Medication Administration

Introduction

Medical administration is an essential aspect in today’s world as it sets the standards into what is required to achieve universality and professionalism. Medication administration requires the concerned government entities and agencies to focus on aspects that would make health safe for its citizens. In a bid to ensure this happens, it is always prudent for the agencies to provide a thorough assessment and elaborate plan that can control medication administration.  Health systems require leadership and general management that would ensure that the utilization of resources is done in the right way (Parry et al., 2015). According to recent reports and studies, creating sustainable health systems requires a one on one basis assessment that eradicates all the risk factors that might be a hitch to the goals of the administrators and those concerned with health and medication. Management of medical and health systems is a sophisticated task that cannot be achieved without the input of different agencies. Specialists involved in the management of specific healthcare departments and offices are not only the most important policymakers in this regards but are also among the important decision makers in the industry. Medication administration requires a high-level of accountability and the desire to achieve orientation. Collaborating with the different entities and agencies is also an aseet5s in medication administration. Ensuring the success of most projects especially those that are capital intensive requires prudence in financial skills. Innovative thinking is one single value that cannot be replaced in matters of medication administration.

All in all, professionalism has to be at the highest level to ensure that the goals and objectives set are achieved. Based on the needs of a health center and the staff at such a center, it is important to ensure that team leadership, talent development and the ability to handle challenges that arise is possible. The paper focuses on issues of significance that touch on the administration of medication especially for unlicensed service providers (Parry et al., 2015). In dealing with matters that are related to training, requirements, and determination of competency. The paper provides insights into what other scholars and practitioners have researched about medication administration and how this literature could be used to improve the situation. The history of the policies that touch on medical administration is also discussed and the beneficiaries and outcomes of such administration.  Financial impact and the support systems available to make medication administration for unlicensed practitioners are also discussed in an in-depth manner. The paper also touches on statistics available on medication administration and the roles that the practitioner nurses would be playing on the field in general. In essence, much is discussed in the paper, but the whole idea is to develop a relationship by which relatability is guaranteed and working to improve the future of administration in medication is done (Keers et al., 2018). Setting the standards high, and promoting healthcare policies and bills is the only way to achieve quality healthcare for all communities around the country and medication administration is important in setting the pace, instilling discipline and professionalism and enhancing preparedness.

Literature Review

The literature review is important in highlighting the scholarly and research steps taken in finding out about medication administration. The purpose of the review, in this case, is to dig in a more profound way the literature provided on medication administration and probably find the best way to improve the quality of such knowledge in the future (Parry et al., 2015). Explaining the standpoint is not only important, but it is also the way to help unearth the many myths and beliefs that individuals have conc3erning medication administration. According to Parry et al. (2015) medication administration is not only a prerequisite to achieving universality in health care, but it is also crucial in setting the standards and codes of conduct by the professionals who in most cases are unlicensed (Bucknall et al., 2019). Building a network of these practitioners and creating an enabling environment for them to operate on not only eases the burden on the agencies but it also boosts the confidence of citizens on matters to do with healthcare. Bucknall et al., (2019) provide further information that by allowing medication administration to be at the forefront while regulating the practitioners not only promotes research on a higher level but also makes healthcare providers reliable. Keers et al., (2018)  in his works, says that restricting healthcare practitioners only brings harm to the whole industry and exposes the weaknesses in healthcare provision and by allowing medication administration to be a priority, these weaknesses will be minimized and kept at bay (Parry et al., 2015).

