Action Plan Development for Administration of Medicine - Essay Example

Action Plan Development for Administration of Medicine Introduction A student and practicing nurse requires remaining focused not only on the principles of his/her profession but also on the right ideas and steps for the implementation of various tasks and the realization of goals. To this effect, there is a need for a statement indicating what one intends to achieve in his/her career. The preparation of an action plan is quite vital in ensuring student and practicing nurses achieve their objectives. Thus, instead of worrying about the future, it pays to start planning for it through action plans. The main steps in the drafting of an action plan include the identification of objectives, the setting of achievable and measurable objectives, prioritisation of tasks and the identification of the necessary steps to achieving goals. The other steps include being able to effectively work under pressure and complete tasks in time. By writing down objectives, one’s goals and dreams are turned into plans, provided the plan is thought out, acted on and reflected upon. Importantly, a timetable would ensure a nurse’s action plan is effective, has clear-set goals and defined steps. This action plan on administration of medicine explores the areas in which I have tangible and sufficient coverage, knowledge and skills and the areas that need improvement. Moreover, the action plan covers the strategies, interventions and the timetable by which the improvements will be achieved. Achievements in Drug Administration At this level of my nursing course, I have covered quite a vast area as far as medication administration is concerned. Most important in the areas covered are the general implications and principles of medication administrations. Although a common practice among nurses, medicine administration is a rather crucial clinical procedure, which refers to the manner in which medicine is delivered and controlled. In fact, the manner in which medicine is administered determines the probability of a patient gaining any clinical benefits or suffering diverse effects of medication (Doerr-MacEwen & Haight, 2006). Among the major areas of medication administration so far covered include the factors affecting drug bioavailability, types/routes of drug administration, and NMC’s guide for administration of medicines among other areas. Drug bioavailability refers to the proportion of an administered medication, which actually reaches a patient’s systemic circulation and is distributed to the intended action site using the different routes of administration result that result in different levels of bioavailability. This is an important knowledge on medicine administration given that nurses should understand the best route that would yield the most bioavailability for a drug. For instance, drugs delivered through direct IV injection supposedly have 100% bioavailability. In addition, certain types of drugs are absorbed best in certain organs or systems of the body. For example, if administered so that they are absorbed by the gastrointestinal mucosa, certain medicines could end up having bioavailability comparable to that of an IV injected drugs. Unfortunately, many drugs lack the level of bioavailability by the oral route, implying that they their oral dosage is usually higher than if given parenterally, which refers to the administration of a medication into the body via routes other than the gastro-intestinal tract (Miller &Miller, 2011). These routes could be infusion, injection or implantation. Routes of Administration Routes of administration are the other concepts of administration of medicine that I have covered well so far. There are numerous routes by which medicine may be delivered into the systemic circulation of a patient, each with its strengths and weaknesses. It is thus imperative that nurses understand these routes’ implications, effectiveness, weaknesses, strengths, and patient experience. Examples of the routes are oral, sublingual, rectal, topical, and parenteral (intravenous, intramuscular, subcutaneous) administration. Oral administration is perhaps the most commonly and frequently used mode of drug administration given that it is considered not only the most economical but also the most convenient. It is particularly used for administering solid drugs which have high degree of stability and give accurate dosages such as tablets and capsules (Harrison, et al., 2010). The oral route is however disadvantageous in the sense that the drug absorption of the gastro-intestinal tract is quite unpredictable due to the presence of food in the tract, which could alter gut pH, gastric motility or emptying time, thus affecting the speed and scope of drug absorption. The other disadvantage is that patients, more so children and the aged have different capacities to tolerate solid forms of dose. Moreover, actions such as chewing or crushing may interfere with the release-control mechanism, causing an immediate release of the full/toxic dose or content of a drug (Hirschfeld et al., 1981). This toxic level of dosage may then be absorbed leading to toxicity or sub-optimal treatment. An advantage of oral administration for patients is that doses are often taken once or twice in a day. Rectal and Topical Administration Rectal administration