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https://www.readbyqxmd.com/read/27922774/controlled-drugs-and-the-principle-of-double-effect-the-role-of-the-district-nurse
#1
Richard Griffith
The role of district nurses in the effective management of pain in palliative care has been strengthened by the Misuse of Drugs (Amendment No.2) (England, Wales and Scotland) Regulations 2012 that allow district nurses who are independent or supplementary prescribers to prescribe and administer controlled drugs. However, prescribing controlled drugs brings increased responsibility and accountability for the safe management of these medicines. In this article Richard Griffith considers the principle of double effect that seeks to ensure that patients in intractable pain receive the analgesia they require to manage that pain while district nurses avoid liability and prosecution under the law of murder...
December 2, 2016: British Journal of Community Nursing
https://www.readbyqxmd.com/read/27919877/pharmacist-driven-respiratory-syncytial-virus-prophylaxis-stewardship-service-in-a-neonatal-intensive-care-unit
#2
Sara E Rostas, Christopher McPherson
PURPOSE: The development and implementation of a pharmacist-driven respiratory syncytial virus (RSV) prophylaxis stewardship program in a neonatal intensive care unit (NICU) are described. SUMMARY: An RSV prophylaxis stewardship service was created in the NICU at Brigham and Women's Hospital to align with the newly updated 2014 American Academy of Pediatrics (AAP) recommendations for palivizumab. The service comprised two NICU clinical pharmacists with oversight from the NICU medical director and the chair of the NICU infection control committee...
December 15, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27917768/iatrogenic-medication-errors-in-a-paediatric-intensive-care-unit-in-durban-south-africa
#3
A Gokhul, P M Jeena, A Gray
BACKGROUND: Iatrogenic medication errors due to calculation errors are an under-reported concern in children. OBJECTIVE: To determine the incidence and source of iatrogenic medication errors in a paediatric intensive care unit (PICU). METHODS: A prospective study was conducted in the PICU at Inkosi Albert Luthuli Hospital, Durban, South Africa, over a 3-month period in 2014. Medication-related calculation skills of medical practitioners and nurses were assessed through the voluntary anonymous completion of a questionnaire...
December 1, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/27913033/nurse-practitioner-prescribing-in-australia-a-comprehensive-literature-review
#4
REVIEW
Jacqueline Fong, Thomas Buckley, Andrew Cashin, Lisa Pont
BACKGROUND: In Australia, the nurse practitioner (NP) obtained prescriptive authority in some jurisdictions in 2001. One of the key aspects in which the scope of NPs differs from Registered Nurses (RNs) relates to the legal privilege to prescribe medications. Although NPs have had prescriptive authority in Australia since 2001, with access to the Commonwealth subsidy scheme (PBS) since 2010, little is known about NPs prescriptive patterns or outcomes of prescriptive practice. AIM: The aim of this scoping review was to examine the extent, range and nature of research conducted in relation to NP prescribing in the Australian health context as well as identify gaps in the existing literature...
November 29, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/27909252/nurses-as-antibiotic-brokers-institutionalized-praxis-in-the-hospital
#5
Alex Broom, Jennifer Broom, Emma Kirby, Graham Scambler
We are likely moving rapidly toward a post-antibiotic era, as a result of escalating antimicrobial resistance, rapidly declining antibiotic production and profligate overuse. Hitherto research has almost exclusively focused on doctors' prescribing, with nurses' roles in antibiotic use remaining virtually invisible. Drawing on interviews with 30 nurses, we focus on nurses as brokers of doctors' antibiotic decisions, nursing capacity to challenge doctors' decisions, and, "back stage" strategies for circumnavigating organizational constraints...
November 30, 2016: Qualitative Health Research
https://www.readbyqxmd.com/read/27908294/outcomes-of-notifications-to-health-practitioner-boards-a-retrospective-cohort-study
#6
Matthew J Spittal, David M Studdert, Ron Paterson, Marie M Bismark
BACKGROUND: Medical boards and other practitioner boards aim to protect the public from unsafe practice. Previous research has examined disciplinary actions against doctors, but other professions (e.g., nurses and midwives, dentists, psychologists, pharmacists) remain understudied. We sought to describe the outcomes of notifications of concern regarding the health, performance, and conduct of health practitioners from ten professions in Australia and to identify factors associated with the imposition of restrictive actions...
December 2, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27904743/frontline-worker-perceptions-of-medication-safety-in-india
#7
Sangeeta Sharma, Fauzia Tabassum, Sarbjeet Khurana, Kaveri Kapoor
BACKGROUND: To explore interprofessionals' perceptions about patient safety, particularly medication safety and associated factors and barriers. METHODS: A total of 389 respondents were recruited using convenience sample in the cross sectional survey. RESULTS: Medication safety was perceived as somewhat safe (60%). One-third of respondents witnessed 3-4 or more medication errors (MEs) within the past 1 year. Out of that, one quarter were reportedly, sentinel events...
