Should known allergy status be included as a medication administration ‘right’?

This article employs a paediatric case study, involving a 3-year-old child who had an anaphylactic reaction that occurred as a result of the multidisciplinary team’s failure to identify and acknowledge the patient’s documented ‘known allergy’ status. It examines and reconsiders the ongoing healthcare dilemma of medication errors and recommends that known allergy status should be considered the second medication administration ‘right’ before the prescribing, transcribing, dispensing and administration of any drug. Identifying and documenting drug allergy status is particularly important when caring for paediatric patients, because they cannot speak for themselves and must rely on their parents, guardians or health professionals as patient advocates. The literature states that medication errors can be prevented by employing a ‘rights of medication administration’ format, whether that be the familiar ‘5 rights’ or a more detailed list. However, none of these formats specify known allergy status as a distinct ‘right’. The medication safety literature is also found wanting in respect of the known allergy status of the patient. When health professionals employ a medication administration rights format prior to prescribing, transcribing, dispensing or administering a medication, the ‘known allergy status’ of the patient should be a transparent inclusion

A Theory for patient advocacy: An Islamic Nursing Model

Patient advocacy for all human beings is a fundamental ideal as it assures the patient their rights and their safety when admitted to a healthcare facility. Nursing as a health care profession is complicated by the fact that it is concerned with vulnerable human beings, and ethical principles which need to be considered when providing treatment, or care for the patient. The logic for this book is twofold, the first justification for authoring this text was to enlighten nurses and other healthcare professionals to reflect on a dilemma which affects patient care and safety. A quandary in the literature which has been named a “Theory-Practice-Ethics gap” (Mortell et al, 2013). Patient safety and high quality of care are fundamental facets related to all healthcare practices. When people are admitted to hospital, they just presume that they will receive safe, quality treatment from healthcare professionals who have a duty of care. Society does not expect to be put at risk or be harmed, since the principal goal of healthcare is to augment care, safety and wellbeing, and so optimize the quality of people’s lives (Leape, 2015; Wilson et al, 2009). The second justification for authoring this book, was to present an important new theory and model for patient advocacy to the professional healthcare community. The generated theory, states that, if healthcare professionals incorporate their religious, cultural and family values into their humanitarian ideals, they will be effective as patient advocates. The advocacy model which was generated the following components of advocacy, “Vulnerable-acy”, which was advocacy for the vulnerable, “Familial-acy”, which was advocacy that a family member would provide to a loved one, “Cultural-acy” was linked to culture, such as ethnic awareness and sensitivity, “Religion-acy” was coupled with a Muslim’s Islamic holy obligations, however, this concept can be adapted for any religion and religious beliefs and “Human-acy”, which identified a person’s humanity and must be provided by any member of the human race. The theory and model is therefore relevant for all healthcare professionals and providers, as it has a neoteric Islamic perspective that will hopefully guide nurses and health care professionals to reflect as advocates for their patients and the care that they provide

Fall prevention education to reduce fall risk among community-dwelling older persons: a systematic review

Objectives: This review aims to identify types of the existing fall prevention education (FPE) and their effectiveness in promoting fall risk awareness, knowledge and preventive fall behaviour change among community-dwelling older people. Background: FPE is a cost-effective and helpful tool for reducing fall occurrences. Evaluation: This is a systematic review study using electronic searches via EBSCOHost® platform, ScienceDirect, Scopus and Google Scholar in March 2021. The review protocol was registered with PROSPERO (CRD42021232102). The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement flow chart guided the search strategy. Articles published from January 2010 to March 2021 were included for quality appraisal using the 'Transparent Reporting of Evaluations with Non-randomised Designs' (TREND) and the 'Consolidated Standards of Reporting Trials' (CONSORT) statement for randomised controlled trial studies. Key issues: Six FPE studies selected emphasised on personal health status, exercise and environmental risk factors. These studies reported an increase in fall risk awareness or knowledge and a positive change in fall preventive behaviours. Two studies included nurses as educators in FPE. Conclusion: FPE evidently improved awareness or knowledge and preventive fall behaviour change among older adults. Nurses are in great potential in planning and providing FPE for older adults in community settings. Implications for nursing management: Expand nurses' roles in fall prevention programmes in community settings by using high-quality and evidence-based educational tools. Highlight the nurse's role and collaborative management in FPE

Theory - Practice - Ethics: Is there a Gap? A Unique Concept to Reflect on

This article will discuss a unique concept which the author calls the “theory-practice-ethics gap”. It advises the reader of the existing healthcare dilemmas related to medical errors which endangers a patient’s safety. The predicament is one of non-compliance or unethical practices by healthcare professionals. Predictably, the healthcare academics declare that when clinical practice is lacking, a “theory-practice gap” is typically to blame. Within this paradigm there is a gap between theoretical knowledge and its appliance in practice. Testimony relating to the non-integration of theory and practice makes the conjecture that environmental dynamics are accountable and will affect learning and practice results, hence the "gap". Nevertheless, it is the author's credence, that to "bridge the gap" relating to theory and practice an additional factor must be taken into account. The factor is called “Ethics” and introduces a unique concept which the author has labelled the “theory-practice-ethics gap”. This unique concept must be considered when appraising the undesirable consequences of medical errors in healthcare practice

Hand hygiene compliance: is there a theory-practice-ethics gap?

