< PROGRAM >

BACHELOR OF NURSING SCIENCE WITH HONOURS

< SEMESTER / YEAR>

SEMESTER 3 / JANUARY 2023

< COURSE CODE>

NBHS 1314

< COURSE TITLE>

PHARMACOLOGY FOR NURSES

MATRICULATION NO : 910809065371001
IDENTITY CARD NO. : 910809065371
TELEPHONE NO. : 01116625229
E-MAIL : fariedfrd91@oum.edu.my
LEARNING CENTRE : Petaling Jaya Learning Centre
 Table of Contents

Introduction...................................................................................................................1
The Importance of Nurses’ Role in Medication Safety Concerning Nursing Practice.2
Nurses’ Responsibilities toward the Principle of Drug Administration in Improving
Medication Administration Safety................................................................................4
Conclusion....................................................................................................................7
References.....................................................................................................................8

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Introduction

Registered nurses, known as the healthcare professional group, play an important

role in promoting patient safety while serving nursing care services to patients,
especially related to medication safety. It is important for nurses to demonstrate
appropriate skill and practice in medication safety, prevention of medication errors,
and medication error management, which are known as core skills related to the
medication management of patients (Chui, Pohjanoksa-Mäntylä, & Snyder, 2019).
Generally, nurses actively participate in the late stages of the medication
administration process, including medication preparation, medication administration,
documentation of the medication administration, and monitoring the medication
response of the patients. All these activities and other medication-related nursing
activities occupy around 25% to 40% of the nurses working time in the clinical area,
especially in the hospital environment (Khalil & Lee, 2018). Even though medication
errors may occur at any stage of the medication administration process, the nursing
staff is the last link to stop the medication error incidence before occurring and
reaches the patients (Jafaru & Abubakar, 2022). Thus, nurses not only must be
prepared to catch their errors in the medication administration process, but the
nursing staff also play a vital role in determining any errors of other healthcare
professional groups involved in the chain of medication administration before its
reaching patients. Then they may impair patient safety (Durham, 2020). Therefore, I
will discuss several areas related to medication safety in nursing practice in this task.
Firstly, I will discuss the importance of nurses’ role in medication safety concerning
nursing practice. Then, I will also explain the nurses’ responsibilities toward the
principle of drug administration in improving medication administration safety. The
discussion will focus on the latest related evidence-based practice. In the last section,
I summarised the important points or information related to this task. I also may
ensure all the information and facts discussed in this task must be relevant to the
current situation. Thus, the several review and research articles related to the topic of
this task published between 2018 and 2023 will be referred to as the source of
reference while completing this task.

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The Importance of Nurses’ Role in Medication Safety Concerning Nursing
Practice

Nowadays, medications are available in multiple varieties for administration, and

they are also administered via multiple routes, such as orally, intravenously,
subcutaneously, or inhaled. Mostly, the oral route is used as the most adequate and
beneficial method of consuming medications. It is because taking the medications
orally may provide the optimum effect by minimising any related adverse side
effects while taking the drug. The medication taken orally or by mouth will be
absorbed from the small intestine to the liver through the portal vein. Once the
medication is metabolised, it will enter the circulation system for systemic effect
(Eradiri, 2018). Thus, it is recognised as the nurse’s duty to understand the
pharmacology and medical speciality of pharmaceutical care. It is essential to
support safe and professional practice regarding drug administration on behalf of the
nurses (Choi & Song, 2021).

Then, in modern nursing practice, the demand to calculate the drug dosages in drug
preparation before the drug is administered to the patients is common. Thus, it is
essential for nurses to ensure they are highly competent in conducting drug
calculations accurately and effectively. It is to prevent the nurses not to put the
patient at high risk of administering inaccurate drug dosages or lapses. Accurate drug
dosage calculation is one of the essential roles of nurses in drug preparation so that
the drug administration process takes place safely. The nurses must perform various
required mathematical calculations competently in the clinical area and with minimal
supervision from experienced nurses or colleagues (Valcourt & Smith, 2021). It is
also reminded that the nurses must take adequate time when putting the drug dosage
calculations in drug preparation, recheck the answers, and keep themselves to a
minimum distraction during drug dosage calculation. It is to prevent any risk of error
during the drug dosage calculation, which may promote the incidence of medication
errors and impair the patient’s health outcome when receiving the wrong drug dosage
(Musharyanti, Haryanti, & Claramita, 2021).

