Open Resources for Nursing (Open RN) Show
ANA Code of Ethics for NursesThe American Nurses Association (ANA) is a professional organization that represents the interests of the nation’s 4 million registered nurses and is at the forefront of improving the quality of health care for all.[1]The ANA developed the Code of Ethics for Nurses as a guide for carrying out nursing responsibilities in a manner consistent with quality in nursing care and the ethical obligations of the profession.[2]Several provisions from the Code of Ethics impact how nurses should administer medication in an ethical manner. A summary of each provision from the Code of Ethics and how it affects medication administration is outlined below.
Whenever a nurse provides patient care, the ANA Code of Ethics should be kept in mind. A nurse is preparing to administer medications to a patient. While reviewing the chart, the nurse notices two medications with similar mechanisms of action have been prescribed by two different providers. What is the nurse’s best response? Note: Answers to the Critical Thinking activities can be found in the “Answer Key” sections at the end of the book. ANA Professional Standards and Scope of PracticeThe American Nurses Association (ANA) publishes the Nursing: Scope and Standards of Practice. This resource is updated regularly and outlines professional nursing performance according to national standards.[6]The ANA defines as “the protection, promotion, and optimization of health and abilities, prevention of illness and injury, facilitation of healing, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, groups, communities, and populations.” A is defined as an individual who is educationally prepared and licensed by a state to practice as a registered nurse. Nursing practice is characterized by the following tenets:
State nurse practice acts further define the scope of practice of RNs and Licensed Practical Nurses (LPNs) within each state. The Wisconsin Nurse Practice Act is further discussed in the “Legal Foundations” section. ANA Standards of PracticeANA Standards of Practice are authoritative statements of duties that all registered nurses, regardless of role, population, or specialty, are expected to perform competently. include assessment, diagnosis, outcome identification, planning, implementation, and evaluation (ADOPIE) components of providing patient care. Implementation also includes the components of health promotion and health teaching. Medication administration should include all components of ADOPIE. Health Promotion and Patient TeachingThe ANA standards for patient teaching state, “The registered nurse employs strategies to promote health and a safe environment.”[8]Specific behaviors related to patient teaching about medication include:
In the book Preventing Medication Errors by the Institute of Medicine (2007), additional key actions to include when teaching patients about safe use of their medications are:
ANA Standards of Professional PerformanceANA Standards of Professional Performance describe a competent level of behavior in the professional role, including activities related to ethics, culturally congruent practice, communication, collaboration, leadership, education, evidence-based practice, and quality of practice.[11] Cultural Congruent PracticeThe ANA defines as the application of evidence-based nursing that is in agreement with the preferred cultural values, beliefs, worldview, and practices of the healthcare consumer and other stakeholders. represents the process by which nurses demonstrate culturally congruent practice. Nurses must assess the cultural beliefs and practices of their patients and implement culturally congruent interventions when administering medications and teaching about them. Additional information about cultural implications for medication administration is further discussed in the “Cultural and Social Determinants Related to Medication Administration” section later in this chapter. A nurse is preparing to administer metoprolol, a cardiac medication, to a patient and implements the nursing process: ASSESSES the vital signs prior to administration and discovers the heart rate is 48. DIAGNOSES that the heart rate is too low to safely administer the medication per the parameters provided. Establishes the OUTCOME to keep the patient’s heart rate within normal range of 60-100. PLANS to call the physician, as well as report this incident in the shift handoff report. Implements INTERVENTIONS by withholding the metoprolol at this time, documenting the incident that the medication is withheld, and notifying the provider. Continues to EVALUATE the patient status throughout the shift after not receiving the metoprolol. The nurse is providing patient teaching to a patient about the medication before discharge. The nurse provides a handout with instructions, as well as a list of the current medications. What other information should be provided to the patient? Note: Answers to the Critical Thinking activities can be found in the “Answer Key” sections at the end of the book. Fig 2.1 ANA Model of Professional Nursing Practice RegulationFigure 2.1 is an image from Nursing: Scope and Standards of Practice by the ANA (2015). [12] It explains how professional scope of practice, standards, and code of ethics are the “base” of nursing practice. Nursing practice is further defined by the State’s Nurse Practice Act, rules and regulations, institutional policies and procedures, and self-determination by the individual nurse. All these components are required to provide quality, safe patient care that is evidence-based. What are nursing considerations before IV medication administration?Standard I. The administration of intravenous solutions/medications shall be upon a physician's order. Prior to solution/medication administration, the nurse shall assess the following: appropriateness of the prescribed therapy; patient's age and condition; and dose, route and rate of the solution/medication ordered.
What is the procedure used to administer IV medications?With standard IV administration, a needle is usually inserted into a vein in your wrist, elbow, or the back of your hand. The catheter is then pushed over the needle. The needle is removed, and the catheter remains in your vein. All IV catheters are typically given in a hospital or clinic.
What precautions need to be taken when administering IV medications?Use a blunt filter needle or blunt needle when preparing injections. Never use a needle when injecting IV medication. Always use a needleless system. After preparing the medication, always label the medication syringe with the patient name, date, time, medication, and dose.
What are the nursing responsibilities for IV therapy?The nurse's responsibilities in managing IV therapy include the following:. assessing an IV site.. priming and hanging a primary IV bag.. preparing and hanging a secondary IV bag.. calculating IV rates.. monitoring the effectiveness of IV therapy.. discontinuing a peripheral IV.. |