In order to improve medication safety, it is recommended that nurses undertake a variety of pragmatic steps. The primary principle of this paper is to establish the theoretical importance of the nurse’s role in the safe administration of oral medication. This will be accomplished by firstly identifying the importance of patient safety in drug calculations and the complexed nature of paediatric dosages. Secondly, the guidelines on medicine administration imposed by The Nursing and Midwifery Council (NMC) will be addressed and considered in light of current legislation and government policy. Finally, this paper will emphasise the importance of training of both knowledge and skills in relation to practice before discussing the unique role of the children’s nurse in the safe administration of oral medication.
Medications are now available in multiple varieties for administration, via multiple routes. For most patients, the oral route is the most adequate and beneficial method of consuming medications, this is to provide the optimum effect and minimise any related adverse side effects. Medications administered by mouth are commonly absorbed from the small intestine to the liver through the portal vein. One the medication is metabolised it enters the circulation system for systematic effect. The Nursing and Midwifery Council (2008) states that it is the duty of the nurse to understand the pharmacology and medical speciality of pharmaceutical care. This is in order to support safe and professional practice on the nurse’s behalf.
In modern nursing practice, the demand to calculate drug dosages is not uncommon. It is essential that the nurse ensures that these calculations are executed with competence and accuracy, so as not to put themselves but more importantly the patient at risk of administering inaccurate drug dosages or lapses. Therefore it is the responsibility of the nurse as a duty of care to patients to ensure that they are competent in the successful execution of various required mathematical calculations. They must ensure that the take adequate time when working out calculations, recheck answers and ensure that any distraction are kept to a minimum.
The results of a recent study (Pentin & Smith, 2006) identified that many nurses do not have the ability to mentally calculate, resulting in the need for the use of calculators. It further establishes that nurses have anxiety issues in relation to being encouraged not to use calculators within clinical practice, as many nurses depend on this to minimise potential miscalculations. It is the role of the nurse to ensure patient safety is the number one priority in all aspects of patient care, including that of drug calculations. However guidelines imposed by the NMC (2008) states that calculators should not be used as a substitute for manual arthritic. Consequently medication calculations are a complexed and daunting activity, if nurses do not have the required level of mathematical ability.
Safe and efficient disposal of medications to children and infants requires a combination of professional competencies, which will be addressed later in this paper. The oral route is favoured for distributing medicines in infants and children whenever realistic. This is because children associate less pain and anxiety with taking medication by mouth, it is often cheaper than other methods and it is more feasible to facilitate. Children are more susceptible to medication dosage errors because of the unique calculations involved. Nurses must ensure that they are aware of their own ability and are fully competent in undertaking required calculations, however these skills should be established before qualification and registration. Drug dosages for infants and children are calculated on either body surface area or the child’s body weight , hence more complexed calculations are required. Paediatric dosages must be accurate to guarantee adequate therapeutic levels. It is the nurses responsibility to understand the system of measurement and the relationship between units to fully understand the arithmetic involved in calculations.