Intravenous Infusions Intravenous Infusions

Ethical IssuesEthical Issues

Antoinette AttardAntoinette Attard

Intravenous InfusionsIntravenous Infusions

�� Is there any difference between oral and Is there any difference between oral and

intramuscular administration of drugs and intramuscular administration of drugs and

intravenous administration?intravenous administration?

�� Are there any ethical issues related to non Are there any ethical issues related to non

intravenous administration of drugs?intravenous administration of drugs?

Intravenous InfusionsIntravenous Infusions

�� A study carried out by Taxis & Barber A study carried out by Taxis & Barber

(2003) about the incidence & severity of (2003) about the incidence & severity of

intravenous drug errors identified the intravenous drug errors identified the

following errors:following errors:

Preparation ErrorsPreparation Errors

�� Preparation of wrong drugPreparation of wrong drug

�� Preparation of an unauthorized drugPreparation of an unauthorized drug

Preparation ErrorsPreparation Errors

�� Errors in solvent/Errors in solvent/diluentdiluent (use of (use of

wrong solvent / wrong solvent / diluentdiluent or wrong or wrong

volume)volume)

�� Preparation of wrong dosePreparation of wrong dose

��Omission of prescribed drugOmission of prescribed drug

Preparation ErrorsPreparation Errors

�� Preparation of wrong drugPreparation of wrong drug

�� Preparation of an unauthorized drugPreparation of an unauthorized drug

�� Errors in solvent/Errors in solvent/diluentdiluent (use of wrong (use of wrong

solvent / solvent / diluentdiluent or wrong volume)or wrong volume)

�� Preparation of wrong dosePreparation of wrong dose

�� Omission of prescribed drugOmission of prescribed drug

Administration ErrorsAdministration Errors

�� Administration to wrong patientAdministration to wrong patient

�� Fast administration of bolus dose through Fast administration of bolus dose through

a peripheral linea peripheral line

Administration ErrorsAdministration Errors

�� Fast administration of bolus dose through Fast administration of bolus dose through

a central linea central line

�� Incompatibility errorsIncompatibility errors

Administration ErrorsAdministration Errors

�� Administration to wrong patientAdministration to wrong patient

�� Fast administration of bolus dose through Fast administration of bolus dose through

a peripheral linea peripheral line

�� Fast administration of bolus dose through Fast administration of bolus dose through

a central linea central line

�� Incompatibility errorsIncompatibility errors

Medication ErrorsMedication Errors

�� Most of these could happen with other Most of these could happen with other

modes of administration. modes of administration.

�� It is therefore, essential that with all types It is therefore, essential that with all types

of administration of drugs, every effort is of administration of drugs, every effort is

made to reduce the possibility of made to reduce the possibility of

medication errorsmedication errors

ACCOUNTABILITYACCOUNTABILITY

�� Accountability can be defined as being Accountability can be defined as being

answerableanswerable for how one has carried out for how one has carried out

his / her his / her responsibilityresponsibility

CompetenceCompetence

�� A person is competent when that person A person is competent when that person

understands what s/he is about to understands what s/he is about to

undertake, and can anticipate any undertake, and can anticipate any

problems that may ariseproblems that may arise

CompetenceCompetence

�� No amount of courses or certificates can No amount of courses or certificates can

guarantee that a person is competent.guarantee that a person is competent.

�� It is only when one is capable of It is only when one is capable of

identifying what one is capable of doing identifying what one is capable of doing

and what are the limitations to one’s and what are the limitations to one’s

practice that a person is deemed to be practice that a person is deemed to be

competent.competent.

KnowledgeKnowledge

�� competent nurses are competent nurses are knowledgeable knowledgeable

nurses nurses –– not not only biomedical knowledge only biomedical knowledge

but a broader knowledge to enable but a broader knowledge to enable

effective decision making in effective decision making in partnership partnership

with patients.with patients.

Code Of EthicsCode Of Ethics

��Nurses are accountableNurses are accountable to:to:

Maintain and improve their professional

knowledge and competence

Acknowledge any limitations in their

knowledge and competence and decline any

duties or responsibilities unless able to

perform them in a safe and skilled manner

UKCC UKCC –– Scope of Professional Scope of Professional

Practice:Practice:

�� ““the nurse must ensure that any the nurse must ensure that any enlargement or adjustment of the scope enlargement or adjustment of the scope of personal professional practice must be of personal professional practice must be achieved without compromising or achieved without compromising or fragmenting existing aspects of fragmenting existing aspects of professional practice and care and that the professional practice and care and that the requirements of the Council’s Code of requirements of the Council’s Code of Professional Conduct are satisfied Professional Conduct are satisfied throughout the whole area of practice’ throughout the whole area of practice’ (UKCC 1992a, section 9.4)(UKCC 1992a, section 9.4)

Role ExtensionRole Extension

Nurses must be certified to Nurses must be certified to

perform any activity that is not perform any activity that is not

learned in prelearned in pre--registration registration

training. training.

Role expansionRole expansion

�� nurses undertake those activities that they nurses undertake those activities that they

are competent to perform.are competent to perform.

The expanded role of the nurse The expanded role of the nurse

entails the exercise of additional entails the exercise of additional

technical expertise.technical expertise.

Role ExpansionRole Expansion��AutonomyAutonomy

Informed ConsentInformed Consent

AccountabilityAccountability

��AuthorityAuthority

need for defined need for defined

parameters of authorityparameters of authority

Thank you for your attentionThank you for your attention