Reflective accounts

Medicines optimisation

A CPD article improved Bing Raz’s knowledge of how patient involvement can contribute to the safe and effective use of medicines

A CPD article improved Bing Raz’s knowledge of how patient involvement can contribute to the safe and effective use of medicines

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What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice?

The article discussed medicines optimisation, which was defined as a patient-centred approach to safe and effective medicines use to ensure patients achieve the best possible outcomes. It emphasised that involving patients in decisions about their care will assist in ensuring they get the most from their medicines.

What did you learn from the CPD activity, feedback and/or event and/or experience in your practice?

The article stated that four guiding principles underpin medicines optimisation: aim to understand the patient’s experience; ensure evidence-based choice of medicines; ensure medicines use is as safe as possible; and make medicines optimisation part of routine practice.

I learned about several factors that influence medicines optimisation, particularly patient involvement, which has an important role in medicine adherence, safety and efficiency. The article provided information about a medication review framework that can support nurses to optimise the patient’s medicines. While this framework is designed to be used by prescribers and pharmacists, nurses should be familiar with it, because they will often be asked questions about medicines.

The article reiterated that nurses should be aware of the risks associated with polypharmacy. Many patients, especially older adults, may take several medicines each day. The article emphasised that clinicians should be careful when prescribing five or more drugs for a patient and should use a medication review framework to minimise the risks.

How did you change or improve your practice?

This article has changed my attitude to administering medicines. I ensure patients are involved in their treatment and I am careful to gain their consent before administering any drugs. For example, patients may be prescribed analgaesics even though they are not in pain; similarly, some are prescribed laxatives despite having regular bowel movements. I will consider the effects that any medicines might have on the patient’s health, in particular their liver and kidneys.

After reading the article, I will liaise with the prescriber to ensure patients are not given medicines unnecessarily. I have learned that nurses should attempt to understand how to achieve the optimum effect of every medicine they administer.

I will ensure I am familiar with any new patient’s medicine so that I understand each drug’s indications, side effects and potential adverse reactions.

How is this relevant to the Code? Select one or more themes: Prioritise people, Practise effectively, Preserve safety, Promote professionalism and trust

As part of The Code’s theme of preserving safety, nurses must advise on, prescribe, supply, dispense or administer medicines within the limits of their training and competence.

To practise effectively, nurses must work cooperatively with colleagues to preserve the safety of those receiving care. Nurses should liaise closely with the prescriber, informing them if there are any changes in the patient’s condition that might require a medication review.

Nurses must also practise in line with the best available evidence, which includes being aware of any medicine updates, particularly relating to adverse reactions. Nurses should ensure patients have the latest information about medicines.

Bing Raz is a staff nurse at St George’s Hospital, London

This reflective account is based on NS836 Kaufman G (2016) Medicines optimisation: priorities and challenges. Nursing Standard. 30, 30, 53-59

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