Safe Medicine Administration Counseling for Pregnant and Breastfeeding Mothers

The use of drugs for pregnancy and breastfeeding needs to be self-medication and the importance of counselling to increase the mother's knowledge about the correct use of drugs so that pregnant and lactating women's level of health and knowledge increases. The counselling purpose was to determine the mother's level of knowledge and whether there was a difference in the knowledge level of the use of drugs during pregnancy and lactation. The method used is pre and post-media analysis (flipchart). Data analysis obtain by scoring questionnaires, univariate analysis, and statistical analysis. Mann-Whitney test results showed that in the post-test or after giving counselling using flipchart media, there was a change in respondents' knowledge from before being given a flipchart and after being given a flipchart. The hypothesis from this counselling is accepted, which means that giving flipcharts affects the level of knowledge. The calculations using the spearman test obtained p-value pretest 0.732 and p-value post-test 0.253 for pregnant women and obtained p-value pretest and post-test of 0.033 (p <0.05) for breastfeeding mothers, then there is a relationship between the education level pregnant and lactating mothers with knowledge. The Wilcoxon test data pretest and post-test knowledge of pregnant and lactating mothers had a p-value of 0.003 (p 0.05), the effect of counselling concluded with flipchart media on the knowledge of pregnant and lactating mothers about the use of drugs.

Efficacy of Herbal Medicine Administration using Neem (Azadirchta indica L) Leaves as Case Study

Plants used for treatment of diverse ailments primitively are concocted and used indiscriminately. The efficacy of "Herbal medicine" which is an ancient tradition, used in some parts of Nigeria was investigated to establish herbal applications of Neem (Azadirachta indica) leaves. Neem leaves (Azadirachta indica) was popularly recognised for the treatment of malaria fever. The leaves were plucked at appropriate peak period of the day when oil and moisture contents were recorded maximum. The peak period of contents was found to occurred between 8am-10am on a very sunny days, 10am to 12 on cool days, and 3:00pm to 5:00pm on cloudy days. Aqueous extract from macerated Neem leaves was subjected to qualitative and quantitative analysis. Available phytochemicals evaluated include; saponin (34.89mg/g), tannin (31.715mg/g), flavonoid (31.835mg/g), phenol (43.59mg/g), terpernoid (14.585mg/g), cardiac glycosides (39.335mg/g), steroid (16.185mg/g) and alkaloid (28.76mg/g). These values differ significantly to recommended oral dosage formulation for human consumption: Saponin (1.433ml), Tannin (1.418ml), Flavonoid (13.91ml), Phenol (2.29ml), Terpernoid (8.23ml), Cardiac Glycosides (0.003177ml), Steroid (0.62mg/g). Consequently, local consumption of herbal resources should be regulated to avoid abuse and long or short-term effects of drug contents as proven in the neem leaves as local herbs.

Nursing Skill and Responsibility in Administration of Low Molecular Weight Heparin by Prefilled Syringe

Low-molecular-weight heparins (LMWHs) have proven to be effective in the prevention and treatment of thrombotic disorders, as well as substitute for unfractionated heparin (UFH). LMWHs are a diverse collection of medicines with different biochemical and pharmacological characteristics, despite the fact that they all have antithrombotic actions. Medicine is administered into the subcutaneous tissues with these injections. Small amounts of injections are delivered by the subcutaneous approach, which involves inserting a small thin needle beneath the skin and slowly injecting the medicine. Low molecular weight heparins make up dalteparin and enoxaparin, two anticoagulants. The rights of medicine administration must be followed by nurses. For patients on LMWH medication, the most essential blood test is prothrombin time. Following administration, look for any signs of bleeding, such as occult blood in the stool, malena, bleeding gums, and skin discoloration/hematoma. The antidote for low molecular weight heparin is protamine sulphate. It is effective at counteracting the effects of LMWH. 100 units of LMWH are neutralised by 1 mg of protamine sulphate.If it's been more than 8 hours since you've given LMWH, provide 0.5 mg protamin per 100 units of LMWH.

