40: Abu

Abu is 10 years old and recently has been experiencing frequent grand mal seizures. During his clinic appointment it becomes apparent that Abu has not been taking his anti-epileptics as they make him ‘feel drowsy’ and he forgets to take his prescription when he is at his friend’s house.

  • What statute law governs medicine management in the UK?
  • How does our nursing profession regulate the administration of medications?
  • Who are the potential decision-makers involved in Abu’s care?
  • You explain to Abu all about the risks he is taking when he does not take his medication; but what other actions could you take to improve his adherence?
  • In reviewing your answer to the previous question, what principles of decision-making have you used. Can you identify any decision-making models?

› Suggested answers

  • What statute law governs medicine management in the UK?

The Medicines Act (1968).

  • How does our nursing profession regulate the administration of medications?

Nursing and Midwifery Council (2007) Standards for Medicine Management. London: NMC.

  • Who are the potential decision-makers involved in Abu’s care?

Abu, his parents, specialist epilepsy nurse, school nurse, general practitioner, neurology consultant, pharmacist.

  • You explain to Abu all about the risks he is taking when he does not take his medication; but what other actions could you take to improve his adherence?

It is important to involve all CYP in decisions regarding their own healthcare and treatment. The ethical principle of autonomy guides us to give Abu a sense of control which can enhance his adherence to taking his medication. The nurse can also facilitate adherence through a number of means by advocating for Abu with the medical team and pharmacy. For example, selecting regimes that avoid the need for multiple daily dosing during school hours, avoiding medication with undesirable side-effects and dose rounding. Providing Abu with medicine information which is tailored to his age and cognitive ability coupled with regular contact with healthcare professionals can all support the development of his care plan.

  • In reviewing your answer to the previous question, what principles of decision-making have you used. Can you identify any decision-making models?

Depending on your clinical practice you may have experienced a similar scenario in your own practice. Thus, you may have used pattern recognition and therefore adopted an intuitive-humanistic approach to decision-making in which you instinctively chose to provide Abu with medicine information tailored to his age and cognitive ability. Alternatively, you may have taken a scientific, hypothetical-deductive approach in which you referred to Trust and NMC guidelines to generate a hypothesis. If you considered both subjective and objective data to decide upon your care plan you may have adopted the approach of the clinical decision-making model.