Next, safe and efficient drug administration in children and infants requires a
combination of professional competencies. The oral route is recognised as one of the
drug administration routes used in administering drugs to children and infants

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whenever realistic. It is because, by orally taking the drug, the children may
experience less pain and low anxiety level, which is also known as the cheaper
method than other methods and more feasible to facilitate (Hendyatama & Mardiana,
2020). However, it should be remembered that children and infants are known as the
group of patients more susceptible to medication dosage errors. It is due to the
unique drug calculation involved during the drug preparation. Thus, it is important to
ensure they are aware of their ability in drug calculation for children and infants.
Then they are also should highly competent in conducting the drug dosage
calculation for children and infants in the real clinical area (Musharyanti, Haryanti,
& Claramita, 2021). In the drug dosage calculation for infants and children, the
nurses should involve either the body weight or body surface area of the children or
infants, which involves a more complex drug dosage calculation process. It is
important for nurses to know that the accuracy of pediatric drug dosage is required to
ensure the drug able to achieve adequate therapeutic levels in promoting positive
health outcomes in paediatrics. The nurses also should understand the system of
measurement and the relationship between the units so that they can fully understand
the arithmetic involved in drug dosage calculations. Therefore, nurses must establish
all of these skills involved in drug dosage calculation before qualification and
registration (Lazare, 2018).

Furthermore, most previous studies have mentioned that nurses significantly

implement the ‘Nine Rights’ in medicine management. It involved the patients must
receive the right drug so that it may enhance the patients receiving the right treatment
and omission reduced. The next steps are involved the nurses’ role in ensuring the
medication is given to the right patients and at the right time so that it may minimise
the potential of the patient to exposure to the potentially harmful medications and the
risk of overdosing a patient or reducing the risk of patient’s care being negatively
affected. Then followed by the nurses’ role in ensuring the patient receives the right
dose of the drug through the right route of the drug being administered. It may be
ensured that the patients are competently medicated and that the best course of action
is being taken. At the end of the drug administration process, the nurses must ensure
the right documentation regarding the drug administration process is completed and
well-prepared. It is important to ensure lawful and competent practice. Then it also
may minimise any confusion regarding the medication administration process so that

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it may promote the continuity of care (Davidson, 2019). Other than that, the nurses
also must ensure the right action has to take where the right form and the right
response from the patient after the medication administration, and is also known as
nursing management, in order to reduce any risk of adverse side effects or
complications after drug being administered to the patients (Jones & Treiber, 2018).

Besides that, the nurses also have a fundamental role in ensuring the safe storage of
medication so that they can promote patient safety. In general, most healthcare
facilities around the globe may provide policies and guidelines related to medication
handling for nurses. Thus, the nurses must adhere to and implement the local policies
in medication handling, including practising the safe storage and security of the
medicines in the clinical area. In the nursing practice, the nurses are identified as the
healthcare professionals who have the role of ensuring the medication is stored in
accordance with guidelines provided by the manufacturer, and any important
information related to each medication should be accurately documented (Croke,
2023).

To summarise, the nursing staff should act with integrity and professionalism at all
times, including during drug preparation and administration, so that they are able to
support safe and professional practice in medication handling. It is essential to ensure
all of the nurses are highly competent in delivering the required level of care to
patients related to medication handling with the aim of promoting medication safety
practice. All of the nurses also must adhere to the specific guideline and protocols in
accordance with the local policies related to medication handling, and adhere to all
principles and guidelines so that they are able to promote safe and competent practice
related to the medication preparation and administration on behalf of nurses
(Durham, 2020).

Nurses’ Responsibilities toward the Principle of Drug Administration in

Improving Medication Administration Safety

Nowadays, registered nurses around the globe are educationally prepared, morally
responsible, and professional;y accountable for fulfilling their roles safely in
medication administration. Medication administration is known as a core
responsibility of registered nurses around the globe, especially those working in the

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in-patients units of the hospital environment (Salami, 2018). In order to overcome or
reduce the risk of medication administration errors in the clinical area, most hospitals
should ensure that nurses competently fulfil their role in the medication
administration process. It includes the nurses ensuring the right medication is
properly drawn up in the correct dose and administered at the right time through the
right route and to the right patient (Khalid, Masih, & Afzal, 2022). The nurses, also
known as the trained healthcare professionals, administer the drugs directly to
patients and are the last links in the safe medication administration chain (Huang &
Huang, 2019). Thus, nurses have significant responsibilities in improving medication
administration safety related to the principle of drug administration.

