Nursing staff

Patients and nursing staff may use a range of applicators (pads, sponges, brushes, spatulas) during medicament administration, particularly for topical products. If reused, these easily become contaminated and may be responsible for perpetuating contamination between fresh stocks of product, as has indeed been shown in studies of cosmetic products. Disposable applicators or swabs should therefore always be used. 

The consultant pharmacist is reviewing the care of AN, who is a 79-year-old male resident of a long-term care facility. According to his records, he has received phenytoin and phenobarbital ever since suffering a stroke 12 years ago. There is no record of a seizure in his chart, and the nursing staff has not observed a seizure since he arrived at the facility 2 years ago. His family recalls that he had 1 seizure around the time of his stroke, but has not had any more seizures. 

Antonow, J.A., Smith, A.B. and Silver, M.P. (2000). Medication error reporting A survey of nursing staff. J. Nursing Care Quality 15 42 18. 

Post carpenters would install interior partitions - one to set apart the nursing staff and another to provide a quiet cubicle for the NF and VITA cognitive testing. An in-house bathroom, complete with chemical toilet and sink would be placed in one comer, leaving ample space for the volunteers, their beds and accompanying hassocks for staff Nothing less than a veritable Holiday Inn, modified to accommodate chemical warfare volunteers. 

My own practice was to refer to agents such as BZ or other related glycolates as similar to belladonna or atropine - belladonnoids if you will. Since the terms atropine and belladonna were also unfamiliar to many volunteers, I said that the effects would vary from person to person, but generally, they would include dryness of the mouth, sleepiness, difficulty in solving problems, and altered perceptions. I assured them that both the nursing staff and I would monitor them closely. I explained that extensive pre-clinical studies in several animal species had revealed no permanent ill effects. I told them we believed the drug to be safe, and would discuss the effects in detail after the test was over. Very few volunteers chose to withdraw after this orientation. 

Modern clinical research requires considerable cooperation and partnership between the investigator, the sponsor and the regulatory authorities. In consequence, the investigator will need to treat certain outsiders with the same amount of trust that is shown to nursing staff and fellow physicians. Violations of confidentiality of subjects are rare from sponsor staff and certainly no more frequent than that experienced from hospital staff. 

Institutional Review Boards. In university clinics and other hospitals engaged in research, ethics committees (also called Institutional Review Boards, IRBs) have been formed over the last three decades to monitor clinical research activities from scientific, legal, ethical and social viewpoints. All protocols relating to clinical trials must be submitted to these committees, which are generally made up of one or several doctors, a lawyer, a representative of the nursing staff and also community representatives such as priests. This composition forces clinical researchers to set out their intentions in such a way as to be clear enough for a lay person to understand and to assess whether the inconvenience and risks involved for the patient are in a reasonable relationship to the possible benefit of the planned trial. 

Case Example A 44-year-old chronic alcoholic man presented in the emergency room with disorientation and combativeness after 2 days of abstinence. He complained of visual and tactile hallucinations and was found to have elevated heart rate, blood pressure, and temperature. Lorazepam was slowly administered intravenously, and after 15 minutes, the patient was mildly sedated. He was then transferred to an inpatient unit. During this 30-minute interval, he received no additional lorazepam, and when he arrived on the floor, his symptoms had returned. He became agitated, struck one of the nursing staff, and had to be physically restrained. 

We support the intelligent choice of medications based on rational reasons, but avoid the position that all medication is bad, serving only as a substitute for adequate staffing. In this context, there is a great deal of trial and error in dosage adjustment, and there is no substitute for close monitoring in conjunction with frequent feedback from nursing staff. 

Encouraged nursing staff in the Accident and Emergency Department to streamline their requests for admission... 

The Cooperative is a not-for-profit organization that operates in downtown Oakland. A physician serves as medical director, and registered nurses staff the Cooperative during business hours. To become a member, a patient must provide a written statement from a treating physician assenting to marijuana therapy and must submit to a screening interview. If accepted as a member, the patient receives an identification card entitling him to obtain marijuana from the Cooperative. 

The pharmacist, in concert with the medical and nursing staffs, must develop policies and procedures for ensuring the quality of medication therapy. This must include processes designed to ensure the safe and effective use of medications and to increase the probability of desired patient outcomes. 

Mr Jones is subsequently transferred to the cardiology ward where his continuing atrial fibrillation is later confirmed as persistent atrial fibrillation. As the ward clinical pharmacist, you are responsible for daily review of drug charts and advice to medical and nursing staff on all aspects of drug treatment for patients on the ward. 

Customer dissatisfaction is one of the hardest costs to determine, but the most easily observable. Customers expect that products typically held by a pharmacy are readily available for purchase during normal business hours. Stockouts often produce frustrabon and dissatisfaction among customers, but, if infrequent, may be forgiven. However, frequent stockouts can result in a loss of business. In hospitals, frequent stockouts of commonly used products can result in a decline in the quality of patient care, create frustration among the medical and nursing staffs, and promote dissension between the pharmacy and other staffs. 

Evaluate the need for / activate a[Pg.8]

What is meant by the term disaster response functional role Can you identify some disaster response functional roles for nursing staff in your health care agency ... 

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