CLT Conference 2015
Medication Management Training for Mental Health
Student Nurses
By Candi, Richard & Paul
Edge Hill University
6th July 2015
Background
On registration, nurses are expected to have sufficient knowledge and skills in medication
management to practice safely and competently.
Do they?
This presentation will analyse this statement and will discuss 2 areas:
1. Student Perspective
2. Evidence.
Strategies to address this issue will also be discussed.
Background – Student Perspective
Evaluations highlight that students are generally unhappy in 2 areas:
Not enough lectures on Medication Management
Not enough time on clinical placements to participate in medication rounds
Changing arena of mental health care – closure of hospitals, reduction in hospital beds, diversity
of care in the community.
Background - Evidence
Medication Management is described by the Medicines and Healthcare products Regulatory
Agency (MHRA) AS…
‘The clinical , cost-effective and safe use of medicines to ensure patients get the maximum
benefit they need, while at the same time minimising potential harm.’
Medication administration is not purely a mechanistic task and 'knowing’ is an important part of
safety ( Reade-Searle et al 2010).
NMC (2010) Standard 8 Administration of Medication states…
‘you must know the therapeutic uses of the medication to be administered, its normal dosage,
side effects, precautions and contra indications’
Nurses are the largest workforce involved in medicine management and in excess of 40% of a
nurses time is spent on medicine related activities ( Ndosi & Newell 2009).
Background - Evidence
Study by Hemingway et al ( 2011) identified 4 areas of poor performance:
1. Poor knowledge of pharmacology
2. Poor ability to contextualise medication management to the complex and changing needs of
patients.
3. Environmental factors that prevent the nurse from solely concentrating on medication
administration.
4. Drug calculation difficulties.
Medication Errors
Second most common type of incident reported by NHS staff, after accidents, between January 2005- June 2006.
In this period, 59,802 medication safety incidents reported.
80% of these in acute, general and community hospitals.
4.9% in primary care settings. (NPSA 2008).
Types of errors:
28.7 % Wrong dose
17.1% Omitted medicines
11.5 % Wrong medication. ( Healthcare Commission 2007)
Solutions?
During discussion, 3 senior lectures in mental health identified the following to be delivered
in final year of Pre- Registration Bsc Mental Health Nurse Training:
Facilitation of a Mental Health Workshop.
Formative Medication OSCE for Mental Health Students.
The combination aims to link the theoretical component eg pharmacology (the why) - to
nursing interventions (the how) eg administering prescribed medication ( Hemingway et al
2010).
The Workshop
A facilitated day the encompasses the following:
Formative testing of knowledge base via a quiz.
Lecture on Medication Groups, Prescribing & Side Effects
Lecture on how medications work
Facilitated Group work identifying interventions and issues from a range of clinical scenarios.
Formative OSCE
Students are expected to simulate a medication round.
The following is expected:
Safe administration procedure – 5Rs
Knowledge of medication, side effects, contra indications, prescribing protocols, MHA specific
issues , drug calculations.
Findings
The Workshop and OSCE have now been facilitated 4 times, having commenced with September
2011.
Despite there being a difference in course delivery, knowledge base is very similar:
Students are generally safe at administration procedure
5-10% demonstrate good knowledge of medication, side effects etc
30-40% demonstrate average knowledge
50% demonstrate poor knowledge and would fail if this was summative!
Evaluations.
Extremely positive!
100% students state they enjoyed day and felt it had benefitted their knowledge.
85% state they feel they need more on medication management and that it should also be
encompassed in earlier modules:
‘fabulous day’ , ‘wish we had more lessons on this’, ‘day perfectly planned and thank you for
scenarios…’ ‘ good mixture….quiz was excellent as challenged knowledge…’’ ‘has been
invaluable…’
‘
Future……
Medication Management is now facilitated in all 3 Life Sciences Modules.
For revalidation:
? Medication Management Module ( field specific)
? Summative Exam or assignment and OSCE - ? Annual
? Mathematical Skills (Pryce –Miller & Emanuel 2010)
? Blended learning
Thank you for listening.
Any questions?
References.
Healthcare Commission. 2007. The Best Medicine. London. Healthcare Commission.
Hemingway, S., Marginnis, R., Baxter, H., Smith, G., Turner. J. & White, J. 2010 Medicines with respect. Phase 1: Implementing a
pathway towards competency in mental health nurses. Mental Health Nursing 30(3) 12-16.
Hemingway, S, Stephen, J & Allmark, H. 2011. Student experiences of medicines management training & education. BNJ Vol.20(5)
291-298.
National Patient Safety Agency . 2007. Safety in doses: Medication safety incidents in the NHS. London. npsa.
Ndosi, M.E. & Newell, R.2009. Nurses knowledge of pharmacology behind drugs they commonly administer. Journal of Clinical
Nursing. 18(4) 570-80.
NMC 2010. Standards for medicine management. London. NMC
Pryce-Miller, M. & Emanuel, V. 2010. Ongoing education would boost competency in drug calculations. Nursingtimes.net.
Reade-Searle, K. , Moxham, L. ,Walker,s. & Happel, B. 2010. Supervising medication administration by undergraduate nursing
students: influencing factors. Journal of Clinical Nursing. 27(16)n16-19.
www.mhra.gov.uk