Issue Overview

Medication administration plays an important role especially in supporting healthcare facilities. The scope of medication administration is broad and cannot be limited to just matters of administration only. According to Keers et al., (2018) medication administration means so much in terms of how patients recover, improve and how they respond to the medication as well. Healthcare institutions are always tasked to ensure that the administration of medication is done following acceptable standards and ways. The issue of medication administration is broad as is several soft spots that cannot be overlooked or ignored. First, the rights of medication administration must be put into context (Parry et al., 2015). Checking the right patient is vital as it reduces the possibility of administering treatment to the wrong person or patient. It is usually crucial to check the name on order and the patient by using two identifiers. It is also important to ask the patients to identify themselves as this is the only way to prove if they are the right patient (Bucknall et al., 2019). Once all this is available, it is important to use technology like the bar code systems to identify the patient in a better way. Since it is wrong to administer medication on the wrong patient or person, the first step is of much significance.  The second prionci[le of right medication ensures that the right patient gets the right medication. According to the words of Wang et al., (2015) right medication means been keen enough to check the medication labels and the order of the drugs or medication.  Confirming that the right dose is given or administered to the patient is also an important step to the nurses and nursing practitioners. To all these professionals these codes of conduct might not be elaborately written down, but they mean so much to the entire industry.  Checking the order of the dose and confirming on the appropriateness of the dose by using a current and updated drug reference (Parry et al., 2015). Calculating the dose and allowing another nurse to calculate the dose will in a vast margin reduce the possibility of errors. Drugs and medications must be administered through a specific route to have the right impact and implications on the patients (Bucknall et al., 2019).  Nursing practitioners and nurses must at all times ensure that this happens within the right route. It is also important to confirm that the patient can take or receive the medication by the route that has been ordered. In case patients cannot take the medications in the ordered route, it is always right to change this to favor the wellbeing of the patient (Keers et al., 2018). Developing wellness for patients is not an easy task; it means getting the right time to give the medication. Double checking that the dose has been given at the right time and confirming when last the dose was given is valuable to the nurses and the practitioners (Bucknall et al., 2019).  Unlicensed practitioners with this knowledge can at times supervise self-administration by patients who can correctly do it. Document administration itself especially after giving the ordered medication is of significant value to the practitioners as it allows this to be verified at all times (Parry et al., 2015). Charting the time, route and any other specific information that relates to the patients is also necessary at this stage. Dedicating extra effort to confirm the rationale for the ordered medication is vital as it strengthens the procedure and the goodwill (Bucknall et al., 2019).  Determining the underlying patient’s history and the effects the medication might have on their bodies is important as it builds confidence. Reasons as to why the patients are taking the drugs are essential to the nursing practitioners (Keers et al., 2018).  Revisiting the reasons for long term medication use is vital as it is the only way to reduce implications on the patients.  According to research conducted by Berdot, et al. (2016) it is right to ensure that the right response to the drugs is achieved with ease and less pressure to the patients. Documenting the monitoring of the patient and any other nursing interventions that are applicable is a necessary step in easing the pressure of the practitioners and the nurses (Smolowitz et al., 2015).

Policy History

The development of this policy has been something that has been done in stages as the need has necessitated. In the Florida House of Representatives the bill was referred to as a general one under the Health and Human Services Committee (Bucknall et al., 2019).  Stevenson sponsored the bill.  The bill aims to revise training requirements for unlicensed direct service providers who can assist in the administration of medication or self-administration of the same. It also aims to provide validation requirements for competency and skills of unlicensed direct service providers. The service providers must comply with the set standards and complete an in-service training course on an annual basis. Before the policy was introduced, no elaborate piece of legislation could encourage the training of unlicensed direct service providers, and this was only done without a stable framework(Parry et al., 2015). The development of the policy was to reduce the suffering of patients who cannot access the help and assistance of licensed service providers.  The policy also aimed at empowering such officers to have the confidence in medication administration directly and help in self-administration of medicine. The overall idea was to empower medical health in Florida and make it something that can be depended upon by the citizens. In the Florida Senate, the bill was sponsored by the Appropriations; Passidomo proposed Children, Families, and Elder Affairs and. The bill is not in any way different from that which was drafted by Stevenson, and the difference is the houses by which it was first tabled (Keers et al., 2018). The bill by Stevenson was launched on 7/1/2018, and the last action on it was on 3/27/2018.  Many other policies affect this bill and how it could be interpreted in Florida. The bill had challenges in both houses, but it was not rejected. It was supported, and it has been working. The development of the bill was as a result of the continuous need to streamline healthcare through medication administration which has been affecting the quality of how services are delivered to the public in Florida.

Beneficiaries / Outcomes

The beneficiaries of the bill will be unlimited. In this case, the passing of the bill will benefit the patients who are supposed to get quality health services. In creating a reliable provision of services and medication administration, the bill will seal loopholes that might exist into the administration of medication (Keers et al., 2018).  Nurses ans nursing practitioners will as well benefit from the policy as they will be protected from occurrences that might be aimed at destroying their professional conduct. Hospital administrations will in a significant way reduce the burdens that exist when inefficient nursing professionals are tasked with administering medication(Bucknall et al., 2019).  Altogether creating confidence in the healthcare sector is important as it will reduce the fears that usually affect patients when they are to get medication from such medical facilities. The bill will create an efficient healthcare system in the different states where the bill will be passed (Wang et al., 2015). Improving healthcare is not an easy task and bills and acts are only instruments that can be used to strengthen this cause. Hospital administrators will be able to find a reliable backbone by which they can base their service delivery standards on as this will be stipulated transparently in the bill (Bucknall et al., 2019).  The greatest beneficiaries of the bill will be the patients but this cannot be limited as all relevant stakeholders will in one way or another benefit from the bill. The bill might be used to create a more enabling environment for medical practitioners and nurses as with it it might contain new modalities that might be used as a stepping stone (Keers et al., 2018).  In the administration of medication, it is usually important to understand how this might affect the patients in question. Developing and pushing such a bill would in this case not only check the needs of these patients but it would as well align these patients with the goals of the healthcare providers (Bucknall et al., 2019).  The community where such health centers are situated in will significantly benefit from the bill. On healthcare, the bill will raise the standards and bar for medication administration and further reduce the time taken by these patients to recover and handle the diseases or infections.

