<p class="wp-block-paragraph">The best medication management strategies in nursing involve the collection of each medication with name, doses, frequency, time on admission. It is a national patient safety initiative that promotes positive outcomes. There is evidence that incomplete medication review in nursing often contributes to medication errors. </p>



<p class="wp-block-paragraph">Some medication errors can result in adverse outcomes. Healthcare providers and nurses must obtain a complete list of medications from each patient on admission to comply with the Joint Commission 2019 National Patient Safety Goal #3 &#8211; <a href="https://www.jointcommission.org/standards_information/npsgs.aspx">NPSG</a> 03.06.01.<br></p>



<p class="wp-block-paragraph">Healthcare staff should educate each patient about the rationale for collecting medication history. Also, the healthcare staff obtains the list to improve compliance with the national standards. All healthcare facilities should develop a medication management plan to promote patient safety and prevent adverse events.</p>



<div class="wp-block-image"><figure class="aligncenter size-large is-resized"><img src="https://nursesophieconsulting.com/wp-content/uploads/2019/10/Medication-1-image-1024x659.png" class="wp-image-1577" width="512" height="330"/></figure></div>



<h2 class="wp-block-heading" id="h-medication-review-in-nursing-providers-role">Medication Review In Nursing: Providers Role</h2>



<p class="wp-block-paragraph">It is often difficult to persuade patients to provide a complete list of home medications. Many patients do not know the correct instructions about their medications. Some patients love to store their medicine, and they are not always willing to share information with healthcare staff. Providers are responsible for obtaining complete medication history and the current list from each patient. </p>



<p class="wp-block-paragraph">Providers also complete a medication reconciliation based on clinical symptoms and treatment plans. Medication reconciliation requires medication review and validation for continuation or discontinuation. Therefore, providers decide what medication to order and to discontinue during the entire length of stay. This process promotes the best medication management strategies in nursing. <br></p>



<p class="wp-block-paragraph">Providers are responsible for approving the use of home medications and other therapeutic substitutions. Doctors often mention medication plan in their admission note to promote transparency. The providers also perform medication reconciliation prior to each patient discharge and during outpatient visits. Finally, a complete medication order must include the right patient, medication, dose, frequency, time, indication, response, and route. </p>



<h2 class="wp-block-heading" id="h-medication-management-in-nursing">Medication Management In Nursing</h2>



<p class="wp-block-paragraph">Nurses are responsible for collecting medication history and entering the information in the medical records. If patients are unable to provide the name of the medication, nurses can obtain a description of the medication and indication (1 pink tablet daily for blood thinner). Nurses should inform patients or family members to bring the actual medication in the pharmacy dispensed bottle. <br></p>



<p class="wp-block-paragraph">Nurses should not prepare medicines compound because it is not within the professional scope of practice. Please contact your facility pharmacy for guidance. However, n<g class="gr_ gr_93 gr-alert gr_spell gr_inline_cards gr_disable_anim_appear ContextualSpelling ins-del multiReplace" id="93" data-gr-id="93">urses</g> can reconstitute medication based on manufacturer or pharmacy guidelines. When nurses follow instructions, they promote the best medication management strategies in nursing. </p>



<p class="wp-block-paragraph">Nurses do no complete medication reconciliation but rather add information in a clinical database for safety and cross-reference. Nurses should educate patients about medication storage while under the care of medical professionals to prevent therapeutic duplication and possible harm. <br></p>



<p class="wp-block-paragraph">The primary nurse should secure all the patients&#8217; home medications and return them per the discharge instructions. Thus, a medical Provider must approve home medications for administration in the healthcare settings. Nurses should verify all medication orders and also use critical thinking during medication administration to prevent medication errors. Lastly, polypharmacy can contribute to patients&#8217; <a href="https://www.nursesophieconsulting.com/the-role-of-nurses-in-fall-prevention-programs/">Falls</a>.</p>



<div class="wp-block-image"><figure class="aligncenter size-large is-resized"><img src="https://nursesophieconsulting.com/wp-content/uploads/2019/10/medication-image-2-1024x834.png" class="wp-image-1579" width="512" height="417"/></figure></div>



<h2 class="wp-block-heading" id="h-medication-safety">Medication Safety</h2>



<p class="wp-block-paragraph">Unfortunately, providers are human and do make mistakes-to err is human. ( Institute of Medicine) Nurses are the last discipline to conduct medication verification before administration. Therefore, prudence is essential during medication administration. I successfully caught many medication errors during my years of nursing. Thus, nursing vigilance can prevent adverse outcomes and facilitates medication management in nursing.<br></p>



