Medication Errors in Nursing Ethics of Veracity and Gate Keeping Essay Example

Medication Errors in Nursing: Ethics of Veracity and Gate Keeping Paper Part of the nursing ethics is the immediate reporting and filing of any medication error committed during the span of nurse’s duty. Standard protocol mandated by most institutions is the placement of incident report upon committing the mistake; however, practitioners do not place these records on the patient’s permanent database or even on the patient charts to avoid compromise of their medical comrades. The main issue confronting such practice is the ethical principle of professional gate keeping versus duty of veracity and the violation of patient’s right to know every event of the care process. b. Problem Background Based from the definition of National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP), medication error is considered as â€Å"any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient or consumer† (NCCMERP; cited in Brendle, 2007 p. We will write a custom essay sample on Medication Errors in Nursing: Ethics of Veracity and Gate Keeping specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Medication Errors in Nursing: Ethics of Veracity and Gate Keeping specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Medication Errors in Nursing: Ethics of Veracity and Gate Keeping specifically for you FOR ONLY $16.38 $13.9/page Hire Writer 146). Nurses are confronted by medication errors often times and the act of filing an incident report to alert other members of the health care team is indeed the best collaborative intervention supported by their duty of nonmaleficence (Yeo and Moorhouse, 1996 p. 295). However, these reports are purposely undocumented in the patient charts or permanent records to prevent the risks of legal suit against the practitioner who committed the error, which arguably contradicts to the ethical principle of nurses’ duty of veracity. II. Review of Literature a. Medication Error Medication error is a critical violation of the five rights of medication administration, which can lead to legal liabilities of malpractice or incompetence (White, 2000 p. 486). According to the reports made by the Institute of Medicine (IOM), medication errors are the most prevalent health care errors in the hospital practice affecting approximately 3. 7% of the patients (Brendle, 2007 p. 146). In case of medication errors, the nurses are obliged legally and ethically to report them directly to the nursing manager or in charge physician as mandated. According to Josephson (2005), improper medication administration can double the risk of the patient from dying due to the complications brought by the misadministration of the drug (p. 53-54). IOM reports state that medication errors approximately cause 44,000 to 98,000 deaths annually with liability and health care costs accounting to U. S. $17 to $29 billion each year (Brendle, 2007 p. 146). b. Professional Gate Keeping: Process of Containing the Error Part of the medical team code is to protect the credentials and status of their co-health care providers from external professional threats, which is known as professional gate keeping (Pickering and Thompson, 2001 p. 156-157). According to Timby (2008), after committing a misadministration of medication, the nurse immediately files the incident using the incident sheets or accident form to document the incident; however, this document is not made available via the patient’s permanent record or chart documentation as a form of professional gate keeping (p. 775). Medication errors are filed using this reports to formally endorse the facts of the incident to either the physician or nursing manager. According to Roe (2002), once the incident report has been submitted, the nurse responsible for the mistake must document the interventions done (e. g. administration of antidote, etc. ), individual responsible for the counter intervention and time and date (p. 6). The incident report and the exact details of the mistake are not documented in the patient chart to protect the practitioner from legal suit (Timby, 2008 p. 775). Even if the documentation of the incident is ethically compromised based on the principle of veracity, the health care team ensures the reversal and cure of any possible complications dealt by the misadministration of the drug. According to Williams (2008), it is always important to perform timely and accurate documentation in order to prevent the misadministration of any medication. Training nursing staffs on the different error-preventive systems have become crucial to the management of the workforce. Capriotti has emphasized the need for periodical review and update of medication calculations as preventive tasks against medication errors. According to Davis (2008), an e-learning system was designed to facilitate individualized training and learning packages involving the controlling, storage, administration, wastage and disposal of medicines. c. Ethical Principle of Veracity Based on the principle of veracity, the nurse is also obliged to keep the patient informed on all the events associated to his or her health care regimen. According to Boyd (2007), the ethics of veracity mandates the health care provider to tell the patient all truths concerning his or her health care process (p. 169). Despite the legal and professional risks of disclosing the mistake committed by the nurse, the ethics of veracity demands the disclosure of information to the patient and other involved members of the health care team (Bosek and Savage, 2007 p. 376). According to Lipe and Beasley (2003), the principle of veracity demands the disclosure of information either by the designated nursing head or physician involved in the patient care regimen (p. 232). However, if the institution adheres to the ethical principle of veracity, another principle of health care professionalism –gate keeping- becomes compromised. According to Bosek and Savage (2007), the nurse must immediately report the incident to the nursing leader due to three most important rationales, specifically (a) the nursing leader has an ethical commitment to benefit the nurse staffs, (b) nursing leaders are tasked to protect the patients assigned in their corresponding department, and (c) nursing leaders require the filing of incident reports to better evaluate the performances of their nursing workforce (p. 376). In the study of Luk, Ng and Ko et al. , K. (2008), health care authorities are likely to comfort, understand and support their staffs following the disclosure of incident, which consequently removes any existing professional barrier for gate keeping. However, the principle of veracity still disapproves the non-disclosure of error to the patient. III. Discussion In synthesis of the discussion, medication errors can cause a life threatening harm to the patient. If the health care provider do not immediately notify or disclose the truth of the actual accident to the appropriate personnel – nursing leaders, physicians, the patient may suffer from the complications of the drug misadministration (Roe, 2002 p. 6). On the other hand, if the health care provider discloses the information to the health care authorities involved, the professional and competency evaluations of the nurse concerned may become affected (Yeo and Moorhouse, 1996 p. 295). Nonetheless, the nurse satisfies the principle of veracity by telling the truth of the situation to the health care authorities filing, which aims at providing the best interest for the patient. However, such act fails to satisfy veracity on the part of the patient since the incident report remains undocumented on the patient chart and permanent records (Bosek and Savage, 2007 p. 376). Furthermore, the concerned practitioner does not inform the patient about the misadministration, despite the counter procedures done to alleviate the possible complications of medication error. Lastly, if the practitioner discloses the information to both patient and health care authorities, the nurse may be able to satisfy the principle of veracity but the patient is likely to file a suit for malpractice or professional incompetence. In all the three situations presented, the best option for the nurse is to direct the accident to the higher authorities by following the standard protocol of filing an incident report. Next, the nurse must monitor the patient for possible reactions from the drug misadministration, while ensuring the immediate administration of interventions countering any possible side effects of the drug misadministration (Roberts and Hoop, 2008 p. 104). Considering the best interests for both patient and nurse, it is more practical to keep the incident from the permanent medical records for the protection of the health care provider under gate keeping (Pickering and Thompson, 2001 p. 156-157). Despite the professional benefit of gate keeping, non-disclosure of the information directly to the patient may erode the patient-provider trust relationships and dramatically cause an impact to the institution’s quality of care. As supported by the study of Schulmeister (2008), the safety measures (e. g. patient identification schemes, bar code scans, etc. ) aimed at preventing these errors only reduce the incidence of errors but cannot entirely eliminate medication errors. In fact, from January 2000 until December 2005, MEDMARX pharmaceuticals recorded 2,783 errors associated to barcode verification system (Schulmeister,2008). According to MEDMARX, wrong administration of medications commonly resulted to allergic responses manifesting rashes, swelling, itching, wheezing and pulmonary distresses (Beyea and Hicks, 2003). Nonetheless, the jurisdiction of disclosure largely depends on the health care authorities and, as long as the incident has a minor impact on the patient, the disclosure of information must still follow the principle of gate keeping. Meanwhile, appropriate interventions must be done to the patient ensuring the safety and countering of drug side effects. IV. Summary In conclusion, medication errors are likely to occur within the health care setting. An immediate action is considered vital to the prevention of any potential life threatening risk. The nurse attending to the medication needs of the patients must be well aware of the ethical principles of gate keeping and veracity in deciding the