McKenna's Pharmacology, 2e

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P A R T 1  Introduction to nursing pharmacology

information to ensure safe administration of a drug and to evaluate the drug’s effectiveness and adverse effects. ■■ Assessment must include information on the history of past illnesses and the current complaint, as well as a physical examination; this provides a database of baseline information to ensure safe administration of a drug and to evaluate the drug’s effectiveness and adverse effects. ■■ Care priorities are developed from the information gathered during health assessment. Implementation involves taking the information gathered and synthesised into care priorities to plan appropriate care. This process includes determining desired outcomes, setting goals for safe and effective drug administration, providing comfort measures to help the person cope with the therapeutic or adverse effects of a drug and providing education for the person and their family to ensure safe and effective drug therapy. ■■ Evaluation is part of the continuing process of care provision that leads to changes in assessment, diagnosis and intervention. The person is continually evaluated for therapeutic response, the occurrence of adverse drug effects and the occurrence of drug–drug, drug–food, drug–alternative therapy or drug–laboratory test interactions. ■■ Care plans and educational materials can be prepared for each drug being given, using information about a drug’s therapeutic effects, adverse effects and special considerations. ■■ Prevention of medication errors is a complicated task that involves the prescriber, the pharmacist, the nurse or midwife administering the drugs and the person. Nurses and midwives need to be vigilant in administering drugs and to check the seven “rights” of drug administration. The person needs to be educated to be their own advocate and to take steps to avoid medication errors.

■■ BOX 4.2  Reporting adverse drugs events

and regulates product for therapeutic uses. MEDSAFE collects information on the safety and quality of medicines from the Centre for Adverse Reaction and Monitoring (CARM) and other regulatory authorities such as the FDA (America), EMA (Europe) and TGA (Australia) after they have been approved. This is called pharmacovigilance. Pharmacovigilance involves: • Monitoring the use of medicines in everyday practice to identify previously unrecognised adverse effects or changes in the patterns of adverse effects. • Assessing the risks and benefits of medicines to determine if action is required to improve their safe use. • Providing information to healthcare professionals and consumers to promote safe use of medicines. • Monitoring the impact of any action taken and assessing whether further action is required. Institutions also have their own policies for report- ing medication errors that protect people and staff and identify particular areas in which education or system changes may be needed. Always be aware of the policies of your employing institution or agency. If you see or participate in a medication error, report it to your institution, and then report it to the national report- ing program. Your report will be shared with all of the appropriate agencies—the TGA and the drug manu- facturer. Healthcare providers working together and sharing information can make a big impact in decreas- ing the occurrence of medication errors. CHAPTER SUMMARY ■■ Nursing is a complex art and science that provides for nurturing and care of the sick, as well as prevention and education services. ■■ Midwifery is also a complex art and science providing care for childbearing women and their families, as well as promotion of women’s health across the lifespan. ■■ Components of health assessment (history of past illnesses and the current complaint, as well as a physical examination) provide a database of baseline In Australia, adverse drug events are reported to the Australian Government, Department of Health and Ageing, Therapeutic Goods Administration. These can be reported either electronically or by mail. Go online to: www.tga.gov.au/safety/problem.htm Consumers can report directly by telephone on 1300 134 237.

Pharmacology: Intramuscular injection Pharmacology: Intravenous injection

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ONLINE RESOURCES

An extensive range of additional resources to enhance teaching and learning and to facilitate understanding of this chapter may be found online at the text’s accompanying website, located on thePoint at http://thepoint.lww.com. These include Watch and Learn videos, Concepts in Action animations, journal articles, review questions, case studies, discussion topics and quizzes.