<p class="wp-block-paragraph">I always verify the last time someone removed the medication from the dispenser or the previous time someone signed it as given to avoid an error. Nurses should review medication that requires therapeutic lab monitoring carefully by following their agency&#8217;s guidelines — for example, Coumadin and Heparin drip. Furthermore, nurses have to educate patients about all-new medication, the indication, side effects, and adverse reactions. </p>



<h2 class="wp-block-heading" id="h-medication-administration-steps">Medication Administration Steps</h2>



<ul class="wp-block-list"><li>Patient Identification &#8211; verify patient identity using two identifiers according to the facility&#8217;s protocol ( <a href="https://www.jointcommission.org/standards_information/npsgs.aspx">NPSG</a> .01.01.01) </li><li>Verify medication order using six to eight medication rights: right medication, right patient, right route, correct dose, right time, proper indication, and the right response.</li><li>Avoid distractions during medication administration. </li><li>Verify high alert medication, i.e., insulin, heparin, controlled substances with another nurse. </li><li>Obtain appropriate personal protective equipment &#8211; <a href="https://www.osha.gov/SLTC/personalprotectiveequipment/">PPE</a> <br> ( antineoplastic drugs and other classification) </li><li>Follow manufacturers or pharmacy guidelines for specific instructions. ( keep out of light, refrigerate) </li><li>pharmaceutical waste -use approved disposal. ( smart sink, black bin, yellow bins, <g class="gr_ gr_415 gr-alert gr_gramm gr_inline_cards gr_disable_anim_appear Punctuation only-ins replaceWithoutSep" id="415" data-gr-id="415">etc</g>..)</li><li>Educate the patient about the medication. </li><li>Monitor the patient&#8217;s response and document interventions </li><li>Reassess the patient&#8217;s symptoms to monitor effectiveness according to the organization’s standard. (pain reassessment) </li></ul>





<h2 class="wp-block-heading" id="h-pharmacy-resources">Pharmacy Resources</h2>



<p class="wp-block-paragraph">In most facilities, pharmacy staff is responsible for procuring, preparing, dispensing medication, reviewing Providers&#8217; orders, and validating the request for nursing to administer. Pharmacists also<mark class="annotation-text annotation-text-yoast" id="annotation-text-9e7177f7-4bb8-4366-ae3a-2e2024911a1e"></mark> clarify orders with Providers when indicated and provide specific supplies to facilitate safe medication management in nursing.<br></p>



<p class="wp-block-paragraph">Pharmacy is also very resourceful and can be consulted for medication guidance. The department of pharmacy also manages therapeutic dosing and lab associated with some medication. Please review your facility instructions for guidance.</p>



<div class="wp-block-image"><figure class="aligncenter size-large is-resized"><img src="https://nursesophieconsulting.com/wp-content/uploads/2019/10/medication-image-3-1024x662.png" class="wp-image-1581" width="512" height="331"/></figure></div>



<h2 class="wp-block-heading" id="h-final-thoughts">Final Thoughts</h2>



<p class="wp-block-paragraph">Medication management in nursing requires a multidisciplinary team approach and can be complex in some instances. Healthcare professionals are responsible for discussing medication management with every patient and providing education to each patient or health care partner following the Joint Commission and organizational standards. Safe medication management can prevent adverse outcomes and patient harm. </p>



<p class="wp-block-paragraph">Many healthcare organizations adopted safety measures to avoid medication errors. Nurses are responsible for following medication rights during administration. For instance, nurses must verify the right patient, right medication, right dose, right route, right time, right indication, right frequency, and right response. These rights vary by institutions, but they aim to promote patient safety during medication administration.</p>



<h2 class="wp-block-heading" id="h-medication-rights-cheat-sheet"><a href="https://www.nursesophieconsulting.com/wp-content/uploads/2020/09/medication-rights-1.pdf" target="_blank" rel="noreferrer noopener">Medication Rights Cheat Sheet</a></h2>



<figure class="wp-block-image"><img src="https://nursesophieconsulting.com/wp-content/uploads/2019/09/Nurse-Sophie.png" alt="Nurse Sophie's Signature" class="wp-image-975"/></figure>

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