nurses should be prompt except emergencty care
• Keep punctuality in time so that the work can be done with out conflicts

Environment control

• It refereed sa the ability of a person to control over nature, plan and direct the environment.
• It plays an important role in determining client perception towards illnesses
• Some culture believe that they can overpower nature

Example

In the health care situation , some patients refuse to take medications, because of their cultural practices.They believe that going to some pastor, or religious centres help to eliminate the illness.The nurse should communicate effectively to them consideruing their culture and make them understand the importance of taking the medicine. Through proper explanation in coordinating with other members of the health team develop an effective plan of care.