is the other route of delivering medicine into patients’ circulatory systems that has been covered well. Although it has several disadvantages related to patient acceptability in certain countries, rectal administration has certain benefits. For example, it is a helpful method of achieving localized drug delivery into the large bowel for the treatment of inflammatory bowel diseases and pyrexia, in which case, patients are not able to swallow. In addition, the induction of vomiting and nausea could be achieved by administering antiemetics rectally. Topical administration, the other common route of drug delivery in which drugs are directly applied on the intended site of action, has several benefits, particularly for localized diseases. For example, topical administration has reduced risks of side-effects since the systemic circulation is not reached in great drug concentration. Examples of applications of topical administration include the use of beta-blocker eye drops to treat glaucoma and the use of topical steroids to manage dermatitis. Areas that Require Improvement Several areas of medication administration have however not been covered well and need more effort and improvement. These include medication administration calculations, side effects, drug groupings and drug interactions. Given the importance of these issues and challenges to practitioners, it is of utmost urgency that I develop and implement certain strategies to address them. Like in many other disciplines, knowledge about drug interactions, drug groupings, side effects continue to develop rather fast in the administration of medication. Particularly in need of improvement is my understanding of the various groupings of drugs and their possible side effects. There is thus a need for those involved in medication administration to re-establish and regain patient and consumer trust. To achieve the desired level of consumer and patient trust, there is need to establish sound and effective guidelines on the fundamentals of adapting the medical code of ethical conduct for the medicine administration (Malenka et al., 2009). Drug Grouping is the other area that needs expansive covering. An understanding of the group a drug belongs to is quite useful for nurses. Among the classes of drugs that nurses should be conversant with is the therapeutic group in which drugs are classified by the disorders or symptoms they treat (Deter, 2005). As a nurse, I should thus understand drugs such as antihypertensives and antiemetics, which treat high blood pressure and nausea respectively. It is also necessary to understand the subclasses in the above drug groups. These subclasses are based on how drugs work in the body to produce specific effects. For example, inhibitor drugs including beta-blockers, diuretics, calcium channel blockers, and angiotensin-converting enzyme (ACE) fall under antihypertensives but work differently. It will also be vital that I expand my knowledge on the issue of drug interactions, which is such a crucial area for nurses in administering medication. The importance of this knowledge would be to allow me to understand the various substances with which a drug could react and the nature of such reactions and their impacts on the effectiveness of a drug. While synergetic interactions increase the activity and effectiveness of drugs, antagonistic interactions decrease drug effectiveness. Besides drug-to-drug interactions, there are also food-drug interactions that nurses should be conversed with, emphasizing the need for nurses to be knowledgeable on drug interactions. . (Lees et al., 2004). Drug medication calculation is the other area that is yet to be exhaustively covered and thus requires development via several interventions. The recognition that the ability to accurately and quickly undertake drug calculations is an essential skill for health professionals should be quite clear to medical students (Gauwitz, 2011). Unfortunately, many of these students and practitioners are weak or unsure of their mathematical abilities. Therefore, several strategies such as undertaking exercises and using medication calculation software should be implemented. These strategies should cover all the fundamentals of medication calculations, more so relating to the metric system and the calculation of medication doses. Though not substitutes for academic instructions, these exercises would provide an easy-to-access area for one to evaluate own skills and learn the essentials of medication calculations besides offering the opportunity to practise simple and complex calculations. The main reason for seeking to improve on these areas is to allow me to meet the NMC standards for proficiency by graduating with the key skills and employability expected of my academic studies. Among the skills that will help me be NMC-proficient include oral and written communication, problem solving, IT usage, teamwork, and sound management of own learning process. Other NMC compliant skills that these strategies would furnish me with include personal and professional development skills, care delivery skills, professional and ethical practice kills, and care management. Interventions/Techniques to Improve on the Weak Areas To achieve the required level of understanding and knowledge in the areas of drug interactions/effects and calculations, which