LM2 - legal, ethical, sociocultural and issues of medication admin. Flashcards
what did the American Nurses Association (ANA)?
- ANA code of ethics for nurses
- ANA nursing scope and standards of practice (RN, LPN, and nursing process - ADPIE)
- ANA standards for professional performance
what is the NCLEX?
-national council licensure examination (NCLEX) - national exam all grads must pass to obtain licensure
- next gen NCLEX (NGN) - april 2023
what does the NCLEX test?
- recognize cues
- analyze cues
- prioritize hypotheses
- generate solutions
- take action
- evaluate outcomes
what does the food and drug administration do?
Center for Drug
Evaluation and Research (CDER)
what does the joint commission do?
- accredits and certifies health
care organizations in the US
what does the Center of Medicare and Medicaid Services (CMS) do?
- establishes regulation for medication administration for their recipients
what does the US drug enforcement agency (DEA) do?
- controlled substance laws and regulation
- DEA’s Pharmacist’s Manual: outlines all the laws
—> Ex. Physician/NP with DEA number, written and electronic prescription only (DEA approved
software), no phone or fax allowed. Refills Schedule II not allowed, new Rx. Schedule III or IV med refill only 5 time
what is drug diversion?
- legally prescribed controlled
substances being transferred to others to use
about substance use disorder in healthcare?
- warning signs (behavioral changes, physical signs, and drug diversion). - - professionals—assistance
program and treatment
what is the drug approval process for new drugs?
- preclinical investigation
- clinical investigation –> use of placebo group in research will prevent bias and unrealistic expectation research
- review of the new drug application
- post-market surveillance
- nurses have the most opportunities to participate in phase 4
what is informed consent?
nurse is to witness client signature on informed consent to:
- see client gave consent voluntarily
- signature is authentic
- client is competent
what are the legal liabilities for nurses in med admin?
- responsible for own actions
- know what drug is ordered and why
- assessments/labs
- effects on the body
- side effects
- special considerations like age, weight
what are the “five-plus-five rights” of med admin?
*right PATIENT
*right DRUG
*right DOSE
*right ROUTE
*right TIME
- right documentation
- right assessment
- right to education
- right to evaluation
- right to refuse
what does JCAHO (Joint Commission on Accreditation
of Healthcare Organizations require prior to med admin? (*right PATIENT)
2 forms of identification
- ID bracelet
- photo
- asking client DOB
- beware of client’s w/same first of last names
- check allergy bracelet
how do you know you have the *right DRUG?
- check that order is complete and legible
- compare your physician order to med admin record (MAR)
- know why client is receiving the med
- check drug label (orders) THREE times before giving
1) at time of contact w/drug container
2) before pouring/placing in med cup
3) after pouring/placing in med cup
how to make sure you have the *right DOSE?
- accurate calculation is critical!!
- check recommended range in drug book
- if in doubt, check w/ pharmacist or physician
- two nurse required to check high alert PINCH meds
how to know if the *right TIME?
- administer at ordered times
- food considerations
- adjust schedule to fit client needs if able to
- procedures or diagnostic tests
- check expiration date
how to know if *right ROUTE?
- assess ability to swallow w/ oral meds
- do not crush or mix meds w/o approval
- use aseptic technique
- administer at appropriate sites
- stay w/client until oral meds are swallowed
- give client choice of food for mixing, if able
what are the nurse’s responsibilities BEFORE entering the client’s room?
- check three times to be sure the medication is correct
- never administer medication someone else has prepared
- never leave medications unattended
- if uncertain about order, check original written order,
pursue until clear!!
what are the nurse’s responsibilities AFTER entering the room?
- if client questions the appearance, dosage, or method of med admin, recheck the order and med
- administer drugs within __1______ hr. scheduled time (per
facility policy). - chart meds immediately after administration
what are the ethics in nursing?
- values influence health care beliefs, including
medication decisions - ethical principles guide our actions
- ethical codes provide frameworks
- ethical dilemmas occasionally arise
what is cultural humility?
- being humble and respectful of other individuals or cultures that challenges oneself to their
own cultural biases - aware they can’t have knowledge
of all culture, and it is a lifelong learning process (goal)
what is social determinants of health (SDOH)?
- awareness of the conditions of where people live, learn, work, and play effects their health, functioning, quality of life and
risks (ex. unsafe neighborhood, poverty)
what is health literacy?
- ability to obtain, process, and
understand basic health information to make informed
health decisions
