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HSNS206 Transition To Australia Nursing Practice

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HSNS206 Transition To Australia Nursing Practice

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HSNS206 Transition To Australia Nursing Practice

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Course Code: HSNS206
University: University Of New England

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Country: Australia

Question
Task: 
Mrs Melissa Mendez is a 72- year-old woman who has been on the medical ward for 3 days after an flare up of her rheumatoid arthritis, leading to pain, swelling causing decreased mobility and the ability to attend to her own activities of daily living (ADLs). She is prescribed 20mg of methotrexate weekly, prednisone 10mg daily, and simvastatin 40 mg at night daily for her cholesterol. 
On the morning medication round the RN calls the medical officer as Mrs Mendez is feeling unwell with symptoms of urinary frequency, dysuria and urge incontinence. The medical officer diagnoses a urinary tract infection (UTI) and prescribes trimethoprim 200 mg twice daily for 3 days. On Sunday, the RN is very and prescribes trimethoprim 200 mg twice daily for 3 days. On Sunday, the RN is very concerned that Mrs Mendez has deteriorated and is nauseous and confused. She calls an the medical officer to review Mrs Mendez who changes the trimethoprim to co-amoxiclav because her UTI symptoms have not improved. 
After a few days Mrs Mendez is feeling much better, her UTI symptoms resolve and she is discharged from hospital. The practice pharmacist checks the discharge summary and identifies a drug interaction with the trimethoprim and methotrexate. 
 
Failure to recognise and appropriately manage medication errors is a significant issue not only in NSW public hospitals but also in hospitals and healthcare organisations around the world. The lack of recognition and appropriate management of medication errors in acute hospital wards, has been identified as an important contributory factor in adverse events and is therefore a high priority patient safety issue (Australian Commission Safety and Quality in Health Care (ACSQHC). 
Discuss the following in relation to this case: 
Discuss and critically analyse the relevant medication policies, guidelines and Registered nurse standards for practice (NMBA, 2016) in relation to tis case study. 
This assignment is important because it will enable you develop a greater understanding of the Australian medication policies, guidelines and professional practice standards within your role as a nursing student as well as a transitioning registered nurse within Australia. You are required to apply your critical thinking skills to the case study and show your capacity to identify, interpret, and critically analyse issues raised by the case study. This assignment is the first assessment within the unit. The concepts that you are exploring will assist in building your knowledge in relation a registered nurses accountability and responsibility within other assessments you will need to undertake in this unit. 
Answer 

The case study represents health issues of 72 years old woman who was admitted to the medical ward for three days due to pain and swelling of rheumatoid arthritis, which hindered her mobility. The next morning a registered nurse called the medical officer and informed about her urinary frequency. After, Diagnosis, the UTI infection was detected and trimethoprim was administrated which  further deteriorated her condition and she was feeling nauseous and confused. The next medical officer changed her medication with co-amoxiclav in order to improve her UTI symptoms. In this context, the health professionals failed to recognize and manage the health issues, which further led to more medication error. There are certain rules, regulation, medical protocols, and policies need to be followed by nurse
According to Sluggett et al. (2017), the first objective of the medication policy is to ensure the immediate long-term safety of the patient. In the above case study, the registered nurses failed to provide comfort and accurate patient-centered care. The registered nurse administrate medication twice without checking interactions which further made the patient nauseous (Peeters et al., 2017). Moreover,  Food and Drug Administration approved medication guidelines suggested that certain information is necessary for preventing serious adverse effect and in this context; health professionals lacked that knowledge which further questioned patient’s safety (Bobo et al., 2016). Moreover, patient decision-making should be taken into account before administrating any medication, which has a side effect (Peeters et al., 2017). In this context, no consent had been taken which further questioned the patient’s safety and violated outright for the patient.
According to Sluggett et al. (2017), registered nurses, practice is patient-centered and evidence-based with preventive curative and informative care (Gattinoni  & Marini, 2015). In order to be an efficient registered nurse, every nurse should communicate effectively and priorities the need of the patients by being respectful to the patient. Applying appropriate knowledge before administrating any medication and taking the right decision for the situation is also a crucial part of the nursing job (Gray,Rowe & Barnes, 2015). Considering the above context, three NMBA standards were violated. Standard four stated that comprehensive conduct and assessments are crucial for patient-centric care. Here, register nurses failed to analyze and asses the information, which resulted in improper practice. According to standard six, every registered nurse should provide safe, appropriate and responsive quality nursing practice (Gattinoni  & Marini, 2015). In this context, registered nurses failed to use the appropriate process for identifying and reporting actual risk related to the issue (Gray,Rowe & Barnes, 2015). Consequently, the patient received poor patient-centered care. Standard seven suggested highlighted the importance of the evaluation of outcome to inform nursing practices. It suggested that register nurses should take the responsibility to evaluate the outcome of any interventions, especially for the administration of any medication in order to ensure that the patients receive standard patient-centered care (Gray,Rowe & Barnes, 2015). In this context, the registered nurse did not evaluate which led to an adverse effect (Gattinoni  & Marini, 2015). Thus, it can be concluded that the in order to provide the care these standards should be followed.
References:
Bobo, D., Robinson, K. J., Islam, J., Thurecht, K. J., & Corrie, S. R. (2016). Nanoparticle-based medicines: a review of FDA-approved materials and clinical trials to date. Pharmaceutical research, 33(10), 2373-2387.
Gattinoni, L., & Marini, J. J. (2015). Prone positioning and neuromuscular blocking agents are part of standard care in severe ARDS patients: we are not sure.
Gray, M., Rowe, J., & Barnes, M. (2015). Australian midwives’ interpretation of the re-registration, recency of practice standard. Australian Health Review, 39(4), 462.
Peeters, G., Tett, S. E., Duncan, E. L., Mishra, G. D., & Dobson, A. J. (2014). Osteoporosis medication dispensing for older Australian women from 2002 to 2010: influences of publications, guidelines, marketing activities and policy. Pharmacoepidemiology and drug safety, 23(12), 1303-1311.
Sluggett, J. K., Ilomäki, J., Seaman, K. L., Corlis, M., & Bell, J. S. (2017). Medication management policy, practice and research in Australian residential aged care: current and future directions. Pharmacological research, 116, 20-28.

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