HLT54115 Diploma of Nursing

HLT54115 Diploma of Nursing
HLTENN007 - Administer and monitor medicines and intravenous therapy
Written Assessment Student Copy
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Instructions to Students
Welcome to the written assessment. To successfully complete the assessment requirements,
you need to follow the following instructions.
Step 1
Read the study guide and the related resources.
Step 2
Read this assessment to gain an understanding of what you need to do to complete the unit.
Talk to your trainer or supervisor and ask for help if you need to.
Step 3
Complete all questions in this assessment. Please write clearly in pen (not pencil). You may
attach printed answers. Do not remove any pages from this assessment.
Step 4
Complete the cover sheet and attach to this assessment. We recommend you make and keep
a copy of your assessments.
Step 5
Submit for assessment.
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Part A
Question 1
The following website may assist with this question
http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/FAQ/Enrolled-nurses-
and-medicine-administration.aspx
The Enrolled Nurse practices with and under the direction and supervision of the Registered
Nurse, and assists in the provision of nursing care. At all times the Enrolled Nurse retains
responsibility for his/her own actions and remains accountable to the Registered Nurse for all
delegated functions. Enrolled Nurses will be required to function only within the limits of their
education and competence.
What is meant by supervision?
Answer:
In the field of healthcare, supervision is used in psychotherapy, counselling and other disciplines
of mental health. Even in somatic disciplines supervision is used on practitioners on their
preparatory work for the patients and also their bond with the patients. Instead of being a formal
backdated investigation, supervision is rather a replacement. Supervision contains the meeting
of the practitioner with another professional on a regular basis, one who usually possesses
training in supervision skills and is not necessarily a senior (Butterworth and Faugier, 2013).
Such meetings are done for the discussion of professional issues and caseworks in a structured
manner. It is sometimes known as counselling or clinical supervision. The primary purpose of
supervision is helping the practitioners for learning from his progress and experience in
expertise and also for ensuring better quality services to the patients and the clients
(Butterworth and Faugier, 2013). The learnings of the practitioner would be applied to the
planning, diagnostic as well as therapeutic work. In the British National Health Service, several
disciplines have the usage of clinical supervision. It is now mandatory for having regular and
proper clinical supervision for the federal and registered health professionals like
physiotherapists, occupational therapists, dieticians, drama, music and art therapists. The
supervision skills that are focused on the solution are used in clinical super work as counselling
others. There is a compulsion of having supervision for a minimum of 1.5 hours a month’s time
period for the British Association of Counselling and Psychotherapy’s practicing members.
Supervision is a formal procedure of professional learning and support that helps in allowing
midwifes(supervisee) and nurses for developing the significant competence, knowledge and the
responsibility for their practices and enhancing public safety and protection as well (Butterworth
and Faugier, 2013). Supervision can be direct or indirect in accordance with the context’s nature
under which the supervision of practice takes place. In the practice plan of a supervision’s
context, a supervisor is responsible for providing reports to the territory board, state or the
committee of registration at intended intervals. A written agreement between the supervisee and
the supervisor which is submitted to the significant Nursing and Midwifery Board of Australia’s
(NMBA’s) registration committee, territory board or the state is known as the agreement of
Supervision. Such an agreement helps in identifying the supervisee and the supervisor, the two
party’s agreed responsibilities and the place of practice. A supervision report is a formal
document which is submitted in a format that is approved by NMBA and is given during the
relevant intervals and is agreed in the practiced plan of the supervision (Severinsson and Sand,
2010). The report details and shows the progress of the practice plan of the supervision. An
additional report of supervision might be submitted by a supervisor during any point of time.
Such a report is prepared when there is any mandatory requirement or proposal of changes to
the practice plan of the supervision or in case of the supervisee’s concerns.
