Comparison of medication policies to guide nursing practice across seven Victorian health services
Mariann Fossum A B , Lee Hughes A , Elizabeth Manias A , Paul Bennett A , Trisha Dunning A , Alison Hutchinson A , Julie Considine A , Mari Botti A , Maxine M. Duke A and Tracey Bucknall AA Deakin University, School of Nursing and Midwifery, 221 Burwood Highway, Burwood, Vic. 3125, Australia. Email: lee.hughes@deakin.edu.au; emanias@deakin.edu.au; p.bennette@deakin.edu.au; trisha.dunning@deakin.edu.au; alison.hutchinson@deakin.edu.au; julie.considine@deakin.edu.au; mari.botti@deakin.edu.au; maxine.duke@deakin.edu.au; tracey.bucknall@deakin.edu.au
B Corresponding author. Email: m.fossum@deakin.edu.au
Australian Health Review 40(5) 526-532 https://doi.org/10.1071/AH15202
Submitted: 29 May 2015 Accepted: 24 November 2015 Published: 25 January 2016
Abstract
Objectives The objective of this paper is to review and compare the content of medication management policies across seven Australian health services located in the state of Victoria.
Methods The medication management policies for health professionals involved in administering medications were obtained from seven health services under one jurisdiction. Analysis focused on policy content, including the health service requirements and regulations governing practice.
Results and Conclusions The policies of the seven health services contained standard information about staff authorisation, controlled medications and poisons, labelling injections and infusions, patient self-administration, documentation and managing medication errors. However, policy related to individual health professional responsibilities, single- and double-checking medications, telephone orders and expected staff competencies varied across the seven health services. Some inconsistencies in health professionals’ responsibilities among medication management policies were identified.
What is known about the topic? Medication errors are recognised as the single most preventable cause of patient harm in hospitals and occur most frequently during administration. Medication management is a complex process involving several management and treatment decisions. Policies are developed to assist health professionals to safely manage medications and standardise practice; however, co-occurring activities and interruptions increase the risk of medication errors.
What does this paper add? In the present policy analysis, we identified some variation in the content of medication management policies across seven Victorian health services. Policies varied in relation to medications that require single- and double-checking, as well as by whom, nurse-initiated medications, administration rights, telephone orders and competencies required to check medications.
What are the implications for practitioners? Variation in medication management policies across organisations is highlighted and raises concerns regarding consistency in governance and practice related to medication management. Lack of practice standardisation has previously been implicated in medication errors. Lack of intrajurisdictional concordance should be addressed to increase consistency. Inconsistency in expectations between healthcare services may lead to confusion about expectations among health professionals moving from one healthcare service to another, and possibly lead to increased risk of medication errors.
Additional keywords: clinical decision making, health policy, hospitals, medication therapy management, nursing.
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