It is worth noting that one of the important clinical problems is the limited scope of nursing practice. This is particularly damaging for patients in need of pain management. In some countries, nurses can function as anesthetists, which plays an important role in managing patients with acute pain. Doctors and nurses should be used interchangeably in some areas of practice (Nairn & Pinnock, 2017). Primary care nurses are able to provide the same range of services that family doctors usually deliver (if they have received specific training). The role of nurses should be expanded while maintaining the level of costs and increasing the effectiveness of treatment for patients with acute pain syndrome. If nurses are empowered to take on greater responsibilities, multiple issues will be addressed in a timely manner.
In cases where patients need to receive pain management and, if at night, the pain intensifies, preventing them from resting, the help of nurses should not be reduced to emotional support and minimal manipulations. Nurses should be able to help patients in more effective and efficient ways, which means expanding their area of expertise (Nairn & Pinnock, 2017). A nurse, working with a doctor, can not only relieve the burden on them but also affect the effectiveness of therapy. An important research question is will the expansion of the scope of nursing practice contribute to qualitative changes in healthcare.
Another crucial clinical problem that is important for nursing care is adherence to catheter injection precautions to prevent infections and other complications. The use of peripheral venous catheters for intravenous infusion provides many advantages in the daily practice of nurses. For instance, it allows having guaranteed venous access for several days and makes carrying out infusion therapy more comfortable (Tan et al., 2016). It also makes ongoing intensive care safer and financially less expensive with equal efficacy. However, the procedure also carries a risk of complications, like any procedure that violates the integrity of the skin. Nurses should be trained in proper handling techniques and strict adherence to aseptic and antiseptic rules and proper catheter care. In this case, most complications for a patient’s health can be avoided.
There are many indications for peripheral vein catheterization in the absence of contraindications to this procedure. There are conditions that prohibit puncture of a vein in a given area or indicate a preference for central venous access in a particular clinical situation. Nurses should be educated on those contraindications that indicate a preference for central venous access. Despite the recommendations that exist, the incorrect use of catheters, as well as the risk of infection, is still significant (Tan et al., 2016). For this reason, it is necessary to investigate whether increasing the level of education of nursing personnel will create opportunities for ensuring high quality of treatment and accumulation of knowledge about the needs of patients as applied to nurse care.
Errors in drug therapy is another clinical problem affecting nursing practice. Moreover, they are the most common causes of adverse treatment outcomes. The complexity of the situation lies in the fact that drug therapy should be organized in such a way that the patient receives the necessary drug in the correct dosage. It should be administered in the prescribed manner and at the appropriate time. In addition to the correct sequence of manipulations, the nurse should also monitor the effect of medications on a patient’s condition (Jember et al., 2018). Nurses should understand the mechanism of action of drugs, the importance of the regimen, and the prevention of complications.
Nursing staff should be particularly careful when working with drugs that are similar in appearance and drug compatibility. The specialist should monitor the patient in order to identify adverse reactions to medications in time, and all appointments should be tracked in the medical record (Jember et al., 2018). The complexity of the situation lies in the fact that the healthcare system is characterized by a shortage of nursing personnel. Nurses burn out and become less attentive; not all specialists are equally efficient in using information technology (IT), which inevitably leads to errors.
The problem of medication errors is relevant to the United States, and the healthcare system needs to take an active position to prevent the instances that can lead to a fatal outcome. Most of them are associated with incorrectly organized work (many medical errors can be prevented by creating a single well-developed system) (Jember et al., 2018). The creation of professional standards and algorithms, computerization of medical institutions will eliminate errors in writing and memorizing prescriptions, and universal treatment regimens and protocols will protect nurses from psychological factors, such as stress and fatigue. An additional question that should be studied is whether advanced training of nurses in the use of IT tools will lead to a decrease in the number of medication errors.
Thus, nurses need to possess knowledge in the field of theory of nursing, nursing pedagogy, psychology, and they should be trained on the safety requirements to ensure a secure healthcare environment. They need to skillfully perform nursing manipulations in strict accordance with current standards and requirements. To carry out the nursing process, a specialist should possess not only practical skills but also be knowledgeable about the current theoretical basis of the profession, and be able to perform a wide range of manipulations.
- Jember, A., Hailu, M., Messele, A., Demeke, T., & Hassen, M. (2018). Proportion of medication error reporting and associated factors among nurses: A cross sectional study. BMC Nursing, 17(9), 1-8. Web.
- Nairn, S., & Pinnock, D. (2017). Pierre Bourdieu: Expanding the scope of nursing research and practice. Nursing Philosophy, 18(4), 1-7. doi:10.1111/nup.12167
- Tan, Y. H. G., Tai, W. L. S., Sim, C., & Ng, H. L. I. (2016). Optimising peripheral venous catheter usage in the general inpatient ward: A prospective observational study. Journal of Clinical Nursing, 26(1-2), 133-139. doi:10.1111/jocn.13451