Use 2 identifiers. Assigning the task of medication administration to the CMA allows for the nursing staff … A clear leader with a hands‐on approach may impose more direct control and strictures in relation to the myriad of regulations and guidelines on medication administration, while a more distant leader lets the staff regulate more independently. Furthermore, the training and skill maintenance in medication administration‐related tasks are to some degree random in that it is voluntary to participate. Right patient. In order to maintain effective operations, the nurses were flexible and had a shifting responsibility. A pilot study was conducted in a nursing home ward providing a similar contextual setting as the current study to test the data collection methods. The coordination reform. Long-term nursing a not an easy field, but comes with many rewards as well as challenges. Work system factors such as competence, leadership and staffing may influence the ability to perform safe medication administration. In periods of high workload, the staff seems to work with great efficiency and they describe the work as going smoothly. Azithromycin has been frequently prescribed when they are having respiratory symptoms requiring an antibiotic. By identifying normal operations, one may learn, adapt and develop appropriate safety measures in the future. Fundamentals of Nursing, Medication Administration, College of Southern Maryland. The nurse role is highly regulated, but the unpredictable nature of healthcare systems often forces RN’s to improvise, to find workarounds and adapts to the conditions offered by the current situation (Lindblad, Flink, & Ekstedt, 2017). Data collection was performed by a single researcher with a nursing background, which may introduce bias. It depends on the workload, if our wishes are granted, we have to ensure that no one gets too much to do, that we assign fairly. There is seldom a right or wrong, but the nurses have to substantiate their opinions or when they make alterations. An alteration in work tasks and workload is sometimes predictable, but most often not. Medication administration in nursing homes is often considered a simple task of “passing medications.” However, in reality medication administration is a complex process requiring many interactions of specific decisions and actions (Kaushal et al., 2001). It gave me a lot of the basic skills necessary, but of course, there is a lot more responsibility as a nurse. Such events may be related to professional practice, health care products, procedures, and systems, including prescribing; order communication; product labeling, packaging, and nomenclature; compounding; dispe… In all nursing homes medication is sometimes administered by qualified nurses, but the majority of medications is administered by nurse attendants, who have in general less specific training in handling of medication than nurses do. The Administration of Medication in the Nursing Home In most nursing facilities, the medication is given when the nursing staff member completes what is known as a “med pass”. State regulation § 2600.190(a) requires that in order for a non-medically licensed, certified, or registered staff person to administer certain medications, the staff person must complete a Department-approved medication administration training course within the past two years. “If it’s too hectic, we do not work so well together”. These categories reflect an intrinsic ability to confront and adjust to a dynamic and challenging workday. To reduce medication administration errors and to ease the burden of medication management for nurses, most nursing homes in Australia use dose administration aid (DAA) devices that are prepared by pharmacies [ 8 ]. Shortly after, the first author briefed the entire staff on both wards during regular staff meetings and asked whether they would consider participating in interviews. Human Factors theory often uses the analogues “blunt end” and “sharp end” to encapsulate much of the same meaning (Rankin et al., 2014; Reason, 2000). A complete and accurate medication list is the foundation for addressing medication reconciliation and medication management issues. The most striking finding is how the nurse in charge is left to compensate for the degree of skills and competencies of their team members. Check the medication label. Check the name on the order and the patient. Medication aides can give regularly scheduled, non-injectable medications in Oklahoma's nursing homes, reports Barbara Acello, R.N. Medication administration in nursing homes is a complex process taking place in a complex system with inherent vulnerabilities, placing high demands on the sociotechnical work system and the staff (Carayon et al., 2014; Choo et al., 2010; Grigg et al., 2011; Odberg et al., 2017). Learn more. Skip to content 800.437.6633 Observations documented that when the doctor was uncertain, the nurses experienced more responsibility together with a feeling of uneasiness. H‰. Since there was no involvement of patients or use of patient information, the study did not require approval from the Norwegian Regional Committee for Medical Health Research Ethics. A substantial number of the tasks related to medication administration were delegated from the MD and could not be delegated to nurse assistants. The flexibility of task assignment is therefore dependent on the skills and competencies needed in the various tasks related to medication administration. These areas are on an individual level (Need for Competence and Shifting Responsibility), team level (Leadership and Available Competence) and organizational level (Staff Stability and The Vulnerable Shifts). According to WHO (2016), MAE’s are preventable at different levels. It may also lead to adverse patient outcomes in that the healthiest patients receive less attention and care. In our previous post, we discussed how to prevent infections in these facilities, which … If I needed to administer morphine and was alone on my shift, I might have taken a photo with my cell phone and sent it to a colleague for confirmation. The study applied a qual‐qual mixed method design (Morse, 2016) using partly participant observations (Hammersley & Atkinson, 2007) supplemented by semi‐structured interviews for data collection. Everything has consequences if we are not thorough in following up. Identifying medication order discrepancies during medication reconciliation: Perceptions of nursing home leaders and staff. If a nurse spots a weakness in a colleague or does not trust him or her to do a specific task, they do it themselves instead. The researcher encountered no such situations. nursing home residents who leave the nursing home for several days; persons receiving home care - Up to 8 days of medications can be prepared (pre-poured) for self-administration by such individuals. The teams were formed so that professions complemented each other with the aim of always having a nurse on all shifts. The staff complain that if they need more advanced competence, they have to use their spare time, receiving no financial reimbursements or incentives. 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