Fundamentals of Midwifery: A Textbook for Students (137 page)

References
320Accenture (2010) The empowered patient: the changing doctor patient relationship in the era of ‘self service’ health care [online] Available: http://www.accenture.com/SiteCollectionDocuments/PDF/ Accenture-Empowered-Patients-Change-Traditional-Doctor-Patient-Relationship.pdfAdams, J. (2006) An exploratory study of complementary and alternative medicine in hospital midwifery: Models of care and professional struggle’.
Complementary Therapies in Clinical Practice
12 (1), pp. 40–47.Aickin, M. (2010) Comparative effectiveness research and CAM.
Journal of Alternative Complementary Medi- cine
16 (1), pp. 1–2 [online] Available: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3116569/Akobeng, A.K. (2005) Understanding randomised controlled trials.
Archives of Disease in Childhood
90, pp.840–844 [online] Available: http://adc.bmj.com/content/90/8/840.fullBarrett, B., Marchand, L., Scheder, J., et al. (2003) Themes of holism, empowerment, access, and legitimacy define complementary, alternative, and integrative medicine in relation to conventional biomedicine,
The Journal of Complementary and Alternative Medicine
9 (6), pp. 937–947.Benson, H., Klipper, M.Z. (2000)
The Relaxation Response
. New York: Harper Collins.Bishop, J.L., Northstone, K., Green, J.R., Thompson, E.A. (2011) The use of complementary and alternative medicine in pregnancy: data from the Avon Longitudinal Study of Parents and Children (ALSPAC)
Complementary Therapies in Medicine
6, pp. 303–310.Cant, S.L., Watts, P., Ruston, A. (2011) Negotiating competency, professionalism and risk: the integration of complementary and alternative medicine by nurses and midwives in NHS hospitals.
Social Science and Medicine
72 (4), pp. 529–536.Department of Health (2007)
Maternity Matters; choice, access, and continuity of care in a safe service
.London: Department of Health.Department of Health (2013) NHS Constitution for England [Online] Available: http://www.nhs.uk/ choiceintheNHS/Rightsandpledges/NHSConstitution/Documents/2013/handbook-to-the-nhs-constitution.pdfDepartment of Health and Human Services (2008)
CAM Basics: What is complementary and alternative medicine?
United States (US) Department of Health and Human Services [Online] Available: http:// nccam.nih.gov/health/whatiscam/Evans, D. (2003) Hierarchy of evidence: a framework for ranking evidence evaluating healthcare interven- tions.
Journal of Clinical Nursing
12, pp. 77–84.Evans, M. (2009) Post dates pregnancy and complementary therapies.
Complementary Therapies in Clinical Practice
15 (4), pp. 220–224.Gaffney, L., Smith, C.A. (2004) Use of complementary therapies in pregnancy: the perceptions of obstetri- cians and midwives in South Australia.
Australian and New Zealand Journal of Obstetrics and Gynaecol- ogy
44 (1), pp. 24–29.Gibson, P.S., Powrie, R. (2001) Herbal and alternative medicine use during pregnancy: a cross sectional survey.
Obstetrics and Gynaecology
97 (4), p. 44.Goldner, M. (2004) Cited in: Tovey P., Easethope G., Adams, J. (2004)
The Mainstreaming of Complementary and Alternative Medicine: Studies in a Social Context
. London: Routledge.Hall, H.G., Griffiths, D.L., McKenna, L.G. (2011) The use of complementary and alternative medicine by pregnant women: a literature review.
Midwifery
27 (6), pp. 817–824.House of Lords (2000) Science and Technology, Sixth report, Complementary and alternative medicine [online] Available: http://www.publications.parliament.uk/pa/ld199900/ldselect/ldsctech/123/12304.htm#a14Jones, C. (2012) Complementary and Alternative medicine in the maternity setting.
British Journal of Mid- wifery
20 (6), pp. 409–418.Kenyon, C. (2009) Risk management standards in midwifery are no substitute for personal knowledge and accountability.
Complementary Therapies in Clinical Practice
15 (4), pp. 209–211.Mitchell, M., Williams, J. (2006) Integrating complementary therapies.
Practicing Midwife
9 (3), pp. 11–16. Mitchell, M., Williams, J. (2007) The role of midwife-complementary therapists: data from in-depth tele-phone interviews.
Evidence Based Midwifery
5 (3), pp. 93–99.Mitchell, M., Williams, J., Hobbs, E., Pollard, K. (2006) The use of complementary therapies in maternity services: A survey.
British Journal of Midwifery
14 (10), pp. 576–582.Mousley, S. (2010) taking the first step: a midwife’s reflection on experiences as an aromatherapist in mid- wifery.