Financial Impact

The medication administration bills do not have any fiscal impact on the Agency for Health Care Administration. However, the failure of the bill to go beyond the reading stage might have adverse effects on administrative costs (Keers et al., 2018).  As it currently stands, Medicaid has a significant implication on the expenditure of Florida as it has the second largest expenditure in the budget of the state behind education. The collapsing of the bill might make the situation even more sophisticated as more financial resources will be required to assist the different healthcare facilities to administer medication in the right way. In case the bill sails through and becomes adopted, mechanisms to cost share can be introduced, and the state will probably reduce its expenditure on health. Since the bill involves a lot of professional consideration, it might take up to 7 months (Bucknall et al., 2019). As it stands the bill currently has stalled and more input in terms of time, commitment is required to see it sail through. Calling the public to action might reduce the financial implications of the bill in a significant way and reduce its cost to the Senate and the state government (Smolowitz et al., 2015). The passing of the bill will affect the budget allocation especially to the health services in the state; however, this will not affect the budget allotted to the implementation of the bill. Many working hours are going to be invested especially on consultation and lobbying, but this cannot be compared to the impact the bill is going to have on healthcare provision in Florida (Bucknall et al., 2019).

Support System

The bill has had supporters, and this is only proof of how the bill is important to the general public and nurses in Florida. The  Florida Prescription Drug Monitoring Program has been in the forefront lobbying for the bill. They have offered advice on what needs to be captured in the bill, and this eased the burden on the legislators. The drug monitoring program has also been at the forefront in raising money to make the bill a success in Florida (Parry et al., 2015). Since the last action on the bill was in 3/27/2018, there have been numerous petitions seeking to push the bill that has stalled for almost a year now. The advancement of the bill passed second reading stage to become law will not only make iot possible for nurses and nursing practitioners to administer medication, but it will also make it for them to guide and advise on self-administration by the patients (Wang et al., 2015).  Several groups have been raising money and having closed-door meetings with legislators to show them on what impact the bill could have on the overall health of Florida. Several petitions have been made into enquiring on why the bill stalled, and no action is being taken on it (Bucknall et al., 2019). The Subcommittee on Health and Human Services has discussed the possibility of pushing the bill beyond the reading stage to enable them to create other bills that could support it. The workload of many legislators has been so much, and thus contribution by most of them is negligible and not enough to guarantee the discussion of the bill (Keers et al., 2018).  The nurses’ unions have also called on the Senate to work on the bill as they are confident of what positive impact the bill could have on the state of healthcare in Florida and the impact it would have on the rest of the states that have not developed a similar bill. The push towards having the bill being passed in Senate and the House of Representatives is not a walk in the park. Although we have been enjoying considerable support from other stakeholders who have the healthcare of Florida ta heart, it is important to put more effort in this as it will guarantee speedy delivery of results (Parry et al., 2015).

Statistics

According to the Center for Disease Control and Prevention up to 10 out of 100 patients suffer or die as a result of the lack of a precise mechanism on how they can administer medications on themselves (Keers et al., 2018).  The Board of Nursing believes that these numbers could be cut by half by allowing unlicensed nurses and nursing practitioners to administer medication on these patients or supervise them during self-administration (Parry et al., 2015). The US Department of Health and Human Services through a 2018 survey showed that the greatest worry of most patients is their inability to continue with medication since they leave healthcare facilities. Findings by the Florida Department of Health have shown that out of the many unlicensed nurses and nursing practitioners, almost half of them are willing to offer their services as long as a steady framework is put into place to protect them (Bucknall et al., 2019, Keers et al., 2018).  In the year 2018, the American Nursing Association played a critical role in ensuring medications got to patients in the right way, and this had a massive impact on the overall health of the patients and the state at large (Wang et al., 2015).  The American Nurses Association provides that the two core activities to focus on is educating their clients about the medications and at the same time educate them on medication self-administration procedures, and this could engage more than 20 % of the unlicensed nurses and nursing practitioners (Bucknall et al., 2019).  During the development of the bill, it was alleged that close to 1500-4500 patients suffering from chronic illnesses require guidance on self-administration of medication and this is usually not possible (Smolowitz et al., 2015). Cumulatively these numbers are enormous when combined with that of the whole state. The need to develop the bill was necessitated by the ever-increasing cases of patients requiring the assistance for medication administration (Parry et al., 2015).  The World Health Organisation believes that the easiest way to manage health is by ensuring that all stakeholders take part that is patients included. In most cases, the overwhelming nature of illnesses and the lack of enough resource persons create this problem, but with the right interventions this can be done with ease (Keers et al., 2018). The US Department of  Health and Human Services ranks Florida healthcare system as the second largest consumer of financial resources, and it is believed that an elaborate medication administration bill will considerably tame the spiraling expenditures on health (Hayes et al., 2015).