most appropriate and practical decision to perform. These principles justify the reason for filing an incident report than directly informing the patient regarding the incident. Even though veracity fails to be applied to the patient, the nurse can still immediately disclose the information to the higher authorities of the health care team preventing further the harm on the part of the patient. In the end of the conflict, it is already the jurisdiction of the provider or institution whether to conform in the principle of gate keeping or perform according to the ethical right of veracity. References Beyea, S. C. , Hicks, R. W. (2003, September). Oops the Patient is Allergic to that Medication. Patient Safety First, 77, 650-654. Bosek, M. , Savage, T. (2007). The Ethical Component of Nursing Education: Integrating Ethics Into Clinical Experience. New York, U. S. A: Lippincott Williams Wilkins. Boyd, M. (2007). Psychiatric Nursing: Contemporary Practice. New York, U. S. A: Lippincott Williams Wilkins. Brendle, L. (2007). Best Practices: Evidence-based Nursing Procedures. New York, U. S. A: Lippincott Williams Wilkins. Capriotti, T. (2004, February). Basic Concepts to Prevent Medication Errors. MEDSURG Nursing, 13, 21-65. Davis, C. (2008, September). A spoonful of training. Nursing Standard, 23, 20-21. Josephson, D. L. (2005). Intravenous Infusion Therapy for Nurses: Principles Practice. London, New York: Cengage Learning. Luk, L. , Ng, W. , Ko et al. , K. (2008, June). Nursing Management of Medication Errors. Nursing Ethics, 15, 28-39. Lipe, S. K. , Beasley, S. (2003). Critical Thinking in Nursing: A Cognitive Skills Workbook. New York, U. S. A: Lippincott Williams Wilkins. Pickering, S. , Thompson, J. (2003). Clinical Governance and Best Value: Meeting the Modernisation Agenda. New York, U. S. A: Elsevier Health Sciences. Roberts, L. , Hoop, J. (2008). Professionalism and Ethics: Q and A Self-Study Guide for Mental Health Professionals. New York, U. S. A: American Psychiatric Pub. Roe, S. (2002). Delmars Clinical Nursing Skills Concepts. London, New York: Cengage Learning. Schulmeister, L. (2008, June). Patient Misidentification in Oncology Care. Clinical Journal of Oncology Nursing, 12, 495-498. Timby, B. (2008). Fundamental Nursing Skills and Concepts. New York, U. S. A: Lippincott Williams Wilkins. White, L. (2000). Foundations of Nursing: Caring for the Whole Person. London, New York: Cengage Learning. Williams, L. (2008, June). Was the medication given?. Long-Term Living, 57, 53-55. Yeo, M. , Moorhouse, A. (1996). Concepts and Cases in Nursing Ethics. New York, U. S. A: Broadview Press.

Essay on Sexual Addiction

Essay on Sexual Addiction Essay on Sexual Addiction Essay on Sexual AddictionToday, specialists have no doubt that sex can be the object of addiction just like food, shopping or gambling, alcoholism or drug addiction. In cases when a person becomes sexually addicted intimate relationships become the keystone, while all life priorities quietly fade into the background and eventually disappear altogether. The only occupation a person devotes one’s own energy and thoughts to is the striving for pleasure, incessant desire to experience sensual delight. As a result, sexual addiction leads to the loss of ability to control thoughts, feelings and actions.The physiological basis of addiction consists in the fact that sex and love provoke the production of the same chemicals in the brain as heroin and cocaine do, and therefore people suffering from sexual addiction obtain from sex the same experience that drug addicts get from drugs, and alcoholics from alcohol: extremely pleasant sensations, incomparable to anything else in their live s. Sexual relationships become for them the only way to lift the spirit. From the standpoint of psychological roots, the addicts use sex in order to suppress such feelings as sadness, anger, anxiety or fear, as well as get rid of the burden of everyday life. Current observations show that this need is so great that sexually addictive people, like alcoholics, are almost unable to resist their addiction, and therefore the emergence of the disease should not be socially justified by hypersexuality or treated as libertinism, another sexual disorder. Further in this paper, we will attempt to draw this line, considering the epidemiology, causes and course of sexual addiction, as well as will discuss possible therapeutic solutions.Understanding sexual addiction: symptomatology and causesSexuality is an integral human need, a source of pleasure and positive emotions. But this is only a part of life, one of the many human needs, and most people do not put it to the forefront among the others . Harmony is violated in the case when for one reason or another, one of the needs, in this case sexual, becomes an obsession, gains distorted shapes and subordinates all person’s thoughts and actions.However, where is the line distinguishing the normal human need for sex from a mania? On the one hand, as Karila et al. (2014, p. 4018) state in their research, some specialists long used to deny the existence of sexual addiction as a mental disorder and rather attributed it to libertinism. On the other hand, the differences