December 2016: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/27898281/goals-of-care-or-goals-of-trust-how-family-members-perceive-goals-for-dying-nursing-home-residents
#8
Cherie Rosemond, Laura C Hanson, Sheryl Zimmerman
PURPOSE OF STUDY: Dementia affects more than 5 million Americans, and is a leading cause of death. Family members of nursing home (NH) residents with advanced dementia report difficulty making decisions about care toward the end of life. As part of a randomized trial testing an intervention to improve decision making, this qualitative study aimed to understand how family decision makers experienced goal-based decision making in advance of the death of their relative. DESIGN AND METHODS: This qualitative study was conducted as part of the goals of care clinical trial...
November 29, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27898136/pharmacological-approaches-for-the-management-of-persistent-pain-in-older-adults-what-nurses-need-to-know
#9
Fabio Guerriero, Ruth Bolier, Janet H Van Cleave, M Cary Reid
HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.4 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo...
December 1, 2016: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/27898134/quality-pain-care-for-older-adults-in-an-era-of-suspicion-and-scrutiny
#10
Barbara St Marie, Paul Arnstein
In two decades, the pendulum has swung from focusing on the undertreatment of pain by prescribers who fail to use medically necessary opioid agents to an intense focus on overprescribing opioid medications and the harms they cause. Within these two extremes rests the older adult with pain and in need of safe and effective care. Today, health care providers are practicing in an era of scrutiny, with new guidelines and regulations superseding their compassion and clinical judgment about the best treatment options when older adults have pain across the care continuum...
December 1, 2016: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/27898133/opioid-misuse-abuse-and-quality-persistent-pain-management-in-older-adults
#11
Yu-Ping Chang, Peggy Compton
The United States is amid an epidemic of prescription opioid drug abuse, bringing with it not only high rates of overdose, but growing rates of heroin abuse and addiction. Liberal opioid drug prescribing on the part of well-meaning clinicians has in part fueled this epidemic, being correlated to opioid death and addiction treatment admission rates. Misuse and abuse of prescription opioid drugs is greatest among young adults (ages 18 to 25); however, the fastest growing age group for opioid drug misuse/abuse is older (ages 50 to 64)...
December 1, 2016: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/27897471/use-of-risk-mitigation-practices-by-family-nurse-practitioners-prescribing-opioids-for-the-management-of-chronic-non-malignant-pain
#12
Sahil Chaudhary, Peggy Compton
BACKGROUND: Ongoing opioid analgesic use in patients suffering from chronic non-malignant pain (CNMP) has been associated with the development of opioid misuse, abuse, addiction, and overdose. To prevent these adverse outcomes, it is important that family nurse practitioners (FNPs) implement recommended risk mitigation practices (RMPs) when treating CNMP patients with opioids. METHODS: A national sample of 856 FNPs was invited to answer an online survey about their utilization of opioids and RMPs in treating CNMP...
November 29, 2016: Substance Abuse
https://www.readbyqxmd.com/read/27896444/is-all-hypoglycaemia-treated-as-equal-an-observational-study-of-how-the-type-of-diabetes-and-treatment-prescribed-prior-to-admission-influences-quality-of-treatment-of-inpatient-hypoglycaemia
#13
Gregory C Jones, Jansher Khan, Christopher A R Sainsbury
AIMS: Inpatient hypoglycaemia is common and associated with adverse outcomes. There is often increased vigilance of hypoglycaemia in inpatients with type 1 diabetes (T1DM) compared to type 2 diabetes (T2DM). We aimed to investigate this apparent discrepancy, utilising the time to repeat (TTR) capillary blood glucose (CBG) measurement as a surrogate for engagement with guidelines stating that CBG should be rechecked following intervention within 15 min of an initial CBG of <4 mmol/L...
November 28, 2016: Acta Diabetologica
https://www.readbyqxmd.com/read/27882560/a-computer-prescribing-order-entry-clinical-decision-support-system-designed-for-neonatal-care-results-of-the-preselected-prescription-concept-at-the-bedside
#14
B Gouyon, S Iacobelli, E Saliba, C Quantin, A Pignolet, E Jacqz-Aigrain, J B Gouyon
WHAT IS KNOWN: The neonatal intensive care units (NICUs) are at the highest risk of drug dose error of all hospital wards. NICUs also have the most complicated prescription modalities. The computerization of the prescription process is currently recommended to decrease the risk of preventable adverse drug effects (pADEs) in NICUs. However, Computer Prescribing Order Entry-Clinical Decision Support (C.P.O.E./C.D.S.) systems have been poorly studied in NICUs, and their technical compatibility with neonatal specificities has been limited...
