The law grants to nurses and nursing staff the right to administer medicines and prescriptions, under their own responsibility. However, given the complexity of their profession, they must meet some requirements concerning their skills and vigilance. In addition, they are required to respect the ethical obligations that are imposed in connection with the exercise of their function and requirements.
The two cases of prescription
Since the application of the decree of 20 march 2012, the medical prescription is no longer reserved for doctors. Now, the law gives nurses the authority to prescribe for their patients drugs in two distinct situations.
For the first case, the person who pursues this profession may not avail himself of his right that if it intervenes if the case considered corresponds to their specialty. Then, only the prescription of some features of health that are listed in PBDA (or list of goods and services refundable) is allowed to the nurses, to the exclusion of drugs that are contraindicated by the physician. Among the list are concerned :
- articles of dressing
- hoops to equip the patients bed
- medical devices are indispensable for the care of incontinence and diseases of the urogenital tract
- medical equipment necessary for infusion services at home
As for the second case, apart from the conditions imposed in the first case, the nurse may prescribe other devices listed in PBDA, after having obtained the agreement of the physician to the patient. The articles affected by this authorization are:
- the mattress or mattress topper in foam in the form of a waffle iron and the cushion used to prevent pressure ulcers
- the naso-gastric or naso-enteral for patients at home
- the orthotics elastic restraint used for the members
- the accessories designed for the blood glucose monitor
For the last two medical devices, they can only be prescribed by the nurse that if the prescription provides for a renewal at the same.
The ethical obligations of the administration of medication
To protect patients from drug errors caused by the negligence of the nurse, the law has defined the responsibilities of the latter before, during and after administration of the treatment. First of all, the text specifies that this act requires the control of type, therapeutic action, dosage, side effects and method of administration of the drug. Then, in case of doubt the patient, the nurse must provide explanations related to the order. In this regard, by following this link, it is possible to retrieve an order for drugs from a pharmacist without a wait at the counter thanks to the service ” Drive “.
In addition, during the operation, the medical staff must check if it is the right patient and the right medication. Then, he must ensure that the care is administered at the right time and right route. Subsequently, it is required to adhere to the prescribed dose. This is the principle of the ” 5 good “. After administration, the nurse monitors the patient to be able to adjust in real time the therapy in case of complications.
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