have been identified to be lacking in some aspects, several techniques could be implemented. First, exercises are quite useful in sharpening medication calculation skills, particularly by exposing one to the major concepts of drug calculations. Importantly conversance with the common metric conversions shown below should be emphasized, remembering the need to convert units of measurement to one system before doing any calculation. An example of the methods for practicing dosage calculation is shown below. In the formula, D-Desired dose, H-Dose on hand, V-Vehicle (tablet/liquid). D/H x V = Amount to Give In addition to exercising with these basic formulas, there are several software that are useful in medication calculations for learning, teaching, practice and research purposes. This software can be loaded and installed into computers and shared with other students. This software thus generates tests, solutions and helps in tracking results for common drug calculations. Interestingly, they also have great capacity to create customized multi-choice and short answer questions on various topics and test conditions. There are also drug calculations quiz pages, which assist students as well as health professionals not only to refresh but also to develop their skills in mathematics in general and drug calculations in particular. Easy Test Creator (ETC) software package could also be used to create web-/terminal based and standardized tests and questionnaires for improving drug calculations. To increase my knowledge on medication calculations, drug interactions, and drug side effects, it would require three to four weeks within which I will access information from various sources on drug side effects in general and the specific drug-drug and drug-food interactions and the importance of such knowledge to nurses. Particularly, information on synergetic and antagonistic interactions will be quite vital. This information will be obtained from sources such as the internet, the university library and public/health facility libraries. In addition to gathering this kind of information, I intend to visit the health unit in my institution and other health professional (nurses) and facilities within reach to explore information on drug side effects and interactions and their effects on medication efficiency, accuracy and reliability. Finally, I will consult government and private nurses who are likely to be experienced and skilled in applying addressing drug side effects and interaction issues arising during medication administration. The timetable below will be strictly observed to ensure that the intended ground is covered within the stipulated four-week period. An Action Plan for Improving in the Areas of Technology Use and Calculations in Medication Administration Objective: To increase my knowledge on medication administration calculations and on the use of technology/IT in medication administration Date of Step Completion Reward Below are the steps by which the above objective is to be achieved Week 1: Practice exercises on medication calculations using various methods June 15, 2012 Vast knowledge on medication administration calculation Week 2: Practice medication calculations using and various software for calculation quizzes, standardized tests and questionnaires June 22, 2012 Vast knowledge on automation of medication administration Week 3: Visit university library and health facilities’ libraries to gather information on medicine side effects and interactions (more so synergetic and antagonistic) June 29, 20120 Vast knowledge on automation of medication administration Week 4: Visit health facilities and practitioners to obtain exposure and practical experience on medicine side effects and interactions (more so synergetic and antagonistic) July 5, 2012 Vast knowledge on automation of medication administration Likely problems to be faced: Unavailability and inaccessibility of resources on the objective areas. References Deter, L. L. (2010) Medication administration (new releases for health science), first edition. Delmar Cengage Learning. Deter, L. L. (2005) Basic medication administration skills, first edition. Delmar Cengage Learning. Doerr-MacEwen, N. A., and Haight, M. E. (2006) "Expert Stakeholders' Views on the Management of Human Pharmaceuticals in the Environment". Environmental Manage, 38(5), 866. Gauwitz, D. (2011) Administering medications, seventh edition. Career Education. Harrison, D., Stevens, B., Bueno, M., Yamada, J., Adams-Webber, T., Beyene, J., and Ohlsson A. (2010). "Efficacy of Sweet Solutions for Analgesia in Infants between 1 and 12 Months of Age: A Systematic Review." Archives of Disease in Childhood, 95(6), 413. Hirschfeld, S., Hyman, H. T., and Wanger, J. J. (1981) "Influence of Velocity on the Response to Intravenous Injections". Archives of Internal Medicine, 47(2), 287. Lees, P., Cunningham, F.M., and Elliott, J. (2004) "Principles of Pharmacodynamics and Their Applications in Veterinary Pharmacology". Journal of Veterinary Pharmacology, 27(6), 397. Malenka, E. J., Nestler, S. E., and Hyman, R. C. (2009). Molecular neuropharmacology: a foundation for clinical neuroscience, second edition. New York: McGraw-Hill Medical. Miller, A. A., and Miller, P. F. (2011) Emerging trends in antibacterial discovery: answering the call to arms. Caister Academic Press. Read More