{"id":54,"date":"2019-10-20T00:00:29","date_gmt":"2019-10-20T04:00:29","guid":{"rendered":"https:\/\/opentextbc.ca\/nursingpharmacology\/chapter\/2-1-safety-ethics-introduction\/"},"modified":"2022-11-29T13:30:37","modified_gmt":"2022-11-29T18:30:37","slug":"2-1-safety-ethics-introduction","status":"publish","type":"chapter","link":"https:\/\/opentextbc.ca\/nursingpharmacology\/chapter\/2-1-safety-ethics-introduction\/","title":{"raw":"2.1 Safety and Ethics Introduction","rendered":"2.1 Safety and Ethics Introduction"},"content":{"raw":"<div class=\"textbox textbox--examples\"><header class=\"textbox__header\">\r\n<h2>Learning Objectives<\/h2>\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n<ol>\r\n \t<li>Identify drug administration guidelines for registered nurses in Canada<\/li>\r\n \t<li>Identify nursing responsibilities to prevent and respond to medication errors<\/li>\r\n \t<li>Identify nursing responsibilities associated with controlled substances<\/li>\r\n \t<li>Identify ethical responsibilities as they relate to medication errors<\/li>\r\n \t<li>Explain client-centered care and cultural safety during medication administration<\/li>\r\n \t<li>Outline nursing actions within the scope of nursing practice as they relate to the administration of medication<\/li>\r\n \t<li>Identify nursing responsibilities associated with safe client medication administration and education<\/li>\r\n<\/ol>\r\n<\/div>\r\n<\/div>\r\n<div class=\"textbox textbox--exercises\"><header class=\"textbox__header\">\r\n<p class=\"textbox__title\">Key Terms<\/p>\r\n\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n<ul class=\"twocolumn\">\r\n \t<li>[pb_glossary id=\"712\"]black box warnings[\/pb_glossary]<\/li>\r\n \t<li>[pb_glossary id=\"815\"]BC College of Nurses and Midwives [\/pb_glossary]<\/li>\r\n \t<li>[pb_glossary id=\"814\"]Canadian Nurses Association (CNA)[\/pb_glossary]<\/li>\r\n \t<li>[pb_glossary id=\"816\"]Code of Ethics for Registered Nurses[\/pb_glossary]<\/li>\r\n \t<li>[pb_glossary id=\"821\"]controls on practice[\/pb_glossary]<\/li>\r\n \t<li>[pb_glossary id=\"811\"]cultural safety[\/pb_glossary]<\/li>\r\n \t<li>[pb_glossary id=\"817\"]do not crush list[\/pb_glossary]<\/li>\r\n \t<li>[pb_glossary id=\"627\"]drug diversion[\/pb_glossary]<\/li>\r\n \t<li>[pb_glossary id=\"818\"]error-prone abbreviations[\/pb_glossary]<\/li>\r\n \t<li>[pb_glossary id=\"641\"]health literacy[\/pb_glossary]<\/li>\r\n \t<li>[pb_glossary id=\"819\"]high-risk[\/pb_glossary]<\/li>\r\n \t<li>[pb_glossary id=\"717\"]inappropriate polypharmacy[\/pb_glossary]<\/li>\r\n \t<li>[pb_glossary id=\"820\"]look-alike and sound-alike drugs[\/pb_glossary]<\/li>\r\n \t<li>[pb_glossary id=\"632\"]nursing[\/pb_glossary]<\/li>\r\n \t<li>[pb_glossary id=\"715\"]nursing process[\/pb_glossary]<\/li>\r\n \t<li>[pb_glossary id=\"716\"]polypharmacy[\/pb_glossary]<\/li>\r\n \t<li>[pb_glossary id=\"824\"]practice standards[\/pb_glossary]<\/li>\r\n \t<li>[pb_glossary id=\"825\"]professional standards[\/pb_glossary]<\/li>\r\n \t<li>[pb_glossary id=\"633\"]registered nurse (RN)[\/pb_glossary]<\/li>\r\n \t<li>[pb_glossary id=\"637\"]root cause analysis[\/pb_glossary]<\/li>\r\n \t<li>[pb_glossary id=\"714\"]safety culture[\/pb_glossary]<\/li>\r\n \t<li>[pb_glossary id=\"823\"]scheduled medications[\/pb_glossary]<\/li>\r\n<\/ul>\r\n<\/div>\r\n<\/div>\r\nMedication administration is an essential task that nurses perform while providing client care. However, safe medication administration is more than just a nursing task; it is a process involving several members of the health care team, as well as legal, ethical, social, and cultural issues. The primary focus of effective medication administration by all health professionals is client safety. Although many measures have been put into place over the past few decades to promote improved client safety, medication errors and adverse effects continue to be a common event. The World Health Organization (WHO) estimates, \"Unsafe medication practices and medication errors are a leading cause of injury and avoidable harm in health care systems across the world. Globally, the cost associated with medication errors has been estimated at $42 billion USD annually.\" [footnote]World Health Organization. (2019). <em>Patient safety.<\/em> <a href=\"https:\/\/www.who.int\/patientsafety\/medication-safety\/en\/\" rel=\"noopener noreferrer\">https:\/\/www.who.int\/patientsafety\/medication-safety\/en\/<\/a>.[\/footnote] This chapter will examine the safety and ethical foundations of medication administration by nurses, as well as the practice standards and cultural and social issues that must be considered to ensure the safe and effective administration of medication.","rendered":"<div class=\"textbox textbox--examples\">\n<header class=\"textbox__header\">\n<h2>Learning Objectives<\/h2>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>Identify drug administration guidelines for registered nurses in Canada<\/li>\n<li>Identify nursing responsibilities to prevent and respond to medication errors<\/li>\n<li>Identify nursing responsibilities associated with controlled substances<\/li>\n<li>Identify ethical responsibilities as they relate to medication errors<\/li>\n<li>Explain client-centered care and cultural safety during medication administration<\/li>\n<li>Outline nursing actions within the scope of nursing practice as they relate to the administration of medication<\/li>\n<li>Identify nursing responsibilities associated with safe client medication administration and education<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--exercises\">\n<header class=\"textbox__header\">\n<p class=\"textbox__title\">Key Terms<\/p>\n<\/header>\n<div class=\"textbox__content\">\n<ul class=\"twocolumn\">\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_54_712\">black box