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Putting it into practice

All posts from: May 2012

How can nurse prescribers ensure effective medicine taking behaviour from patients?

28 May, 2012 Posted by: -

  • Article: Sibley A (2012) How effective are nurses’ medicine discussions? Nursing Times; 108: 22/23, 20-22.

Key points

  1. Guidance on effective medicine discussion indicates that patients’ medicine beliefs are a strong predictor of medicine-taking behaviour
  2. Despite favourable comparison with research on doctor-patient medication discussion, nurse prescribers’ practice may not fully optimise patient medicine taking
  3. Research suggests nurses discuss issues that address the “unintentional” rather than “intentional” reasons for non-adherence
  4. Patients should be given opportunities to initiate medicines discussions
  5. Nurses need continuing professional development to help them to explore patients’ medicine beliefs

Let’s discuss

  • What do the terms compliance, non-adherence and non-concordance mean?
  • Think about a patient. What information would you give them about their prescribed medicines?
  • Why do you think patients fail to take their prescribed medicines?
  • How would you structure a consultation with a patient to improve concordance with taking their medicines?

Related articles

How can the safe administration of drugs to patients with dysphagia be managed?

22 May, 2012 Posted by: -

  • Article: Serrano Santos JM et al (2012) Drug administration guides in dysphagia. Nursing Times; 108: 21, 15-17.

Key points

  • Nurses may benefit from specific training in the administration of medication to patients with dysphagia
  • An individualised medication administration guide (I-MAG) can help nurses to administer medication to this group and increase safety
  • Nurses often feel more confident in their practice when I-MAGs are in place
  • Time and safety are nurses’ main concerns when administering medication to patients with dysphagia
  • Research to determine the cost-effectiveness of I-MAGs is needed

Let’s discuss

  • Think about a patient in your ward or unit who has dysphagia. What measures have you taken to ensure their drugs are administered safely?
  • Why are patients with dysphagia more likely to suffer a medication administration error than those without swallowing difficulties? You should find this link useful.
  • How can the risk of error be reduced?
  • What information do you need to ensure safe drug administration for this group of patients?
  • What should you consider before administering drugs via enteral feeding tubes? You should find this link useful.

What effect can being a patient have on student development?

15 May, 2012 Posted by: -

  • Article: Carter G, Taylor R (2012) Effects of being a patient on student development. Nursing Times; 108: 20, 21-23.

Key points

  • Policy is aiming to put service users at the heart of the healthcare experience
  • Nurses are ideally placed to take compassionate, person-centred care forward
  • Engaging service users in nursing education is crucial to developing nurses who are well prepared for practice
  • Storytelling has provided insights into the healthcare experiences that professionals provide
  • This patient story appears to have affected how students and mentors see their therapeutic relationships with service users

Let’s discuss

  • Do our personal experiences of health care influence how we practice?
  • Outline how you think patient stories can be used to inform practice?
  • Describe the benefits of reflective practice?
  • How can nurses use their personal experience of healthcare in learning situations with student nurses or their peers?

Who should be involved in setting minimum staffing levels?

8 May, 2012 Posted by: -

Key points

  • Defining minimum nurse staffing levels could help to stabilise the nursing workforce, ensure safe levels of staffing and deliver care to an agreed standard.
  • However, careful consideration needs to be paid to variations in patient needs and local clinical contexts, as well as the potential impact on patients.
  • Setting a mandated minimum has major consequences not just in terms of investment required to set up and establish (and periodically recalibrate) levels, but also in terms of mechanisms needed to monitor compliance and deal with non-compliance.
  • Ratios currently in use focus on numbers of nurses to patients. There is a need to look at overall staffing levels, and the skill mix of the nursing team.
  • Ratios do not obviate the need for robust mechanisms for workforce planning locally, to ensure that the right staff with the right skills are in place to meet patient needs.

Let’s discuss

  • Why is there a call of minimum staffing levels in the UK?
  • Who should be involved in setting minimum staffing levels?
  • What are the advantages and disadvantages of set minimum staffing levels?
  • Think about patients in your ward or unit. Is nurse-to-patient ratios the best way of defining staffing levels?

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