Medicatieveiligheid & wetgeving voor internationaal verpleegkundigen
Lesduur is: 60 minOnderdelen in deze les
What are we going to talk about?
Medication Safety (in the Netherlands)
BIG Act
Medicines Act
Safe Incident Reporting (VIM)
Learning from - and with each other!
What is Medication Safety?
Medication safety encompasses all measures and activities that ensure a patient receives the correct medication in a safe and effective manner.
The aim is to prevent medication errors and side effects, from prescribing to administration.
During your internship, you need to give an intramuscular injection. You passed the theoretical exam at school, but you have never performed this skill in practice. Are you authorized and competent?
Yes, passing the theoretical exam at school automatically makes you both authorized and competent.
No, you are authorized based on your education, but not yet competent in practice. You must perform the procedure under direct supervision.
No, as a nurse, you are never allowed to perform this procedure.
Workshop Content
Theory on Medication Safety (20 minutes)
Working on Case Studies in Groups (20 minutes)
Questions about the Case Study? (10 minutes)
Group Reflection (10 minutes)
The doctor has prescribed a medication and you're uncertain about the dosage. What do you do?
The Medicines Act
The Medicines Act establishes the legal framework for the safe handling of medicines in Dutch healthcare.
The act regulates the chain from manufacturer to patient, with the following aspects being most important for nursing practice:
1. Prescribing vs. Administering
Doctor prescribes: As a nurse, you are not authorised to prescribe medication.
Execution request required: You may only prepare or administer medication if there is an official order from a doctor.
2. Reserved Procedures
Risky/reserved procedures:
Authorised and competent: am I allowed?/can I do it?
Classification of Medicines
Prescription Only: Strong medication (such as antibiotics) can only be dispensed by the pharmacy with a doctor's prescription.
Over-the-Counter: Medicines such as paracetamol are available without a prescription.
Extra Strict Control (Opium Act)
Opiates under lock and key: Strong painkillers (such as morphine) fall under the Opium Act and must be stored in a locked opiate cabinet.
Registration and control: Every ampoule or tablet must be precisely signed off; the IGJ (Inspectorate) conducts strict checks on this.
A doctor verbally tells you that a patient can have extra paracetamol. This has not yet been entered into the Electronic Prescribing System (EPS). What do you do?
You administer the paracetamol immediately, because the doctor gave verbal permission.
You refuse to give the paracetamol until the doctor records it digitally or in writing as an official execution request
You ask a fellow second-year student nurse to administer the paracetamol instead.
You are administering Oxycodone (a strong opioid painkiller) to a patient. Which action is legally required within the healthcare institution?
The medication can stay in the open medication cart as long as you remain nearby.
You must log the distribution immediately in the opiate registry, and the remaining stock must stay locked in the opiate cabinet.
Opiates only need to be checked at the end of the week by the institutional pharmacist.
The Key Aspects of Medication Safety
Correct use: The correct prescribing, dispensing, and administering of medicines.
Current information: Healthcare providers (pharmacist, doctor) must have access to up-to-date and shared medication data to prevent errors.
Checks and procedures: Implementing double-checks for high-risk medication and working according to protocols.
Safe storage: Storing and managing medicines correctly.
You realize that you accidentally gave the medication meant for room 4 to the patient in room 5. What is your primary legal and professional duty?
Immediately check the patient's vital signs, inform the doctor/supervisor, and report the error in the internal incident reporting system.
Say nothing and just monitor the patient closely during your shift.
Secretly adjust the medication administration record in the computer so it looks like nothing happened.
Always report (almost) incidents!
Legally required in the Netherlands
Concealing an error is punishable
According to a fixed procedure (VIM)
Ensuring patient safety
Not to punish but to learn from!
Preventing recurrence
5 Checkpoints
Right patient: Is this the correct person?
Right medication: Is this the correct medicine?
Right dose: Is it the correct amount?
Right time: Is it being given at the correct time?
Right method: Is it being administered in the correct way (e.g., swallowing, applying, injecting)?
Case Study
Form groups of 5
Read the case study
Complete the VIM form together
Reflection
1. How does culture or heirarchy affect addressing doctors of colleagues?
2. What can healthcare systems from different countries learn from each other?
answer the reflection questions from the bookletQuick Feedback: How was today's workshop?