between promiscuity and engagement in the perverted forms of sexual relations and addiction as such are quite obvious. In particular, similarly to other kinds of addiction, sexual addiction is characterized by such main symptoms as the inability to control one’s own sexual impulses, obsessions with sex ideas, inability to say â€Å"no’ and promiscuity of choice (Coleman-Kennedy Pendley, 2002, p. 145-47; Schaeffer, 2009, p. 154-55). As Karila et al. (2014, p. 4019) rightly put it, regardless of the particular type of sexual behavior, it turns into addiction when it gains elements of compulsiveness and complete disregard for the consequences.In this way, sexual addiction should be understood as a compulsive sexual behavior that is subconsciously used to achieve psychological comfort and pleasure. Sex addiction symptoms are manifested in (Coleman-Kennedy Pendley, 2002; Giugliano, 2003; Karila et al. 2014; Schaeffer, 2009):implicit emotional obtrusiveness and psychological instability,low level of moral values,regular uncontrolled sexual impulses arising suddenly and not eliminated by the efforts of will and intellect,gradual increase in the frequency of sexual impulses,signs of â€Å"withdrawals† (abstinence syndrome) after a short abstinencepenchant for casual sex with strangers,inability to maintain a long communication and sexual intercourse with the same partnerpersons’ uncontrollability in other spheres of life.In this way, for a sexual addict sex is the only valuable and desired thing in life, in which one can express independence and natural talents, as well as to assert in society. However, the number of sexual partners increases together with a sense of inner emptiness (Giugliano, 2003, p. 181). Considering a person of the opposite sex only as an object for sexual satisfaction, addicts appear not to be able to build long-term relationships or experience emotional bond in existing communications. Inability to fulfill the increasingly burgeoning sexual fantasies often leads to aggression, irritability, sudden mood changes, and depression (Giugliano, 2003; Riemersma Sytsma, 2013).In psychoanalytic understanding, the basis of sexual addiction is all-consuming anxiety (Giugliano, 2003; Coleman-Kennedy Pendley, 2002; Matà ©, 2012). According to Giugliano (2003, p. 179), this anxiety often originates in the disorder of sexual structure of personality: for example, in the sexual ne ed for suppression of painful feelings during early sexual trauma, as well as for overcoming the state of infantile rage, depression, or anhedonia (irritation and displeasure). Reasons of sexoholism can be serious psychological problems related to childhood rape, unsuccessful first sexual experience, parents’ sexual misconduct and distorted set of priorities (Matà ©, 2012, p. 58-61). Thus, basing on 2012 research of childhood trauma by Gabor Matà ©, the factors responsible for the development of sexual addiction for women may be, for example, mother’s chronic depression and hyperstimulating sexualized relationship with father. In the case of men, these might be degrading and rejecting parental figures, especially mother, demonstrative exception of the boy from parental love relationships.In general, expects agree that the lack of love, care, and attention from parents, and especially mother, has a great influence on the formation of future patterns of behavior with t he opposite sex (Giugliano, 2003; Matà ©, 2012; Schaeffer, 2009). An â€Å"underloved† child who lacked affection, gentle mother kisses and hugs finds it difficult to feel confident in adult life even with a good outlook. Such people with low self-esteem constantly feel the desire to assert themselves at the expense of attention of the opposite sex. Men tend to prove to each new partner, to themselves and others their power and â€Å"sexual might†; women conquering another man subconsciously look for acknowledgement. Thus, deviant behavior patterns mainly form as a response to psychological trauma, and have a fairly strong tendency to develop into a full-fledged addiction.Dealing with sexual addiction:epidemiology, risk groups, and their most common behavior patternsThus, numerous studies claim that today about 6% of people are obsessed with the constant idea of sex (Karila et al. 2014, p. 4013). It should be noted that the most or nearly 70% of sexoholics who search for skilled medical help are men (Riemersma Sytsma, 2013, p. 307). As Riemersma and Sytsma (2013, p. 309) describe it, a typical portrait of a sexual addict is a heterosexual man in his forties, married (or having a permanent partner), a professional who leads quite a normal life in all other aspects. At the same time, the situation with identifying dependencies among women is uneasy. According to experts, due to the still-preserved system of double standards, they often do not admit having any disorders and do not seek medical help. Nevertheless, the number of women experiencing constant irresistible need for sex is not less than 30% and shows rapid growth in recent years (Riemersma Sytsma, 2013, p. 312).According to Giugliano (2003), some people are more prone to addiction than others. For example, such traits may indicate that the