Firstly, all nurses should be aware that the medication should never be prepared in
advance. However, certain drugs, such as chemotherapy infusions, can be prepared in
advance. Then, the drugs can only be administered by the nurse involved in their
preparation. The nurses should be aware that they should never administer
medication they have not helped prepare (Salami, 2018). In drug preparation, the
nurses should have a good understanding of the weight systems used in drug
prescriptions. Then the nurses also must be able to calculate the drug dosage
accurately. The nurses also must be aware of and understand the common
abbreviations used in prescribing. Then the nurses also must remember that they
have the right to question any need for clarity in the instructions related to the drug
administration given by other healthcare professionals such as physicians or
pharmacists (Huang & Huang, 2019). In addition, the medication safety practice
promotes patient and nurse safety. Thus, it is highly important for nurses to well-
understand any requirements for the safe handling of harmful medications, such as
the cytotoxic drug used in treating cancer. It is because the cytotoxic drug has the
potential to damage both healthy and cancer cells. Thus, nurses should employ
extreme care while handling this drug and take it in accordance with the local
procedure when handling, preparing, and administering these drugs. The nurses who
are pregnant or those who are suspected they may be pregnant should not involve in
the handling and administration of these drugs (Khalid, Masih, & Afzal, 2022).

Before administering a drug, it is compulsory for the nurses to check and confirm the
identity of the patients with their wrist bands or, if necessary, the nurses can be asked
the patient’s name and date of birth of patient so that its similar to the information

5
available in the patient’s wrist band. The nurses also recommended checking with the
patient if he/she has any allergies to the drug (Jafaru & Abubakar, 2022). Other than
that, to ensure the nurses implement appropriate medication safety practices, its
compulsory for the nurses to have a good understanding regarding the drug that they
have been asked to administer, including well-understand regarding the therapeutic
use, normal dosage, known adverse effects, and any specific contraindications or
precautions which associated with that particular drug. It is important to ensure the
drug is able to provide or achieve the desired therapeutic effect of the drug on the
health outcome of the patients. The nurses also must be familiar with the care plan of
the individual patient and the need for the individual patient to receive the
medication, which is highly recommended to implement patient-centred care during
the drug administration process (Hendyatama & Mardiana, 2020).

Then, it is essential for the nurses to check the prescription for the medication, and
the labels on the containers of the medication should be clear. It must be remembered
that if the nurses find any uncertainty over any aspect of the prescribed instructions,
its compulsory for the nurses to investigate this problem further by contacting the
healthcare professional that prescribes the drug for further clarification, such as a
physician or pharmacist (Khalil & Lee, 2018). The nurses must always communicate
with the prescribing healthcare professionals regarding any misinformation related to
the medication to prevent any risk of medication errors can reach the patients
(Valcourt & Smith, 2021).

Furthermore, the nurses also have the responsibility to consider the current condition
of the patient before administering a prescribed drug. For example, if the current
condition of the patient or the vital signs of the patient contraindicate the medication,
then the medication should not be given to the patient, and advice should be sought.
For example, Digoxin should not be given to patients with a pulse < 60 beats/min. If
the patients had lowered pulse rate than this, then the scheduled digoxin dose
becomes contraindicated and should not be given. Then, the nurses should contact or
communicate with the prescriber, especially the physician, for further discussion. It
is important to prevent any adverse effects related to the health outcome of the
patients (Chui, Pohjanoksa-Mäntylä, & Snyder, 2019). Finally, after receiving the
medication, the nurses play an important role in continuously monitoring for any risk
of adverse events that the patients might experience after taking the drug. The nurses

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also should be aware and ready for any emergency care required to support the
patient if any serious reaction occurs after the drug administration. For example, if
the patients suffer from bronchospasm after taking the drug, the nurses can treat
adverse effects with the salbutamol delivered by a nebuliser (Hendyatama &
Mardiana, 2020).

