Hi, and welcome back to the course vigilance during the hospital stay of loved ones. Now, I will focus on the second and last set of examples and then I'll conclude with some final observations for the course. In this second set of examples, I will focus on how changes in the medicines or in the administration of medicines can change the outcome in a smaller significant way. Also, pharmacy related requests and certain situations related to timing will be discussed. Nurses may have different ways to administer medications even if it is the same route of administration such as an IV route Once they get general orders from the doctors nurses may have some liberty in the choice of delivery method depending on the type and the purpose of the medication Of course, to be more specific of medicine administered directly in the same through an IV pole at a pace this dictated by the nurses fingers such as a bolus in vet injection versus having a small amount being infused through an IV infusion from for certain time period, which is more accurate and at a constant rate.

So, changes as such may make a difference between having or not having a painful or a burning sensation under the skin. How is the problem noticed? Then corrected is shown here. First the problem is described as injection is given directly into the IV hurting the patient because of the lack of a precise control on the savings. This pain is mentioned to the next nurse that have gone through the shift and she then uses a machine to inject the medicine by timed drip on the IV machine infusion. This time the patient does not complain of the pain at all.

Now, I would like to go over a few aspects concerning the pharmacy. depending on the time of admission to the hospital floor a patient's medicine this may not be filled by the hospital pharmacy right away. This situation usually occurs when the admission is at nighttime So some medicines they have in the hospital pharmacy may be different than those prescribed by the PCP or other specialists. However, usually, it is the same final dosage that would take place of course for it to be accurate. For example, one cable of 80 milligrams versus two tablets of 40 milligrams each, as long as it is the same as the patient's original prescription. Or at times it may be a small difference such as a capsule versus a tablet.

In rare cases as an exception, nurses may allow the patient to use whatever medicine he or she has, from home until a solution is found to the availability of that medicine in that particular hospital pharmacy. One last situation to mention is that of administration and insurance related issues. One thing to notice is that we can usually does not allow us to proceed with matters related to neither administration nor insurance. This one has to wait for the week day and work this as holidays will not allow the patient to communicate with the administration staff in the hospital, such as the medical case manager our Insurance Benefits and Coverage and claims. Therefore, during that period, it is the patient and the patient's relatives responsibility to make decisions that are best based on whatever limited information that is available at that time. If there is an urgency in making such decisions This concludes the second set of examples.