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A Supervisor is a properly experienced and qualified registered or enrolled nurse or/and midwife
who is responsible for supervising an individual who undertakes a supervision practice period
that is approves by the NMBA (Severinsson and Sand, 2010). The supervisor is responsible for
assessing, monitoring, providing significant feedback and reporting to the necessary territory
board, state or committee of registration of the NMBA regarding the nurse’s or midwife’s
performance under the supervision. An ideal supervisor should have more than two years of
experience as a midwife or nurse and should have completed a course of a supervisor or
preceptorship. A nurse or midwife who holds registration with undertakings or conditions or a
provisional registration, or enters into a supervision requiring undertaking is known as a
Supervisee (Severinsson and Sand, 2010). They practice under the guidance, direction and
oversight of a supervisor for meeting their objectives and goals of a supervised plan of practice.
Question 2
The following websites may assist with this question
http://www.health.nsw.gov.au/pharmaceutical/pages/legislation.aspx
http://www.safetyandquality.gov.au/wp-content/uploads/2011/09/NSQHS-Standards-Sept-
2012.pdf
The Registered Nurse retains overall accountability and responsibility for the nursing care
provided to his/her allocated consumers whether performed directly, in collaboration with, or
delegated to an Enrolled Nurse.
The Enrolled Nurse working in conjunction with and under the supervision of the Registered
Nurse will assist in the planning, the implementation and delivery of nursing care to consumers.
The Enrolled Nurse will implement medical/treatment orders under the direction and as
delegated by the Registered Nurse with reference to the Enrolled Nurses scope of education
and practice The Enrolled Nurse will practice in accordance with organisational policy within
their level of training and legal obligations. Discuss the legal and regulatory frameworks that
Enrolled nurses need to comply with.
Answer:
An enrolled nurse has several responsibilities and liabilities, and need to comply with certain
legal and regulatory frameworks. An enrolled nurse needs to demonstrate the in-depth
understanding and knowledge the state and territory legislation, commonwealth and the
common law that is relevant to the nursing practice (Eagar, Cowin, Gregory and Firtko, 2010).
During the undertaking of the enrolled nurse’s practice, they need to fulfill all the duties of care.
It is their duty to manifest and exhibit the thorough knowledge and implications of all the
standards, work policies, procedures and codes and guidelines of the Nursing and Midwifery
Board of Australia (NMBA) which are applicable on the nursing practice. In accordance with the
agreed care plan, policies of the workplace, guidelines of the procedures and the professional
standards, the enrolled nurse should provide nursing care. It is a must for them to identify and
clarify their own responsibilities for the particulars of entrusted care in order to work in
collaboration with the registered nurse and the healthcare team. The enrolled nurse should
recognize and identify their own limitations and liabilities in the competence and practice and
should seek supervision from the registered nurse and assist them as and when needed (Eagar,
Cowin, Gregory and Firtko, 2010). They are required to withhold from undertaking any acts
where there is no significant education, experience, training and demonstration regarding
competence or has not been undertaken. During any sorts of occurrence of incidents related to
unsafe practice, the enrolled nurse should immediately report to the registered nurse and other
individuals in authority or people in-charge, and should explores ways of preventing such
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incidents from taking place again in the future. The registered nurse should also negotiate and
cooperate with the all the appropriate personnel as well as the registered nurse for ensuring the
rights and needs of people and patients in care receipt are upheld and addressed.
The nurses should have significant knowledge about certain legal acts and frameworks. these
include the Poison and Therapeutic Goods Regulation Act 2008, the NSW Poisons List,
Standard for the Uniform Scheduling of Medicines and Poisons (SUSMP), the Trafficking and
Drug Misuse Act and Regulations, Dangerous Goods legislation, NSW and Commonwealth
Food regulations, National Industrial Chemicals Notification and Assessment Scheme
(NICNAS), Commonwealth Therapeutic Goods Act, Competition and Consumer legislation,
SafeWork Australia national code for labelling workplace substances, import and exports
regulations that are customs prohibited, Therapeutic Goods Administration (TGA), Australian
Pesticides and Veterinary Medicines Authority (APVMA) etc.
Question 3
The following website may assist with this question
http://www.safetyandquality.gov.au/wp-content/uploads/2012/10/
Standard3_Oct_2012_WEB.pdf
The Australian Commission on Safety and Quality in Health Care developed the National Safety
and Quality Health Service (NSQHS) Standards to improve the quality of health service
provision in Australia. The NSQHS Standards provide a nationally consistent statement of the
level of care consumers should be able to expect from health service organisations. How does
risk management influence prevention and control for Standard 3?
