Transcript Chapter_003-ppt-Intro-to-Cl-Phar-6th-ed

Chapter 3
Legal Aspects Affecting the
Administration of Medications
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Chapter 3
Lesson 3.1
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Learning Objectives
• List the names of major federal laws
concerning drugs and drug use
• Explain in what way the nurse is
responsible for controlled substances
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Learning Objectives (cont.)
• Describe the differences between
authority, responsibility, and
accountability
• Describe some of the risks associated
with common over-the-counter (OTC)
medications
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Medication Regulation
• Federal Guidelines (government)
• State Guidelines (Board of Nursing)
• Facility Guidelines (where you are
practicing)
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Federal Legislation
Three drug categories in the United
States:
• Controlled substances – drugs that may be
easily abused, are dangerous, and require a
prescription
• Prescription, or legend, drugs – drugs that
require a prescription but are not as easily
abused
• Over-the-counter (OTC) medications – drugs
patients may buy without a prescription
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Federal Legislation (cont.)
• Harrison Narcotic Act of 1914 – limited
indiscriminate use of addictive drugs
• Federal Food, Drug, and Cosmetic Act of
1938 – gave authority to government to
determine the safety of a drug prior to
marketing, labeling, specification, and
advertising
• Durham-Humphrey Amendment of 1952 –
restricted number of prescription refills
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Controlled Substances
Nurses may possess these only if:
– They are administering the drugs to the
patient for whom they were prescribed
– They themselves are the patient for whom
the physician has prescribed the drug
– They have been delegated the
responsibility for the unit supply
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Prescription, or Legend, Drugs
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Carefully tested prior to marketing
Use is carefully controlled
Prescription is required
Majority of drugs nurses administer in
the hospital
• Geriatric patients are at special risk
• Safety may not have been determined
for children
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Over-the-Counter Medications
• Low risk for patient when taken
appropriately
• Low dosage
• Patients buy on their own
• May have hidden chemicals
• Require a prescription in the hospital
• Herbal medications have not been
tested for safety and effectiveness
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Chapter 3
Lesson 3.2
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Learning Objectives
• List rules of states and agencies that
affect how nurses give drugs
• Explain in what way the nurse is
responsible for controlled substances
• List what information is included in a
medication order or prescription
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Learning Objectives (cont.)
• Define and give examples of the four
different types of medication orders
• List what you need to do if you make a
medication error
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State Nurse Practice Act
• Determines the level of authority and
responsibility of the nurse
• Different levels of nursing will have different
levels of authority and accountability
• Nurses must adhere to the Nurse Practice Act
in the state in which they are practicing
• Responsibilities may vary in State Nurse
Practice Acts
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Nursing Responsibilities
• All nurses have legal responsibility for
their actions.
• The Nurse Practice Act determines the
level of responsibility and authority of
the nurse.
• Nurses must have the authority to
delegate to a person with the authority
to carry out the task.
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Nursing Process
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Assessment
Diagnosis
Planning
Implementation
Evaluation
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Ordering Procedure
• Step 1: Physician orders medication
• Step 2: Order is transcribed onto Kardex
• Step 3: Charge nurse verifies accuracy
of order and transcription
• Step 4: Order is sent to pharmacy
• Step 5: Medication is dispensed to floor
• Step 6: Nurse administers
according to guidelines
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Medication Card
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Drug Distribution Systems
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Floor or ward stock system
Individual prescription order system
Unit-dose system
Computerized or automated dispensing
system
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Medication Orders
• Required information includes:
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Patient’s full name
Date
Name of medication
Dosage
Frequency
Duration
Route
Signature of physician
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Types of Medication Orders
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Standing orders
Emergency, or “stat,” order
Single order
As-needed, or “prn,” order
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Medication Errors
• Immediately assess the patient
• Notify the physician and implement any
orders
• Continue to assess the patient
• Notify supervisor
• Document findings in patient record
• Complete facility documentation
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