NR2113 by Galya Petkova https://padlet.com/petkovag1/Jonathan34 Group 34 en-us 2019-11-07 12:09:09 UTC 2025-10-10 12:31:44 UTC hello@padlet.com https://bryantarchway.com/wp-content/uploads/2018/10/MentalHealth_Flickr.jpg Scenario 11 petkovag1 https://padlet.com/petkovag1/Jonathan34/wish/595349533 2020-05-26 17:41:13 UTC https://padlet.com/petkovag1/Jonathan34/wish/595349533 Standards framework for health boards and trusts in Wales (MARRS) implemented through local policies and procedures (AWMSG, 2015). petkovag1 https://padlet.com/petkovag1/Jonathan34/wish/595498357
4.3 a.  Formal Health board procedures must be followed in case of  medicine refusal  



]]> 2020-05-26 18:57:47 UTC https://padlet.com/petkovag1/Jonathan34/wish/595498357 Professional Guidance on the Administration of Medicines in Healthcare Settings (RPS, RCN, 2019) petkovag1 https://padlet.com/petkovag1/Jonathan34/wish/595524091 2020-05-26 19:12:22 UTC https://padlet.com/petkovag1/Jonathan34/wish/595524091 17.2 Medicine Refusal petkovag1 https://padlet.com/petkovag1/Jonathan34/wish/595538279
  •  Documented  
  • Notified prescriber MDT 
  • Organisational Policies and Procedures followed 
]]> 2020-05-26 19:20:18 UTC https://padlet.com/petkovag1/Jonathan34/wish/595538279 Example of Health board procedure - Covert administration of medicines Policy (NHS, 2017) petkovag1 https://padlet.com/petkovag1/Jonathan34/wish/595718672 2020-05-26 21:15:10 UTC https://padlet.com/petkovag1/Jonathan34/wish/595718672 Decision tree covert administration petkovag1 https://padlet.com/petkovag1/Jonathan34/wish/595732318 2020-05-26 21:25:41 UTC https://padlet.com/petkovag1/Jonathan34/wish/595732318 5.1. Refusal of treatment petkovag1 https://padlet.com/petkovag1/Jonathan34/wish/595751961
  • An adult with capacity has the right to refuse treatment. 
  • An unwise decision must be respected. 
  • No one else can give consent on behalf of a competent adult.
  • Exemption - competent patients refused consent for treatment detained MHA (1983)
]]> 2020-05-26 21:42:46 UTC https://padlet.com/petkovag1/Jonathan34/wish/595751961 5.2 Refusal of medicine -alternative approaches petkovag1 https://padlet.com/petkovag1/Jonathan34/wish/595785761
  • regular (documented) attempts to encourage patient to take the medicine
  • different time or nurse 
  • different formulation (patch ,disperse tablet)
  • documentation of the refusal in patient record 
    • ]]>     2020-05-26 22:14:13 UTC https://padlet.com/petkovag1/Jonathan34/wish/595785761     MHA (1983) Code of Practice for Wales ( Gov. Wales, 2016) petkovag1 https://padlet.com/petkovag1/Jonathan34/wish/595881279 2020-05-26 23:57:10 UTC https://padlet.com/petkovag1/Jonathan34/wish/595881279 Obtained valid and informed consent - legal and ethical principle (DH, 2009) petkovag1 https://padlet.com/petkovag1/Jonathan34/wish/595932717                  
    • freely  written,verbal, non- verbal 
    • with provided evidence- based information for the  patient 
    ]]>     2020-05-27 00:53:15 UTC https://padlet.com/petkovag1/Jonathan34/wish/595932717     Principles of consent (RCN,2017) petkovag1 https://padlet.com/petkovag1/Jonathan34/wish/596343329 2020-05-27 07:46:41 UTC https://padlet.com/petkovag1/Jonathan34/wish/596343329 On reflection petkovag1 https://padlet.com/petkovag1/Jonathan34/wish/600926072 The nurse obtained consent from the patient and this illustrates evidence- based and professional practice ]]> 2020-05-29 10:50:07 UTC https://padlet.com/petkovag1/Jonathan34/wish/600926072 On reflection petkovag1 https://padlet.com/petkovag1/Jonathan34/wish/601030647 The patient is competent (MCA, 2005) admitted informally (MHA, 1983) and have legal right to refuse medicine and treatment  The nurse respects patient right to make decision about treatment. In addition of using alternative approaches as explaining  about the medication and discussion for the reasons of refusal. This demonstrates nursing practice in accordance with the organisational and legal law and  person - centred and evidence-based care. ]]> 2020-05-29 12:16:50 UTC https://padlet.com/petkovag1/Jonathan34/wish/601030647 MCA (2005) Code of Practice ( Department of Constitutional Affairs, 2007) petkovag1 https://padlet.com/petkovag1/Jonathan34/wish/601299610 An adult has the right to make own decisions and must be assumed to have capacity unless proven otherwise.]]> 2020-05-29 14:38:57 UTC https://padlet.com/petkovag1/Jonathan34/wish/601299610 Registered healthcare professionals involved with medicine administration must act all the time with respect to petkovag1 https://padlet.com/petkovag1/Jonathan34/wish/601451200
  • accountability 
  • professionalism 
  • professional judgement 
    • ]]>     2020-05-29 15:51:29 UTC https://padlet.com/petkovag1/Jonathan34/wish/601451200     NMC Code https://padlet.com/petkovag1/Jonathan34/wish/604611844 2020-06-01 11:59:05 UTC https://padlet.com/petkovag1/Jonathan34/wish/604611844 NMC Code - points supporting the scenario. https://padlet.com/petkovag1/Jonathan34/wish/604613068 1. Treat people as individuals and uphold their dignity.