Answer:
For the Standard 3, risk management is related to the risk of transmission or acquisition of an
infectious agent or an infection for patients, visitors and the workforce within a healthcare
organization. The implementation and the usage of an approach of risk management helps in
allowing the healthcare provider to determine the specific areas where there is low or high risk
and focus on how it should be responded to accordingly. The senior managers of a healthcare
organization and clinical leaders implement certain systems for preventing and managing the
healthcare related infections and convey the same to the staff or the workforce for the
achievement of significant results. The clinicians and other representatives of the organization’s
workplace use and implement the systems for control and prevention of the healthcare related
infections. These infections are very common difficulties that affect the patients of a hospital. In
Australia, every year, patients contract with nearly 200,000 healthcare infections (NHMRC,
2010). Almost half of these healthcare infections can be prevented. In order to control infections
successfully and for minimizing the transmission risks, a certain range of strategies is required
across all the levels of the system of healthcare. It also requires a collective approach for the
implementation to be successful. Such a standard’s objective is the prevention of the patients
from acquiring the healthcare related infections that are preventable and management of the
infections effectively as and when they occur by using strategies which are based on evidences.
There are certain requirements of the Standard 3. Effective management and governance
systems should be implemented and maintained for the healthcare related infections.
Appropriate strategies should be developed, used and maintained for controlling and preventing
these healthcare related infections. Patients that are brought into the hospital carrying an
infection or colonialization, or acquire the same during the period of care should be taken proper
care of, their complications should be determined promptly and should receive the appropriate
treatment and management. A strategic aim of the system of clinical governance is the
significant and safe prescription of antimicrobials. The environment of the healthcare and the
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related facilities should be hygienic and clean. The reprocessing of the instrumentation and
equipment helps in meeting the guidelines of practice that are the best. The patients,
caretakers, service providers and the consumers are provided with relevant information and
knowledge on healthcare related infections.
Question 4
The following website may assist with this question
http://www.newhealthadvisor.com/10-Rights-of-Medication-Administration.html
Discuss the rights of medication administration.
Answer:
Whether it is a nurse providing medications or a patient receiving the same, it is very crucial to
understand the medication administration rights. While consuming medication by oneself, or
while giving it to a family member, safety should be considered at the very first place. There are
always chances and risk of wrong medications or improper dose or the medications of the wrong
person being provided. Such incidents can result in bringing dangerous, harmful and even life-
taking consequences. It is very critical for everyone to have prior knowledge and understanding
of rules of safety for medications even though protocol for the medications have always been
there. The various medication administration rights are as follows.
Right Patient
It should be ensured that the right medications are being given to the right patient (Elliott and
Liu, 2010). If a person is at home and is providing medication to their family member, the bottle
of medication should be checked and it should be ensured that it is being given to the right
person in accordance with the appropriate prescription.
Right Medication
When certain medication is prescribed by a doctor, the medication container would include a
prescription label. Often, mistakes and blunders are made by pharmacies and clinicians as well.
The medication should be checked against the prescription label and a person should be aware of
the names of medications that sound alike.
Right Dosage
One of the most vital administration rights is the right dosage. One should always be careful
about the appropriate proportion of dosage of the medicine to be given to a patient (Elliott and
Liu, 2010). Until and unless surety is obtained regarding the dosage amount, the medications
should not be given to a patient. Different dosages such as pediatric, adult, pregnant, elderly, etc.
should be kept in mind.
Right Route
The right route of medication is important to be considered as well. If a patient is unable to
swallow a pill form medicine, he should be given liquid form of the same. Appropriateness of
medications should be focused on such as whether they can be given by suppositories, cream or
lotions form, syrup form or in form of pills (Macdonald, 2010).
Right Time
The appropriate timing of taking a medication should be given prior consideration to. Whether
the medicines should be given to the patient during the daytime, in the morning or before bed,
before or after meals, all are crucial to be considered (Macdonald, 2010).
The other five rights of medication administration are the Right Documentation, Right Client
Education, Right to Refuse, Right Assessment and the Right Evaluation (Elliott and Liu, 2010).
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