November 23, 2016: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/27879194/prescription-patterns-and-drug-costs-in-german-patients-with-dementia-in-nursing-homes-and-home-care-settings%C3%A2
#15
Louis Jacob, Jens Bohlken, Karel Kostev
AIMS: To analyze prescription patterns and drug costs in German patients with dementia who are in home-care settings and nursing homes. METHODS: The present retrospective study based on the Disease Analyzer epidemiological database and included 41,064 patients treated by general practitioners (GPs) and 20,649 patients treated by psychiatric practitioners (PPs), who were diagnosed with dementia in 2014. Four different types of antidementia therapy were included in the analysis...
November 23, 2016: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/27876477/current-prescribing-practices-for-skin-and-soft-tissue-infections-in-nursing-homes
#16
Diana Feldstein, Philip D Sloane, David Weber, Kimberly Ward, David Reed, Sheryl Zimmerman
OBJECTIVES: Antibiotic stewardship has been called for across all sites of health care, including nursing homes (NHs). Skin and soft tissue infections (SSTIs) are the third most common indication for antibiotics in the NH, and so should be a focus of stewardship. This study audited medical records to identify signs and symptoms of SSTIs treated with antibiotics in relation to the McGeer criteria for surveillance, the Loeb minimum criteria for antibiotic initiation, and prescribing recommendations of the Infectious Disease Society of America...
November 18, 2016: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/27875542/educational-outreach-with-an-integrated-clinical-tool-for-nurse-led-non-communicable-chronic-disease-management-in-primary-care-in-south-africa-a-pragmatic-cluster-randomised-controlled-trial
#17
Lara R Fairall, Naomi Folb, Venessa Timmerman, Carl Lombard, Krisela Steyn, Max O Bachmann, Eric D Bateman, Crick Lund, Ruth Cornick, Gill Faris, Thomas Gaziano, Daniella Georgeu-Pepper, Merrick Zwarenstein, Naomi S Levitt
BACKGROUND: In many low-income countries, care for patients with non-communicable diseases (NCDs) and mental health conditions is provided by nurses. The benefits of nurse substitution and supplementation in NCD care in high-income settings are well recognised, but evidence from low- and middle-income countries is limited. Primary Care 101 (PC101) is a programme designed to support and expand nurses' role in NCD care, comprising educational outreach to nurses and a clinical management tool with enhanced prescribing provisions...
November 2016: PLoS Medicine
https://www.readbyqxmd.com/read/27875012/growth-of-nurse-prescribing-competence-facilitators-and-barriers-during-education
#18
H Hopia, A Karhunen, J Heikkilä
OBJECTIVE: To describe facilitators and barriers in relation to the growth of nurse prescribing competence from the perspective of the nurses studying in a prescribing programme. BACKGROUND: The number of nurses enrolled in a nurse prescribing programme is rapidly increasing in XXX. However, few studies on nurse prescribing education are available and therefore research is needed, particularly from the point of view of nurses studying in the programme. DESIGN: The descriptive, qualitative study used the text of student online learning diaries as data during a 14-month prescribing programme...
November 22, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27873322/non-medical-prescribing-versus-medical-prescribing-for-acute-and-chronic-disease-management-in-primary-and-secondary-care
#19
REVIEW
Greg Weeks, Johnson George, Katie Maclure, Derek Stewart
BACKGROUND: A range of health workforce strategies are needed to address health service demands in low-, middle- and high-income countries. Non-medical prescribing involves nurses, pharmacists, allied health professionals, and physician assistants substituting for doctors in a prescribing role, and this is one approach to improve access to medicines. OBJECTIVES: To assess clinical, patient-reported, and resource use outcomes of non-medical prescribing for managing acute and chronic health conditions in primary and secondary care settings compared with medical prescribing (usual care)...
November 22, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27870547/prescribers-perceptions-of-medication-discontinuation-survey-instrument-development-and-validation
#20
Amy Linsky, Steven R Simon, Kelly Stolzmann, Barbara G Bokhour, Mark Meterko
OBJECTIVES: Primary care providers (PCPs) and clinical pharmacists have concerns about the adverse consequences of using medications inappropriately and generally support the notion of reducing unnecessary drugs. Despite this attitude, many factors impede clinicians' ability to discontinue medication in clinical settings. We sought to develop a survey instrument that assesses PCPs' and pharmacists' experiences, attitudes, and beliefs toward medication discontinuation. STUDY DESIGN: Survey development and psychometric assessment...
November 2016: American Journal of Managed Care
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