Medication Knowledge and Willingness to Nurse-Initiate Medications in an Emergency Department

Posted: April 29th, 2018

Medication Knowledge and Willingness to Nurse-Initiate Medications in an Emergency Department

Nurse-initiated medications (NIMs) are medications that nurses can prescribe and administer to patients without a doctor’s order, within their scope of practice and according to the hospital’s protocols. NIMs are a vital practice for all nurses in emergency departments (EDs), as they can improve patient care and clinical outcomes by reducing time to analgesia, providing safe pain management, and addressing other urgent needs. However, NIMs also require a high level of medication knowledge, confidence, and caution from nurses, as they are responsible for assessing the patient’s condition, choosing the appropriate medication and dose, monitoring the effects and side effects, and documenting the process.

This blog post aims to explore the medication knowledge and willingness of ED nurses to practice NIMs, based on a mixed-methods study by Cabilan et al. (2016) and other relevant sources. The post will also discuss the factors that affect NIMs practice, such as patient-centred care, safety principles, support and education, and improvement over time.

Medication Knowledge of ED Nurses

Medication knowledge is an essential component of NIMs practice, as it enables nurses to make informed decisions about the medications they prescribe and administer. Medication knowledge includes knowing the indications, contraindications, dosages, routes, interactions, side effects, and mechanisms of action of the medications. According to Cabilan et al. (2016) , ED nurses have a consistent level of medication knowledge across different demographic variables, such as age, gender, education, experience, and area of work. However, they also found that there was an overall deficit in nurses’ knowledge of mechanism of action, which is important for understanding how the medications work and what effects they have on the body.

To improve their medication knowledge, ED nurses can use various sources of information, such as colleagues, evidence-based resources, guidelines, protocols, drug manuals, online databases, and continuing education programs. However, these sources may not always be accessible, reliable, or up-to-date. Therefore, ED nurses need to be critical consumers of information and evaluate the quality and validity of the sources they use. They also need to update their knowledge regularly and seek feedback from their peers and supervisors.

Willingness to Practice NIMs

Willingness to practice NIMs is another key factor that influences the frequency and quality of NIMs in EDs. Willingness is influenced by various factors, such as patients’ needs, safety concerns, confidence levels, support systems, and education opportunities. According to Cabilan et al. (2016) , ED nurses are generally willing to practice NIMs because they perceive it as a positive and beneficial practice for patients. They believe that NIMs can improve patient satisfaction, comfort, pain relief, and quality of care. They also feel that NIMs can enhance their autonomy, professionalism, accountability, and scope of practice.

However, ED nurses also face some challenges and barriers that may affect their willingness to practice NIMs. Some of these challenges include lack of time, resources, protocols,

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