    2. Listen to people and respond to their preferences and concerns.

    4. Act in the best interests of people at all times.

    7. Communicate clearly.

    9. Share your skills, knowledge and experience for the benefit of people receiving care and your colleagues.

    18. Advise, prescribe,, administer medicines within the limits of your training and competence. In accordance with the law, NMC Code and other relevant policies. ]]>     2020-06-01 11:59:53 UTC https://padlet.com/petkovag1/Jonathan34/wish/604613068     Principles of nursing practise (RCN, 2020). https://padlet.com/petkovag1/Jonathan34/wish/604647498 2020-06-01 12:23:23 UTC https://padlet.com/petkovag1/Jonathan34/wish/604647498 Principles in regards to scenario: https://padlet.com/petkovag1/Jonathan34/wish/604650293 Principle A - Nurses and nursing staff treat everyone in their care with dignity and humanity. this can be done by understanding their individual needs, ensuring that they show compassion and sensitivity, and provide care and respect patients equally.

    Principle E - Nurses and nursing staff value the communication process as they assess, record and report on treatment and care, handle information sensitively and confidentially, including information regarding medication. 

    Principle B - Nurses and nursing staff take responsibility for the care they provide an understanding of actions carried out – they carry out these actions in a way that is agreed with their patients, and the families and carers of their patients, and in a way that meets the requirements of their professional bodies and the law.

    Principle H - Nurses and nursing staff lead by example, develop themselves and other staff, and influence the way care is given in a manner that is open and responds to individual needs, which is shown through interactions between the nurse and student throughout the scenario.




    ]]>     2020-06-01 12:25:09 UTC https://padlet.com/petkovag1/Jonathan34/wish/604650293     https://padlet.com/petkovag1/Jonathan34/wish/604749147 2020-06-01 13:23:00 UTC https://padlet.com/petkovag1/Jonathan34/wish/604749147 3 of the 6 C's in relation to the scenario https://padlet.com/petkovag1/Jonathan34/wish/604758436 Communication is central to successful caring relationships and to effective team working. Listening is as important as what we say. It is essential for ‘No decision without me’. Communication is the key to a good workplace with benefits for those in our care and staff alike.
    Care is our core business and that of our organisations; and the care we deliver helps the individual person and improves the health of the whole community. Caring defines us and our work. People receiving care expect it to be right for them consistently throughout every stage of their life.
    Competence means all those in caring roles must have the ability to understand an individual’s health and social needs. It is also about having the expertise, clinical
    and technical knowledge to deliver effective care and treatments based on research and evidence.]]>     2020-06-01 13:27:42 UTC https://padlet.com/petkovag1/Jonathan34/wish/604758436     Legislation's a nurse needs to be aware of : https://padlet.com/petkovag1/Jonathan34/wish/604802549 The Mental health Act (1983)
    The Mental Capacity Act (2005)
    The Human Rights Act (1998) 

