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I provide specialist nursing expertise and leadership in medicines management for:
Domiciliary Care Workers who administer medicines in a person's own home. Also to Nurses and Support Workers who administer medicines within adult and children's services in Trust facilities, such as Day Care, Residential Care, Supported Living and Respite facilities.
As the only Medicines Management Specialist Nurse in Northern Ireland, my role is to:
- Lead on the development of safe and effective practice
- Provide/ deliver/ design medicines management education and training programmes across the sectors.
- Innovate service for nursing development for medicines management
- Evaluate the impact of education and training programmes
I am a Registered General Nurse with a degree in Health and Social Care equipping me with the knowledge and critical analysis skills I need to fulfil my role.
As a band 7 Medicines Managment Specialist Nurse, my role requires me to have expert knowledge of medicines management within nursing/ social care settings
Having a PGCE and registered as Lecturer/ Practice Educator on NMC register helps me to understand how people learn and adapt my teaching activites in order to accommodate different learning styles.
My role involves working with a range of professional teams and patient groups so a high level of interpersonal/ communication skills is essential.
Being organised, planning while being flexible to respond to needs of patients and staff to promote 'patient safety' is also critical.
I worked as a District Nurse for 15 years which gave me vaulable insight into care provision in the community, in particular the home setting.
In 2000, I was instumental in setting up a mutidisciplinary manual handling team comprising of two district nurses an OT and a Physio and taught manual handling for 9 years to staff working accross all community facilities. I developed a reference handbook of manual handling procedures which are still be used across the Southern Health and Social Care Trust. While working in the Back Care Team I completed a Diploma in Moving and Handling and a Post Graduate Certificate in Education for health care professionals.
I delivered personal care and medicines management training to Domiciliary Care Workers from 2008, so I was very aware of the issues they faced.
Since being appointed as Medicines Management Specialist Nurse in 2009 I have:
- Standardised medicines procedures for Day Care, Residential Care, Supported Living and Respite facilities.
- Developed a system for competency assessment accross these areas
- Developed safe systems and processes for transcribing medications onto a Trust Medicines Administration Record
- Designed a modified version of the Objective Structured Clinical Examination (OSCE) model to assess the skills of Domiciliary Care Workers in administration of medicines which I wrote up for The British Journal of Community Nursing (published July 2015)
I also work with The Open university Ireland, teaching on K101 Health and Social Care module for the last 10 years, gaining valuable teaching skills and gaining an understanding of how people learn.
I enjoy teaching and seeing people develop their skills and knowledge in all areas of health care. This role has afforded me the opportunity to see staff across a variety of areas in the community gain knowledge and attain competency in medicines management.I have a real desire to see services develop particularly in relation to health and safety. I have had an opportunity to set up safe systems and processes to ensure service users are assisted with their prescribed medicines in a safe and timely manner. I wanted a job where I could make a difference and this job enables me to improve safety and reduce risks in relation to medicines in the community and as a nurse to advocate strongly for service reform and modernisation that will improve quality and efficiency of services and improve the patient experience and patient safety.
As a Medicines Management Specialist Nurse, I enjoy working with a diverse range of staff, carers and patients across statutory and voluntary sectors building trust and professional relationships to advance patient safety at different levels.
I am professionally stimulated through policy development and reviewing systems working to improve safety.
I find the teaching aspect of my role particularly rewarding, it is thrilling to see staff develop their skills and knowledge and progress into more senior roles.
I coach patients and staff to reflect on their medicines management skills and practices and it is rewarding when they use me as a resource to improve their practice.
As the post of Medicines Management was a new concept in the SHSCT and in Northern Ireland, one of my biggest challenges when commencing post was trying to drive initiatives from the bottom up. It was only when a Community Medicines Group was established at Assistant Director Level that I was able to gain momentum in my role and drive safety initiatives forward.
A further major challenge is changing the culture of staff - bridging the theory/ practice gap.
Staff can be reluctant to accept change and this sometimes results in some practical challenges where I need to employ support and negotiation skills to achieve a collaborative outcome.
Being responsive to queries from such a diverse and large group of staff across a large area can also be very demanding on my time.
As I am very motivated to drive safety initiatives and service improvements, I am inclined to take on too much. I do not have any administrative support which means I have to make room for this in my daily workload.
Success in my role has required vision, planning, support and structure along with a lot of determination and patience.
When I commenced my post there were individual medicines procedures across Trust areas and programmes of care. My first action was to standardise medicines procedures for Day Care, Supported Living, Residential Homes and Domiciliary Care.
RQIA require that staff are trained and competent in medicines administration, I devised competency tools and training to ensure that RQIA standards are fully met and staff are competent to perform medication tasks.
In 2011, I devised a system of competency assessments for Domiciliary Care in the form of Objective Structured Clinical Examinations (OSCEs) and have been developing and improving them every year. To emphasise important teaching points and ensure different learning styles are met, I choreograph a demonstration video showing the correct administration process. I make a new video every year incorporating learning from the previous 12 months. I published an article in The British Journal of Community Nursing in July 2015 outlining the initial OSCE process.
I manage a group of 18 skills assessors (nurses) who carry out the OSCEs with my direction and support. The team were awarded 'runner up' in the Southern Trust Excellence Awards (behind the scenes category) in June 2018.
I set up and managed a medicines project across the 3 Trust areas to identify if the correct level of assistance was being provided by domiciliary care with the appropriate documentation. Whilst the project showed the majority of people were receiving the correct level of assistance, it identified a large number of safety and governance issues in relation to prescribing, dispensing and administration of medicines. The issues were addressed and the findings used to inform training and procedures.
My advice to anyone taking on this role is:
- Be visible in areas of responsibility in order to build relationships and gain an understanding
- Be approachable and flexible to finding solutions together
- Ensure that the organisation has your program of change included in its strategy and wider operational plans so change can be driven at all levels
- Be patient as it takes time to get established in the role and gain credibility; changing culture requires a lot of patience.
I have learned so much in my role as a Medicines Management Specialist Nurse. I learned the skills of sensitive listening and devloped my skills of using langauge to identify risk and encourage 'observable candour' in collective decision making to improve systems to support patient safety.
Communication in all its forms are skills to be perfected over time and I continue to do so and role model professional behaviours for change in partnership with patients, carers and colleagues.
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