Practice is usually based on tradition, rituals and outdated information; there is often an additional gap between theoretical knowledge and its application in practice. This theory-practice gap has long existed (Allmark, 1995; Hewison et al, 1996). It often arises when theory is ignored because it is seen as idealistic and impractical, even if it is practical and beneficial. Most research relating to the lack of integration between theory and practice has concluded that environmental factors are responsible and will affect learning and practice outcomes. The author believes an additional dimension of ethics is required to bridge the gap between theory and practice. This would be a moral obligation to ensure theory and practice are integrated. To implement new practices effectively, healthcare practitioners must deem these practices worth while and relevant to their role. This introduces a new concept that the author calls the theory-practice-ethics gap. This theory-practice-ethics gap must be considered when examining some of the unacceptable outcomes in healthcare practice (Mortell, 2009). The literature suggests that there is a crisis of ethics where theory and practice integrate, and practitioners are failing to fulfil their duty as providers of healthcare and as patient advocates. This article examines the theory-practice-ethics gap when applied to hand hygiene. Non-compliance exists in hand hygiene among practitioners, which may increase patient mortality and morbidity rates, and raise healthcare costs. Infection prevention and control programmes to improve hand hygiene among staff include: ongoing education and training; easy access to facilities such as wash basins; antiseptic/alcohol handgels that are convenient, effective, and skin- and userfriendly; and organisational recognition and support for clinicians in hand washing and handgel practices. Yet these all appear to have failed to achieve the required and desired compliance in hand hygiene

Is there a Theory-Practice-Ethics gap? A patient a safety case study

This exposé employs a case study to illuminate an ongoing medical dilemma which places a patient’s safety at risk. The medical dilemma is one of non-compliance by healthcare professionals and is associated with correct patient identification. Typically, the healthcare academics declare that when clinical practice is inadequate, a “theory-practice gap” is usually responsible. Within this paradigm there is often a gap between theoretical knowledge and its application in practice. Most of the evidence relating to the non-integration of theory and practice makes the assumption that environmental factors are responsible and will affect learning and practice outcomes, hence the “gap”. However, it is the author's belief, that to “bridge the gap” between theory and practice an additional component must be considered, called “Ethics”. In order to effectively implement practices, such as identifying a patient correctly, the user must deem these practices to be important and relevant to provide safe patient care in their role as healthcare providers. This introduces a new concept which the author refers to as the “theory-practice-ethics gap” and must be considered when reviewing some of the unacceptable outcomes in healthcare practice, such as wrong patient identification

Patient Safety without Patient Advocacy is improbable, as they are synonymous. Is there a Theory-Practice-Ethics gap?

The aim of a culture of safety in healthcare is to reduce and/or eliminate the risk of harm to patients. However, despite a universal stance towards patient safety, since the Institute of Medicine’s landmark report of 2000, “To Err is Human, building a safer health system” there remains a disturbing escalation in the healthcare errors among hospitalized patients. This underscores trepidations about healthcare professionals and providers’aptitude as effective and caring patient advocates to provide high quality, safe care. In the context of these healthcare mistakes, the “Theory-Practice gap” is often cited as an offending perpetrator. Within this exemplar, there is often a disparity between theoretical knowledge and its application in practice. Evidence relating to the non-integration of theory and practice makes the assumption, that educational dynamics may affect learning and practice outcomes and hence, the “Gap”. Whatever you call them, healthcare mistakes, medical errors, faults, or miscalculations. This exemplar, acknowledges that healthcare professionals and providers are provided with theoretical knowledge and prepared with skills to practice competently and safely. Yet, these same healthcare professionals and providers continue to be noncompliant with the recommended evidence-based practices which creates an ethical dilemma. Therefore, to bridge the gap between theory and practice, a “Theory-Practice-Ethics gap” must be considered when appraising the unacceptable outcomes in healthcare practices, and the failure of healthcare professionals and providers to fulfil their moral duty of care, as patient advocates. One of the defining characteristics of a patient advocate is to ensure patient safety. By convention, patient advocacy is an integral philosophy in healthcare, and an obligation which is expected to be fulfilled by healthcare professionals and providers in the course of discharging their duties. Primum non nocere ‘above all, do no harm’ is a fundamental concept within the healthcare model. However, there is evidence of a failure to implement of this moral concept which relates to a patient’s safety and the advocacy role expected from healthcare professionals. Healthcare professionals declare that this is because of the ambiguity associated with the comprehension of the advocacy concept in relation to the safety role. In addition to the challenge of role acceptance within a patient safety forum as a misunderstood and unappreciated responsibility. The analytical exploration of patient advocacy related to patient safety and the concept of a “Theory-Practice-Ethics gap” will be presented within this chapter, to reinforce the importance of their synonymous relationship for trustworthy healthcare practices. Healthcare professionals and providers need to be mindful of the importance of patient advocacy and the utilization of a safety science which leads to a higher quality of safe patient care. Keywords: advocate, ethics, medical error, quality, safety, theory-practice-ga