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Drug Administration in Objective Structured Clinical Examination



Patient safety is a crucial part of patient care.&nbsp. At all times, all health professionals should keep the safety of the patient in mind.&nbsp. Patient safety practices for drug administration begin at the first contact, from patient identification, patient education, and information, patient contact, the performance of procedures, to leaving the patient comfortable.

&nbsp.&nbsp.&nbsp.&nbsp.&nbsp.&nbsp.&nbsp.&nbsp.&nbsp. One of the important principles of patient safety is infection control.&nbsp. Nosocomial or hospital-acquired infections are the most common complications affecting hospitalized patients today, and one of the major sources of infection is cross-infection by health care workers (Burke, 2003).&nbsp. Meaning, most patients obtain an infection from the hands of those that are treating and caring for them.&nbsp. Most incidents that lead to infection can be prevented and one of the simplest ways to prevent this is by hand-washing.

&nbsp.&nbsp.&nbsp.&nbsp.&nbsp.&nbsp.&nbsp.&nbsp.&nbsp. In the Guideline for Hand Hygiene in Health-Care Settings released by the Centres for Disease Control and Prevention (Boyce and Pittet, 2002), it is recommended that hand washing and hand antisepsis be done if hands are visibly dirty or contaminated.&nbsp. It should also be done before having direct contact with patients, before donning sterile gloves, after contact with a patient’s skin, after contact with body fluids or excretion and wound dressings, and before eating or after using the restroom.&nbsp. In all aspects of contact with the patient, hand hygiene must be done.&nbsp. The guideline further recommends that health care personnel should not wear artificial fingernails, should keep nail tips short, and should remove gloves after caring for a patient.&nbsp. Thus, before drug administration, and even before handling drugs and preparing them, handwashing must always be done.&nbsp. It should also be done after patient contact, and in between interaction with different patients.

&nbsp.&nbsp.&nbsp.&nbsp.&nbsp.&nbsp.&nbsp.&nbsp.&nbsp. Verifying patient identity is another important aspect of patient safety, and not being able to do this could lead to adverse results.&nbsp. Omitting verbal verification of patients’ identity prior to administering medications may lead to a potential adverse event 20% of the time in worst-case scenarios (Lisby, Nielsen, and Mainz, 2005).&nbsp. Even with the use of medication administration technologies such as bar code verification, effectiveness in preventing errors is largely dependent on how practitioners use the technology to verify patient identity and drug identity (Englebright and Franklin, 2005).&nbsp. Remediable causes of having the wrong patient include absent or misused protocols for patient identification and informed consent, faulty exchange of information among caregivers, and poorly functioning teams (Chassin and Becher, 2002).

&nbsp.&nbsp.&nbsp.&nbsp.&nbsp.&nbsp.&nbsp.&nbsp.&nbsp. During my OSCE, I failed to check the identity of the patient with my mentor.&nbsp. I understand that failing to properly verify my patient’s identity could lead to adverse consequences, and will make sure to keep it in mind in future patient interactions.

&nbsp.&nbsp.&nbsp.&nbsp.&nbsp.&nbsp.&nbsp.&nbsp.&nbsp. Doing a brief clinical history can also contribute to patient safety.&nbsp. It allows nurses and other medical personnel to be aware of the patient’s condition, comorbidities, present symptoms and level of comfort.&nbsp. Particularly relevant in drug administration is asking the patient about other drugs being taken and for any personal history or family history of drug allergies.&nbsp. Relying on charts may be inadequate and some patients may not volunteer the information, thinking that it is irrelevant.&nbsp. Thus, doing a brief personal history prior to drug administration is always advisable.

Medication reconciliation is another way to reduce medication errors.&nbsp. This entails comparing medical records, allergies, and home medications, and comparing findings at admission and discharge.&nbsp. Doing this eliminated medication errors (Pronovost et al., 2003).&nbsp. Thus, it is important to always document drugs administered in the chart.&nbsp. This is another thing that I failed to do during my OSCE but realizing now how important it is made me confident that surely, I will remember it during my practice.

Drug Administration in Objective Structured Clinical Examination