person is able to get hooked on sex: suggestibility and imitation, curiosity and the constant search for new sensations, risk appetite and adventuris m, fear of loneliness (Young, 2008, p. 23-26). According to Matà © (2012); observations, potential sexoholics often have uneasy relationship with the parent of the opposite sex. Dependence is often provoked by a crisis situation like, for example, a betrayal when the deceived partner seeks to dissociate oneself from pain by using one of the patterns of deviant sexual behavior (Schaeffer, 2009, p. 159).In general, psychiatrists distinguish 12 behaviors that are often associated with sex addiction (basing on Coleman-Kennedy Pendley, 2002; Giugliano, 2003; Karila et al., 2014; Riemersma Sytsma, 2013; and Schaeffer, 2009):Compulsive masturbation reaching in some cases 20 times a day,Numerous sex and extramarital sexual relations, a high demand for sexual intercourse,Promiscuity in sexual partners, frequent â€Å"one night† relationships,Obtrusive use and watching of pornographic materials, pornophilia,Sex with strangers without using condoms and other contraception and protect ion against STDs,Phone sex, constant participation in sexual forums on the Internet and social networks,Obsessive dating through electronic and conventional dating services,Frequent use of prostitutes or gigolos,Exhibitionism,Voyeurism (watching other people have sex),Sexual harassment and sexual abuse,Propensity for sexual abuse and incest, and other paraphilias.If a person’s behavior matches at least four of the above symptoms, there is high probability that an individual is a sexual addict (Karila et al., 2014, p. 4015).Essay on   Sexual Addiction part 2

Canadian Blood Services Analysis Research Paper

Canadian Blood Services Analysis - Research Paper Example Introduction It has been the wish of Canadian Blood Services to continue saving lives through supplying adequate blood. Nonetheless, it is quite obvious that the blood supply is barely enough to meet the increasing demand resulting from the ageing population as well as increased number of emergencies and elective surgeries. As a result, this has called for development of efficient and effective strategies aimed at increasing blood supply through increased donors as well as repeat donations. This memo contains SWOT analysis and strategies that can be used to attain increased blood supply are outlined. Discussion Objectives of Canadian Blood Services Canadian Blood Services is an organization that attempts to motivate people to donate blood. The organization’s main objective is to increase the number of donors to approximately 400,000 and donor retention statistics in order to meet the challenges of increasing blood demand. Increasing blood demand is associated with ageing popul ation, increased emergencies and elective surgeries, and the need to reduce waiting time. Attaining this objective however, requires effective motivational strategies. SWOT Analysis In order to identify the best strategies that will lead to increased blood supply from donors, there is need to understand the strengths, weakness, opportunities, and threats surrounding CBS. The SWOT analysis exhibit 1 displays some of the strengths, weakness, opportunities, and threats facing the organization. Market Segmentation Market segmentation is an important aspect in marketing since it provides an overview and vista to identify specific groups of persons or individuals to focus on while using promotional strategies to influence their behaviors. There are two forms or categories of market segment that CBS should focus on in a bid to increasing number of donors and repeated donations. These two categories are non-remunerated and remunerated blood donation market segments. Remunerated Blood Donati on Segment: The remunerated blood donation segment involves individuals who are above 17 years of age. These individuals are reached out to through mails, flyers, or word or mouth. In most cases, the segment obtains financial incentives from CBS hence termed as remunerated blood donation segment. CBS has concentrated so much on this segment given that they are the majority within the country. However, the main challenge the organization faces is to motivate this segment in order to increase blood donations. Non-remunerated Blood Donation Segment: This segment contains three main groups; schools individuals aged between 15 and 24, working individuals between age 25 and 24, and the senior donors aged above 55 years. The first two categories of this segment are often influenced by their friends who have donated before. Other ways through which they are motivated to donate include satisfaction in saving another person’s life, the need for acceptance, friendship, and love, and the conviction that some day they will be in the same situation. Reaching the school and working age is usually through internet, school learning programs, word of mouth, mails, and television programs. Notably, such individuals rarely donate blood since their donations depend on donation program in schools, time, and other obligations. The senior donors (aged above 55 years) on the other hand make donating decisions depending on personal