Conclusion

In conclusion, medication error incidence can be prevented by implementing

appropriate medication safety practices among healthcare professionals involved in
the medication administration process of handling, especially nursing staff. Other
than that, nursing management of medication errors is an important aspect of the
healthcare system around the globe. The nursing staff should equip themselves with
adequate and latest knowledge regarding medication administration so that they are
able to implement appropriate skills in medication administration and handling so
that they are able to quickly identify and intercept medication errors, regardless of
the source, before the medication error has the opportunity to reach the patient. Thus,
the nurses directly and actively involved in medication handling should ensure their
knowledge of current medications is adequate to prevent any medication
administration and handling errors. Finally, medication administration is recognised
as the fundamental aspect of the nursing role in the clinical area, especially in the
hospital environment. The nursing staff should also be aware of their unique role in
the medication administration process. The nursing staff can report medication errors
once identified and promote medication safety practices in the clinical area.

7
References

Choi, M.-K., & Song, I.-S. (2021). Pharmacokinetic Drug–Drug Interactions and
Herb–Drug Interactions. Pharmaceutics, 13(5), 610.
https://doi.org/10.3390/pharmaceutics13050610

Chui, M. A., Pohjanoksa-Mäntylä, M., & Snyder, M. E. (2019). Improving

medication safety in varied health systems. Research in Social and
Administrative Pharmacy, 15(7), 811–812.
https://doi.org/10.1016/j.sapharm.2019.04.012

Croke, L. (2023). Guideline for Medication Safety. AORN Journal, 117(3).

https://doi.org/10.1002/aorn.13889

Davidson, H. E. (2019). Medications: Deciding the Right Time to Stop. The Senior
Care Pharmacist, 34(10), 627–627. https://doi.org/10.4140/tcp.n.2019.627

Durham, B. (2020). The nurseʼs role in medication safety. Nursing, 45(4), 1–4.
https://doi.org/10.1097/01.nurse.0000461850.24153.8b

Eradiri, O. (2018). Medication without harm: Challenges and opportunities in

advancing the global medication safety agenda. Journal of Clinical Trials, 08.
https://doi.org/10.4172/2167-0870-c2-024

Hendyatama, T. H., & Mardiana, N. (2020). Calculation of Drug Dosage In Chronic

Kidney Disease. Current Internal Medicine Research and Practice Surabaya
Journal, 1(1), 21. https://doi.org/10.20473/cimrj.v1i1.16894

Huang, S., & Huang, G. (2019). Preparation and drug delivery of dextran-drug
complex. Drug Delivery, 26(1), 252–261.
https://doi.org/10.1080/10717544.2019.1580322

Jafaru, Y., & Abubakar, D. (2022). Medication Administration Safety Practices and
Perceived Barriers Among Nurses: A Cross-Sectional Study in Northern
Nigeria. Global Journal on Quality and Safety in Healthcare, 5(1), 10–17.
https://doi.org/10.36401/jqsh-21-11

Jones, J. H., & Treiber, L. A. (2018). Nurses’ rights of medication administration:

Including authority with accountability and responsibility. Nursing Forum,
53(3), 299–303. https://doi.org/10.1111/nuf.12252

Khalid, N., Masih, S., & Afzal, M. (2022). Practices On Safe-Handling of Cytotoxic
Drugs Among Oncology Nurses in Two Public Sector Hospitals. Pakistan
Journal of Health Sciences, 12(3), 131–136.
https://doi.org/10.54393/pjhs.v3i07.449

Khalil, H., & Lee, S. (2018). Medication safety challenges in primary care: Nurses’
perspective. Journal of Clinical Nursing, 27(9-10), 2072–2082.
https://doi.org/10.1111/jocn.14353

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Lazare, M.-B. (2018). The Lived Experiences of Undergraduate Nursing Students
Learning Drug Dosage Calculation. International Journal of Nursing &
Clinical Practices, 5(1). https://doi.org/10.15344/2394-4978/2018/297

Musharyanti, L., Haryanti, F., & Claramita, M. (2021). Improving Nursing Students’
Medication Safety Knowledge and Skills on Using the 4C/ID Learning
Model. Journal of Multidisciplinary Healthcare, Volume 14, 287–295.
https://doi.org/10.2147/jmdh.s293917

Salami, I. (2018). Nursing Students’ Medication Errors and Adherence to Medication

Best-Practice. Open Journal of Nursing, 08(05), 281–291.
https://doi.org/10.4236/ojn.2018.85024

Valcourt, M. P., & Smith, D. (2021). Teaching Medication Calculation: A

Contextual Approach. Nurse Educator, 34(4), 34–35.
https://doi.org/10.1097/NNE.0000000000001030

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ONLINE CLASS PARTICIPATION

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