warnings<\/a><\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_54_815\">BC College of Nurses and Midwives <\/a><\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_54_814\">Canadian Nurses Association (CNA)<\/a><\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_54_816\">Code of Ethics for Registered Nurses<\/a><\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_54_821\">controls on practice<\/a><\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_54_811\">cultural safety<\/a><\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_54_817\">do not crush list<\/a><\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_54_627\">drug diversion<\/a><\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_54_818\">error-prone abbreviations<\/a><\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_54_641\">health literacy<\/a><\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_54_819\">high-risk<\/a><\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_54_717\">inappropriate polypharmacy<\/a><\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_54_820\">look-alike and sound-alike drugs<\/a><\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_54_632\">nursing<\/a><\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_54_715\">nursing process<\/a><\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_54_716\">polypharmacy<\/a><\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_54_824\">practice standards<\/a><\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_54_825\">professional standards<\/a><\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_54_633\">registered nurse (RN)<\/a><\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_54_637\">root cause analysis<\/a><\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_54_714\">safety culture<\/a><\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_54_823\">scheduled medications<\/a><\/li>\n<\/ul>\n<\/div>\n<\/div>\n<p>Medication administration is an essential task that nurses perform while providing client care. However, safe medication administration is more than just a nursing task; it is a process involving several members of the health care team, as well as legal, ethical, social, and cultural issues. The primary focus of effective medication administration by all health professionals is client safety. Although many measures have been put into place over the past few decades to promote improved client safety, medication errors and adverse effects continue to be a common event. The World Health Organization (WHO) estimates, &#8220;Unsafe medication practices and medication errors are a leading cause of injury and avoidable harm in health care systems across the world. Globally, the cost associated with medication errors has been estimated at $42 billion USD annually.&#8221; <a class=\"footnote\" title=\"World Health Organization. (2019). Patient safety. https:\/\/www.who.int\/patientsafety\/medication-safety\/en\/.\" id=\"return-footnote-54-1\" href=\"#footnote-54-1\" aria-label=\"Footnote 1\"><sup class=\"footnote\">[1]<\/sup><\/a> This chapter will examine the safety and ethical foundations of medication administration by nurses, as well as the practice standards and cultural and social issues that must be considered to ensure the safe and effective administration of medication.<\/p>\n<hr class=\"before-footnotes clear\" \/><div class=\"footnotes\"><ol><li id=\"footnote-54-1\">World Health Organization. (2019). <em>Patient safety.<\/em> <a href=\"https:\/\/www.who.int\/patientsafety\/medication-safety\/en\/\" rel=\"noopener noreferrer\">https:\/\/www.who.int\/patientsafety\/medication-safety\/en\/<\/a>. <a href=\"#return-footnote-54-1\" class=\"return-footnote\" aria-label=\"Return to footnote 1\">&crarr;<\/a><\/li><\/ol><\/div><div class=\"glossary\"><span class=\"screen-reader-text\" id=\"definition\">definition<\/span><template id=\"term_54_712\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_54_712\"><div tabindex=\"-1\"><p>The strongest warnings issued by the Federal Drug Association (FDA) that signify a drug carries a significant risk of serious or life-threatening adverse effects.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_54_815\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_54_815\"><div tabindex=\"-1\"><p>The regulating body for nurses in British Columbia<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_54_814\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_54_814\"><div tabindex=\"-1\"><p>A professional organization that represents the national and global interests of Canadian nurses.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_54_816\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_54_816\"><div tabindex=\"-1\"><p>Developed by the CNA as a guide for carrying out nursing responsibilities in a manner consistent with quality in nursing care and the ethical obligations of the profession.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_54_821\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_54_821\"><div tabindex=\"-1\"><p>Explains the bases for nurses' scope of practice. There are four levels of controls on registered nurses' practice.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_54_811\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_54_811\"><div tabindex=\"-1\"><p>Outcome-based respectful engagement that addresses power imbalances from a societal and health care systems lens.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_54_817\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_54_817\"><div tabindex=\"-1\"><p>A list of medications that should not be crushed, often due to a sustained-release formulation.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_54_627\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_54_627\"><div tabindex=\"-1\"><p>The transfer of any legally prescribed controlled substance from the individual for whom it was prescribed to another person for any illicit use.