Working in a minefield; Nurses’ strategies for handling medicine administration interruptions in hospitals, -a qualtiative interview study

Background Administering medicines is one of the most high-risk tasks in health care. However, nurses are frequently interrupted during medicine administration, which jeopardises patient safety. Few studies have examined nurses’ experiences and the strategies they adopt to cope with interruptions during medicine rounds. This paper identifies nurses’ strategies for handling and reducing interruptions and ensuring safety during medicine rounds, within the confines of the hospitals’ organisational systems. Methods This descriptive and exploratory research study was undertaken with experienced nurses in Norwegian hospitals in 2015 using semi-structured interviews. Interviews were designed to elicit experiences and strategies used for handling interruptions to medicine rounds. Data were analysed using qualitative content analysis based on inductive reasoning to identify meaningful subjects and reach an interpretive level of understanding regarding nurses’ experiences. Results All 19 senior nurses who were approached were interviewed. From 644 condensed meaning units, we identified eight interpretative units and three themes: ‘working in environments of interruptions’, ‘personal coping strategies’, and ‘management-related strategies’. Nurses’ working environments were characterised by interruptions and distractions, which often threatened patient safety. To handle this unpredictability and maintain ward organisation, nurses developed their own personal strategies to overcome inherent problems with their working conditions, the absence of effective management, and colleagues’ reluctance to assume responsibility for minimising interruptions. Conclusions Administration of medicines in hospitals can be described as ‘working in a minefield’. Our findings indicate that the hospital management, in cooperation with nurses and other healthcare professionals, should take responsibility for improving the routine process of medicine administration by minimising avoidable interruptions. Patient safety can be improved when the hospital management takes steps to protect nurses’ work environments and assumes responsibility for resolving these challenges.

Facilitators and barriers to the clinical administration of herbal medicine in Ghana: a qualitative study

Background Herbal medicine administration in conventional health care services is gaining popularity lately. Much has not been documented on the perceived enhancers and challenges to herbal medicine administration at the hospital. The study sought to explore the facilitators and barriers to the clinical administration of herbal medicine in Ghana. Method Qualitative descriptive exploratory design was employed. Fourteen participants among the consented and purposively sampled nurses were interviewed. Data was transcribed and analysed using content analysis. Results The participants disclosed that facilitators to the clinical administration of herbal medicine include doctors’ prescription, affordability of herbal medications by patients, patients’ willingness to use herbal medicine and availability of herbal medicine. Barriers to the clinical administration of herbal medicine were inadequate knowledge on herbal medicine, lack of publicity, unclear integration, lack of collaboration and policies on herbal medicine administration at the hospital. Other barriers were negative mindset of patients and lack of national health insurance scheme (NHIS) coverage. Conclusion Clinical administration of herbal medicine is faced with an array of challenges. Doctor’s prescription, nursing education on herbal medicine and NHIS coverage of herbal medicine are imperative to improve herbal medicine administration in hospitals. Plain English summary Herbal medicine addition into mainstream health care services is surging high in many countries. This study aimed at finding out what nurses consider as the issues that make it easy or difficult to serve herbal medicine in the hospital. Qualitative method was employed, in-depth face-to-face interviews were conducted and data collected was typed verbatim. The typed data was content analysed and findings supported with the nurses’ statements. The findings of the study showed that facilitators to the clinical use of herbal medicine include doctors’ prescription, affordability of the herbal drug, patient’s willingness to use the herbal medication, patient’s belief about herbal medicine and availability of herbal medicine. Challenges to the clinical use of herbal medicine disclosed were lack of knowledge on herbal medicine, lack of publicity, unclear integration, lack of collaboration between health professionals and herbal medicine providers. Other barriers include negative mindset of patients and lack of national health insurance (NHIS) coverage. The researchers came to a consensus that nurses need further training on herbal medicine to enhance herbal medicine use at the hospital. Health professionals need to collaborate with herbal medicine service providers and NHIS must be reviewed to cover herbal medications.