MIDIRS Midwifery Digest
20 (3), pp. 395–398.Nissen, N. (2011) Challenging perspectives: women, complementary and alternative medicine, and social change.
Interface: A Journal for and About Social Movements
3 (2), pp. 187–212 [online] Available: http://www.interfacejournal.net/wordpress/wp-content/uploads/2011/12/Interface-3-2-Nissen.pdfNational Institute for Health and Care Excellence (NICE) (2013) Glossary [online] Available: http:// www.nice.org.uk/website/glossary/glossary.jsp?alpha=RNursing and Midwifery Council (NMC) (2012)
Midwives Rules and Standards
. London: NMC.Nursing and Midwifery Council (NMC) (2008)
The Code: Standards of Conduct, Performance and Ethics for Nurses and Midwives
. London: NMC.Nursing and Midwifery Council (NMC) (2012) Complementary and alternative therapies [online] Available: http://www.nmc-uk.org/Nurses-and-midwives/Regulation-in-practice/Regulation-in-Practice-Topics/ Complementary-and-alternative-therapies/Park, A., MacDaid, D. (2011) Modelling the potential cost-effectiveness of acupressure in the treatment of chronic low back pain.
Journal of Traditional Chinese Medicine
3 (1).Ranzini, A., Allen, A., Lai, Y.L. (2001) Use of complementary medicines and therapies among obstetric patients.
Obstetrics and Gynaecology
97 (4), 46s.Roche, L. (2011) The Relaxation Response [online] Available: http://www.lorinroche.com/benefits/benefits/ relaxation.htmlSandall, J., Soltani, H., Gates, S., Shennan, A., Devane, D. (2013) Midwife-led continuity models versus other models of care for childbearing women.
Cochrane Database of Systematic Reviews
, Issue 8. [Online] Available: http://summaries.cochrane.org/CD004667/midwife-led-continuity-models-versus-other-models-of-care-for-childbearing-womenSmith, C.A. ,Collins, C.T., Cyna, A.M., Crowther, C.A. (2006) Complementary and alternative therapies for pain management in labour.
Cochrane Database for Systematic Reviews
18 (4):CD003521.Steel, A., Adams, J., Sibbritt, D., Broom, A., Gallois, C., Frawley, J. (2012) Utilisation of complementary and alternative medicine (CAM) practitioners within maternity care provision: results from a nationally representative cohort study of 1835 pregnant women.
BMC Pregnancy and Childbirth
. [Online] Avail- able: http://www.biomedcentral.com/content/pdf/1471-2393-12-146.pdfStolberg, H.O., Norman, G., Trop, I. (2004) Randomised controlled trials.
Fundamentals of Clinical Research for Radiologists
[online] Available: http://www.ajronline.org/doi/pdf/10.2214/ajr.183.6.01831539Tiran, D. (1996) The use of complementary therapies in midwifery practice: a focus on reflexology.
Com- plementary Therapies in Nursing and Midwifery
2 (2), pp. 32–37.Tiran, D. (2003) Implementing complementary therapies into midwifery practice.
Complementary Therapies in Nursing and Midwifery
9 (1), pp. 10–13.Tiran, D., Chummun, H. (2004) Complementary therapies to reduce physiological stress in pregnancy.
Complementary Therapies in Nursing and Midwifery
10 (3), pp. 162–167.Tiran, D. (2006a) Complementary therapies in pregnancy: midwives and obstetricians appreciation of risk.
Complementary Therapies in Clinical Practice
12 (2), pp. 126–131.Tiran, D. (2006b) Late for a very important date.
Practicing Midwife
9 (3), pp. 16–28.Tiran, D. (2006c) Midwives’ responsibilities when caring for women using complementary therapies during labour.
MIDIRS: Midwifery Digest
16 (1), pp. 77–80.Tiran, D. (2007) The importance of obstetric knowledge for complementary practitioners [online] Available: http://www.positivehealth.com/article/midwife/importance-of-obstetric-knowledge-for-complementary-practitioners
321Turner, B.S. (2004) cited in Tovey, P., Easethope, G., Adams, J. (2004)
The Mainstreaming of Complementary and Alternative Medicine: Studies in a Social Context
. London: Routledge.University of Maryland Medical Center (UMMC) (2011) An introduction to CAM [online] Available: http:// www.umm.edu/altmed/articles/an-introduction-000346.htmWarriner, S., Bryan, K., Brown, A.M. (2013) Women’s attitude towards the use of complementary and alterna- tive medicines (CAM) in pregnancy.
Midwifery
30 (1), pp. 138–143.
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Chapter 15‌
Pharmacology and medicines managementMary Beadle
University of Hull, Hull, UK
Andrea Hilton
University of Hull, Hull, UK
Learning outcomesBy the end of this chapter the reader will be able to:

describe the principles of safe administration of medicines

list the rights of medication

describe what to check before, during and after giving medications

discuss what to do after a medication error

describe the key principles of pharmacokinetics and pharmacodynamics

identify these key principles in relation to commonly used medicines in midwifery.
Introduction
The management of medicines is one of the key skills of a midwife; it is important that midwivesand student midwives have the knowledge around what they need to do in order to do this safely and to facilitate the elimination or reduction of errors. This chapter will identify this knowledge and the key points at which this needs to be applied to practice. As part of this process it is important that student midwives and midwives have the most up to date knowl- edge about the medicines involved. This is essential if patients are to make informed choices about whether or not they want to take the medication. The chapter also includes information about some of the key medicines used within the maternity services. This chapter will look at two important aspects in relation to midwifery practice: medicines management and pharmacology.
Fundamentals of Midwifery: A Textbook for Students
, First Edition. Edited by Louise Lewis.© 2015 John Wiley & Sons, Ltd. Published 2015 by John Wiley & Sons, Ltd. Companion website: www.wileyfundamentalseries.com/midwifery324‌The term‘patient’ will be used throughout the chapter as this is the one that tends to be used in pharmacology and medication texts.
Medicines management
Medicines management is ‘
about enabling patients to make the best possible use of medicines
’(National Prescribing Centre (NPC) 2008, p.25), making the most of any benefits and minimising any risks or harm (NPC 2008). It can encompass clinical assessment and the monitoring and review of medicines. Other key features of medicines management include ensuring cost- effective medication is prescribed for patients; guidelines and policies are reviewed and infor- mation is exchanged efficiently with both patients and carers. This is seen as an essential skill and is a theme within any pre-registration midwifery education programme (Nursing and Mid- wifery Council (NMC) 2009).
Midwives must use the principles of safe administration of medicines at all times. One could say that these principles are clear and simple; however, it is evident from the number of medica- tion errors that there is more to this than just following a list of actions. The fact is that there are agreed principles around what to do and that these are enshrined in professional standards and the law, but this process also requires critical and clear thinking to underpin the practice, otherwise the process becomes routine and open to mistakes and people taking risks. These principles are generally explained as ‘
Rights of Medication’
(see Box 15.1) although how many of these there are does vary (Agyemang and While 2010, Alexis and Caldwell 2013; Elliott and Liu 2010).There are also possible rights around the right form/formulation, the right duration and the right to refuse (Elliott and Liu 2010). It is important not to include too many rights, otherwise they become difficult to remember. It can help to divide the ‘Rights’ into the timing within the process of administration, including before, during and after administration.
What to check before administration
This would include that you have the
Right
patient; this can be done using the patient’s identity (ID) bracelet (if in hospital) and asking the patient their name and date of birth. This should be checked against the patient’s prescription chart or care record. This should be a simple action,
Box 15.1
Right
s of Medication