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_54_818\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_54_818\"><div tabindex=\"-1\"><p>Abbreviations, symbols, and dose designations that are frequently misinterpreted and involved in harmful medication errors.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_54_641\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_54_641\"><div tabindex=\"-1\"><p>The ability to access, understand, evaluate, and communicate information as a way to promote, maintain, and improve health in a variety of settings across the life course<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_54_819\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_54_819\"><div tabindex=\"-1\"><p>Drugs that bear a heightened risk of causing significant patient harm when they are used in error.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_54_717\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_54_717\"><div tabindex=\"-1\"><p>Present when one or more medicines are prescribed that are not or no longer needed.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_54_820\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_54_820\"><div tabindex=\"-1\"><p>Medications that require special safeguards to reduce the risk of errors and minimize harm.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_54_632\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_54_632\"><div tabindex=\"-1\"><p>the application of professional nursing knowledge, skills, and judgment for the purpose of: (a) promoting, maintaining, and restoring health; (b) preventing illness, injury, or disability; (c) caring for persons who are sick, injured, disabled, or dying; (d) assisting in pre-natal care, childbirth, and postnatal care; (e) health teaching and health counselling; (f) coordinating health care; or (g) engaging in administration, teaching, or research.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_54_715\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_54_715\"><div tabindex=\"-1\"><p>Standards of Practice that include Assessment, Diagnosis, Outcome Identification, Planning, Implementation, and Evaluation components of providing patient care.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_54_716\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_54_716\"><div tabindex=\"-1\"><p>The concurrent use of multiple medications.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_54_824\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_54_824\"><div tabindex=\"-1\"><p>Guide and direct nurses' practice. \u200bThey set out levels of performance that BCCNM nurse registrants are required to achieve in their practice.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_54_825\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_54_825\"><div tabindex=\"-1\"><p>Statements about levels of performance that nurses are required to achieve in their practice. They reflect the values of the nursing profession, clarify what the profession expects of nurses, and represent the criteria against which nurses\u2019 practice in British Columbia is measured by clients, employers, colleagues, themselves and others<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_54_633\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_54_633\"><div tabindex=\"-1\"><p>An individual who is educationally prepared and licensed by province or territory to practice as a registered nurse.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_54_637\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_54_637\"><div tabindex=\"-1\"><p>An analysis after an error occurs to help identify not only what and how an event occurred, but also why it happened. When investigators are able to determine why an event or failure occurred, they can create workable corrective measures that prevent future errors from occurring.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_54_714\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_54_714\"><div tabindex=\"-1\"><p><strong>\u00a0<\/strong>The culture of a health care agency that empowers staff to speak up about risks to patients and to report errors and near misses, all of which drive improvement in patient care and reduce the incidence of patient harm.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_54_823\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_54_823\"><div tabindex=\"-1\"><p>classification tool for drugs, substances, and certain chemicals that are used to make drugs. Defined by medical use, potential for misuse, and safety or dependence liability.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><\/div>","protected":false},"author":90,"menu_order":1,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[50],"contributor":[],"license":[],"class_list":["post-54","chapter","type-chapter","status-publish","hentry","chapter-type-numberless"],"part":53,"_links":{"self":[{"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/54","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/wp\/v2\/users\/90"}],"version-history":[{"count":7,"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/54\/revisions"}],"predecessor-version":[{"id":1406,"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/54\/revisions\/1406"}],"part":[{"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/parts\/53"}],"metadata":[{"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/54\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/wp\/v2\/media?parent=54"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapter-type?post=54"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/wp\/v2\/contributor?post=54"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/wp\/v2\/license?post=54"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}