    ]]>     2020-06-01 13:48:17 UTC https://padlet.com/petkovag1/Jonathan34/wish/604802549     The nurse used her advocacy skills to empower and educate the patient with information on how her medication works. This helped the patient to make an informed decision about her health. https://padlet.com/petkovag1/Jonathan34/wish/604951887 NMC 2018, educates professionals to act as advocates by assisting patients access information and support about their care so that they will be able to make informed decisions.]]> 2020-06-01 14:55:02 UTC https://padlet.com/petkovag1/Jonathan34/wish/604951887 Informal patient advice leaflet https://padlet.com/petkovag1/Jonathan34/wish/605206743 2020-06-01 16:46:31 UTC https://padlet.com/petkovag1/Jonathan34/wish/605206743 John Heron's 6 category intervention. https://padlet.com/petkovag1/Jonathan34/wish/605212628 2020-06-01 16:49:16 UTC https://padlet.com/petkovag1/Jonathan34/wish/605212628 On reflection - The nurse used both an authoritative and facilitative approach in communication. In addition of interpersonal communication skills used for creating therapeutic and trustful relationship with the patient. This demonstrates evidence-based practice and patient-centred care in accordance with the professional Code of practice (NMC, 2018). https://padlet.com/petkovag1/Jonathan34/wish/605220757
  • Authoritative: Informative and confronting.
  • Facilitative: Catalytic and Supportive. 
  • In addition of the NMC requirement for clear and effective communication  (NMC, 2018) 
    • ]]>     2020-06-01 16:52:54 UTC https://padlet.com/petkovag1/Jonathan34/wish/605220757     Fully informed decision making https://padlet.com/petkovag1/Jonathan34/wish/606538516 1)      The Health and Social care Act 2012- Promotes the involvement of patients and carers in decisions about their care and treatment to enable patient choice.
    2)      The Health Foundation is an independent UK charity committed to promoting person centred care supporting people to develop the knowledge, skills and confidence they need to more effectively manage and make informed decisions about their own health and health care. They released ‘Person centred care made simple’ in 2016 as an overview for person centred care written for health care professionals and those who use the NHS. 
    3)      NMC code of conduct- (2) Listen and respond to their preferences and concerns which can be achieved by: working in partnership with people; by recognising and respecting the contribution that people can make to their own health and wellbeing; to encourage and empower people to share in decisions about their treatment and care; to respect, support and document a persons right to accept or refuse care and treatment; to respect the level to which people receiving care want to be involved in decisions about their own health, wellbeing and care. 
    4)      The NHS choice framework. This document details the government’s commitment to giving patients greater choice and control over how they receive their healthcare and their commitment to empowering patients to shape and manage their own health and care. It explains when you have choices regarding your care and treatment, where to obtain further information to help you choose and how to complain if you’re not offered a choice. 
    5)      RCN principles of nursing practice. Describes what the public can expect from nursing practice in any setting.  Principle D- Nurses and nursing staff provide and promote care that puts people at the centre, involves patients, service users, their families and their carers in decisions and helps them make informed choices about their treatment and care.

    ]]>     2020-06-02 09:49:15 UTC https://padlet.com/petkovag1/Jonathan34/wish/606538516     https://padlet.com/petkovag1/Jonathan34/wish/607544354 Implication of bad practice
    • Failure to follow good practice guidelines might result in putting patients at risk of abuse or neglect.
    • Delay in recovery process
    • Nurses can be struck of the NMC register and lose their job.

    ]]>     2020-06-02 19:11:12 UTC https://padlet.com/petkovag1/Jonathan34/wish/607544354