Nurse Practitioner Role

Nurses play an important role in medication administration especially for unlicensed practitioners and direct service providers. In essence, the role of nurses cannot be underestimated because they are responsible for engaging with a bulwark of activities in matters of medication administration (Wang et al., 2015).  Nurses should engage in safe medication practices that do not compromise the wellbeing of the patients and the health society and contribute to a culture of safety (Parry et al., 2015). Nurses must at all times understand their scope of coverage and the limits of their knowledge, skills, and judgment and in case their knowledge is limited seek assistance and help. Assessing the appropriateness of the medication practices by considering the patients, the medication itself and the environment is important and of the essence.  Promoting this consistency is important in ensuring that the set standards are achieved with ease and simplicity at all times (Bucknall et al., 2019).  Since healthcentres aim to ensure that standards are upheld at all times, it is also important for nurses practitioners to adhere to the expectations especially for direct supervision and when administering medications. Nursing students are required to assess the patient drug allergies, the expected actions, including the side effects of medication, and any precautions that might be taken in case of these needs (Parry et al., 2015). Alterations in the patient’s needs and conditions that could interfere with the physical capacity of patients to take medications is also a role of nursing students that cannot be underestimated at all costs (Hayes et al., 2015).  Understanding the level of understanding and knowledge for each medication is a significant role that nursing students need to be aware of. Competent medication administration is usually a continual process, and this means that it should go beyond the simple task of giving medication to patients (Keers et al., 2018).  For the case of unregistered and authorized practitioners, it is important to promote the preparation of medication correctly while ensuring that the rights of patients are followed. Ensuring the right medications, right dose, and the right frequency of treatments is important in this case (Wang et al., 2015).  Monitoring of patients and ensuring interventions are made when necessary is also an important role of the nursing students. Providing the right education and information about the medications is not only vital in bolstering medication administration, but it is also important in promoting the whole process (Berdot et al. 2016).  Nursing students have the obligation of evaluating the outcomes of the medication on the patient’s health status. Documenting the whole process ensures that medication administration is made with ease and reliability at the same time. Data on medication administration is important and can be used to improve future programs (Keers et al., 2018).  States can choose to borrow from the data provided as it provides enough insights. Since at advanced levels medication administration includes the application of technology, it is also the role of nursing students to promptly document the medication administration in the electronic health record (Bucknall et al., 2019).  Safe medication practice and administration must ensure that research is done prudently and that communication with patients and families is done in the right way. nursing and nursing practitioners are interested in medication administration as it is of core interest and value to the healthcare sector.  Promoting quality is an obligation of all the parties concerned, and nurses are not left behind in this (Parry et al., 2015). In a bid to successfully administer medication, nurses and nursing practitioners are required to have the right set of skills as this is the only way to guarantee quality medication and its administration.  In matters of principles, nurses are responsible for administering medications within their scopes of practice (Hayes et al., 2015). In this regards, it means that nurses are knowledgable about the effects and side effects and interactions and medications and how they could affect the patients. In case these medications do not work as designed, or anticipated nurses should be able to take necessary actions as it might be required (June et al., 2019). In matters of medication administration, nurses should always strive to adhere to the seven rights of medication administration especially in right medication, right client, right route, right documentation, right dose, right reason and right time (Keers et al., 2018).  This is the overall mandate that nurses have been called upon in matters of medication administration. Nurses through their trade unions can lobby for government agencies and other professional bodies to ensure that their interests and needs are put into place in terms of policy formulation (June et al., 2019).   In the legislative processes, it is important not to underestimate the role of nurses as they are the best placed to understand what nursing as a practice in medication administration requires (Bucknall et al., 2019).  Nurses should get concerned at all times when clarification is required or when they might be called upon to do that. Failing to allow nurses to play their important role in overall medication administration could hitch the progress of service delivery and compromise the quality of services that are offered. Lastly, in formulating policies in medication administration will require a mechanism that can be improved continually as achieving considerable success is of essence and value (Parry et al., 2015).