Comparing the Effects of Pulsatile and Continuous Flushing on Time and Type of Peripheral Intravenous Catheters Patency: A Randomized Clinical Trial

Introduction: Peripheral intravenous catheters (PICs) patency techniques such as flushing are being developed. According to some studies, flushing can be used continuously or in pulsatile forms. This study aimed to compare the effects of pulsatile flushing (PF) and continuous flushing (CF) on time and type of PICs patency. Methods: In this double-blind randomized clinical trial, 71 patients were randomly assigned into two groups of PF (n=35) and CF (n=36). The PF protocol was performed as successive injections of 1 mL normal saline (N/S) per second (sec) with a delay of less than 1 sec until the completion of 5 mL of solution. However, CF protocol was performed by injecting 5 mL N/S within 5 sec without any delay before and after each medicine administration. Data related to the time and type of PICs patency were collected using a patency checklist every 12 hours (h) up to 96 h. The statistical analysis was done by R statistical software (Version 3.5.1). Results: The results showed that the number of PICs remaining open was not significantly different between PF and CF groups during 96 h. The highest number of PICs excluded from the study was related to the time of 96 h as a result of partial patency in the two groups. Conclusion: There was no difference between CF and PF regarding the time and type of PICs patency. Thus, both techniques can be used to maintain the catheter patency.

Assessment of oral solid dosage forms administration manner and acceptability

Taking oral solid dosage forms (OSDFs) safely and effectively is particularly important. This study aimed to determine the pattern and knowledge about the proper criteria of OSDF administration and the consumers’ preferences toward OSDF characteristics. The aims of this study were achieved by cross-sectional survey through open and closed-ended questionnaires, and the presence of the main OSDF administration recommendations of a sample of 32 OSDF drug leaflets was assessed. Based on a simple random sample of 250 volunteers, we found inadequate compliance with the OSDF medicine administration criteria. We also found an absence of the main recommendations of OSDF drug administration on most of the investigated OSDF drug leaflets. Conventional white, round tablets were found to be the most preferred type of OSDF drug. These findings can be valuable to pharmaceutical manufacturers, regulatory agencies, and pharmacists to enhancing patient awareness and compliance with OSDF administration for safe and effective drug administration.

Patient safety in the process of pharmacotherapy carried out by nurses – A Polish-Slovak prospective observational study

Aim This study was aimed at the determination and comparison of safety levels at the nurse-managed stage of the pharmacotherapy process in Poland and Slovakia by identifying the key risk factors which directly affect patient safety. Background/Introduction: Pharmacotherapy, i.e. the use of medicines for combating a disease or its symptoms, is one of the crucial elements of patient care. Studies carried out with regard to nursing workloads in the pharmacotherapy process prove that nurses spend 40% of their work on the management of medications. Medicine administration is the most frequent task of all nursing activities, and there is a possibility of committing errors at this stage due to the complex and multifaceted nature of the pharmacotherapy process. Methods The study involved a group of 1774 nurses, of whom 1412 were from Poland and 362 from Slovakia. The original Nursing Risk in Pharmacotherapy (NURIPH) tool was used. The Cronbach alpha coefficient was 0.832. Results Nurses from Slovakia most often, i.e. for 6 out of 9 factors (items: 1, 5, 6, 7, 8, 9), assessed the risk factors as “significant risk (3)”, and Polish nurses most often, i.e. for as many as 8 out of 9 risk factors (items: 1, 2, 3, 4, 5, 6, 7, 9), assessed the risk factors as “very significant (5)”. Significant differences (p < 0.05) were demonstrated in 8 (out of 9) risk factors. Conclusions The pharmacotherapy process implemented by nurses, regardless of the country, is burdened with a considerable number of risk factors and it might negatively affect patient safety. It has been found that the safety of the pharmacotherapy process is assessed by Polish nurses as much lower than by Slovak ones. Training activities in the field of adverse events, adverse reactions to medications and appropriate and effective communication should be introduced for all members of the medical staff involved in the pharmacotherapy process.