Conclusion

The most vital process in the treatment of patients is in medication administration. Lobbying to improve how the medication is administered to the patients either by nurse and nursing practitioners is not only vital but of the essence in driving change in the healthcare sector. Government and agencies are required to find a way by which they can address challenges arising from the delivery of services to the patients. The role of supporting medication administration may not be the roles of the practitioners themselves, but it is important to help them understand each step and the relevance it would have in creating a quality and an efficient healthcare system that the communities are confident in. Training in medication administration, especially for diseases and ailments that are considered sensitive and those that require extra care and caution, is vital and of significance. Initiating elaborate healthcare policies will be instrumental in shaping the future of medication administration in the near future, but this will not be of importance if it will not be to benefit the patients and help them in the recovery process. Lobbying for enough finances to train on medication administration for all practitioners both registered and unregistered is vital as it could guarantee the effectiveness of service delivery in many other instances. Broadening the roles of nurses in medication administration would mean burdening them with more work, and this should be avoided at all costs if sustainable healthcare is to achieve in the long run. Hospital administrators should be in the forefront in providing resources to train nurses and nursing practitioners on how to go about medication administration as this is the only way that can restore hope in the service delivery in most of these health centers.  Creating a reliable support system that does not compromise the quality of healthcare services and the needs of patients will go a long way in enabling medication administration to be high quality, reliable and acceptable all through.  Creating a model by which stakeholders can engage, and question service delivery is an important tool that can change the fortunes of medication administration. Unions for nurses and nursing practitioners should, on the other hand, be interested in lobbying for medication administration in hospitals to be unquestionable as this is the sure way to uphold the dignity of the patients and accord them respect.

On the other hand, it boosts the morale of the nurses as it shows them that professionalism is being upheld. In conclusion, treatment processes are just a way for doctors to help patients overcome the health challenges faced. The ultimate task is in ensuring that the medication administration is done in the right direction by adhering to the different principles. The process might be underestimated, but it hugely determines the fate of the patients.

References

Parry, A. M., Barriball, K. L., & While, A. E. (2015). Factors contributing to Registered Nurse medication administration error: A narrative                review. International journal of nursing studies, 52(1), 403-420.

Berdot, S., Roudot, M., Schramm, C., Katsahian, S., Durieux, P., & Sabatier, B. (2016). Interventions to reduce nurses’ medication administration errors in inpatient settings: a systematic review and meta-analysis. International Journal of Nursing Studies, 53,         342-350.

Bucknall, T., Fossum, M., Hutchinson, A. M., Botti, M., Considine, J., Dunning, T., … & Manias, E. (2019). Nurses’ decision‐making, practices, and perceptions of patient involvement in medication administration in an acute hospital setting. Journal of advanced nursing.

Keers, R. N., Plácido, M., Bennett, K., Clayton, K., Brown, P., & Ashcroft, D. M. (2018). What causes medication administration errors in a     mental health hospital? A qualitative study with nursing staff. PloS one, 13(10), e0206233.

Wang, H. F., Jin, J. F., Feng, X. Q., Huang, X., Zhu, L. L., Zhao, X. Y., & Zhou, Q. (2015). Quality improvements in decreasing medication    administration errors made by nursing staff in an academic medical center hospital: a trend analysis during the journey to Joint           Commission International accreditation and in the post-accreditation era. Therapeutics and clinical risk management, 11,        393.

June, J. W., Meng, H., Dobbs, D., & Hyer, K. (2019). Using Deficiency Data to Measure Quality in Assisted Living Communities: A Florida      Statewide Study. Journal of aging & social policy, 1-16.

Hayes, C., Power, T., Davidson, P. M., Daly, J., & Jackson, D. (2015). The nurse interrupted: Development of a realistic medication              administration simulation for undergraduate nurses. Nurse education today, 35(9), 981-986.

Smolowitz, J., Speakman, E., Wojnar, D., Whelan, E. M., Ulrich, S., Hayes, C., & Wood, L. (2015). Role of the registered nurse in primary      health care: meeting health care needs in the 21st century. Nursing Outlook, 63(2), 130-136.

Healthcare Policy Outline

Thesis Statement: Setting the standards high, and promoting healthcare policies and bills is the only way to achieve quality healthcare for all communities around the country and medication administration is vital in setting the pace, instilling discipline and professionalism and enhancing preparedness.

1. Introduction
2. Literature Review

• Issue Overview
• Policy History
• Beneficiaries / Outcomes
• Financial Impact
• Support System
• Statistics

1. Nurse Practitioner Role
2. Conclusion