Why Is It Important Not To Touch Medicines When Administering Them

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Why Is It Important Not To Touch Medicines When Administering Them

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A recent survey showed that this chain ranked the highest in terms of customer satisfaction for chemists and pharmacies in the country. Other major companies included in the survey were major retail pharmacies Guardian Pharmacy, Chemist Warehouse, and Priceline Pharmacy. The Australian pharmaceutical and biotechnology industry has attracted substantial foreign investment, but despite exports amounting to well over two billion Australian dollars annually, Australia remains a net importer of pharmaceutical goods , importing around four times as much as it exports.

The industry is also supported by government investment in the Pharmaceutical Benefits Scheme PBS , which subsidizes prescription medicines for Australian residents. This is likely to be a significant contribution to prescription medications accounting for the largest revenue share of pharmacies in Australia. An ageing population and increasing incidences of people living with chronic illnesses has long been a driver in the demand for pharmacy services and prescription products.

However, the advent of the COVID pandemic in further highlighted the value of community pharmacies and the healthcare expertise of pharmacists. As such, pharmacies are becoming increasingly integrated into the greater public health agenda, and after the initiative that saw pharmacies administering influenza vaccines to the community, pharmacies and the registered pharmacist workforce are certainly valuable assets in the fight against COVID This text provides general information. Statista assumes no liability for the information given being complete or correct.

Due to varying update cycles, statistics can display more up-to-date data than referenced in the text. Most commonly used prescription drug in Australia. Share of patients who received prescriptions for medication in Australia. Pharmacy Number of pharmacy employees in Australia. Share of recent university pharmacy graduates employed full-time in Australia. Chronic pain Reduced employment cost associated with chronic pain in Australia.

Interesting statistics In the following 5 chapters, you will quickly find the 27 most important statistics relating to "Pharmaceutical industry in Australia". Statistics on the topic. Overview Annual revenue of pharmaceutical and cosmetic goods retail Australia Prevalence of chronic pain Australia by age group. Share of patients who received prescriptions for medication Australia FY Share of online pharmacy sales in Australia , by product type. Share of pharmaceutical sales in Australia , by pharmaceutical class.

Finding and treating that cause, along with the administration of fluid therapy, is essential to rule out refractory fluid loss. If not addressed, this persistent loss of circulating volume could lead to:. This initial fluid resuscitation should be followed by a reassessment. If further fluid resuscitation is required, then fluid boluses of ml should be given. Patients needing continuous boluses of up to 2L will need further medical review.

Routine maintenance fluids are needed in patients who are at ongoing risk of fluid loss. Reasons for this could be poor fluid intake, recent surgery, bowel dysfunction and other comorbidities. When ensuring normal electrolyte parameters are met, it is particularly important to consider the potassium levels. If continued fluid loss is suspected, this should be checked and losses monitored.

Redistribution of fluid can occur in critical illness. This may be seen in patients with cardiac failure, renal failure or sepsis, and oedema may be present. To manage these patients effectively, increased monitoring, further assessment and investigations are needed. In some cases, specialist intervention, such as the monitoring of central venous pressure, kidney function tests or high dependency care, may be required. In those who require ongoing fluid therapy for three or more days, the enteral routes of administration should be considered NICE, Enteral routes reduce the need for IV access and, in doing so, reduce the risks of ongoing IV therapy, such as catheter-related infections.

Crystalloid solutions are isotonic plasma volume expanders that contain electrolytes. They can increase the circulatory volume without altering the chemical balance in the vascular spaces. This is due to their isotonic properties, meaning their components are close to those of blood circulating in the body. Crystalloid solutions are mainly used to increase the intravascular volume when it is reduced. This reduction could be caused by haemorrhage, dehydration or loss of fluid during surgery. The most frequently used crystalloid fluid is sodium chloride 0. Some crystalloid preparations containing additives such as potassium or glucose are used in specific circumstances, for example, in hypokalaemia and hypoglycaemia Joint Formulary Committee, Crystalloid solutions such as sodium chloride 0.

As two-thirds of the infused volume will move into the tissues, only the remaining third will stay in the intravascular space NICE, , leaving a diminished circulating volume in need of further fluid administration. This increased volume can cause unwanted side-effects such as oedema NICE, Excessive amounts of infused sodium chloride 0. The main function of normal saline is to replace lost water, as it distributes the fluid throughout the body — thereby increasing total body water — but does not restore intravascular volume. The loss of water without loss of electrolytes is rare, but can be seen in patients with diabetes insipidus and hypercalcaemia. The additional glucose acts as a source of energy for patients who are unable to take oral foods and fluids Joint Formulary Committee, This is counteracted by using mixed solutions, such as 0.

Colloids are gelatinous solutions that maintain a high osmotic pressure in the blood. Particles in the colloids are too large to pass semi-permeable membranes such as capillary membranes, so colloids stay in the intravascular spaces longer than crystalloids. Examples of colloids are albumin, dextran, hydroxyethyl starch or hetastarch , Haemaccel and Gelofusine. Caution should be used when administering hetastarch: exacerbated by the haemodilution effects of fluid administration, it can negatively affect platelet count, which can have a temporary negative effect on clotting times and coagulation Marx and Schuerholz, Hypertension and tachycardia, cardiac failure, and pulmonary and peripheral oedema are all potential side-effects of the excessive administration of albumin, dextran or hetastarch Frost, ; Marx and Schuerholz, Crystalloids and colloids are plasma volume expanders used to increase a depleted circulating volume.

Over the years they have been used separately or together to manage haemodynamic instability. Both are suitable in fluid resuscitation, hypovolaemia, trauma, sepsis and burns, and in the pre-, post- and peri-operative period. On occasion, they are used together Frost, Colloids carry an increased risk of anaphylaxis, are more expensive Frost, and come with an added complication for vegetarian or vegan patients, as some preparations contain gelatin Joint Formulary Committee, However, colloid solutions are less likely to cause oedema than crystalloid solutions. Crystalloids are less expensive, carry little or no risk of anaphylaxis, and pose no problem for vegetarian or vegan patients. However, evidence on any potential harmful effects of crystalloids is inconclusive.

Table 1 summarises the main characteristics of crysalloid and colloid solutions. The question of which plasma volume expander to use has long been controversial, resulting in several studies and systematic reviews. In recent years, numerous research studies have been performed in different clinical situations to compare crystalloids and colloids and look at their advantages and disadvantages Skytte Larsson et al, ; Jabaley and Dudaryk, ; Yates et al, ; Burdett et al, Jabaley and Dudaryk published a study that compared the effects of crystalloids and colloids in trauma patients who needed fluid resuscitation; as haemorrhage is the second most common cause of death from trauma, the need for haemodynamic stability and the maintenance of tissue and organ perfusion is essential.

The study had limitations, including small sample size, funding and reporting bias, and the results were inconclusive. Yates et al studied post-operative patients who were administered goal-directed fluid therapy. Their study demonstrated that colloids had no benefit over crystalloids in patients who had had colorectal surgery and confirmed that using crystalloids was just as effective. Skytte Larsson et al compared the effect of colloids and crystalloids on renal perfusion, filtration and oxygenation after cardiac surgery. Maintenance of oxygen delivery and renal perfusion are particularly important in the post-operative period to exclude the risk of acute kidney injury.

Skytte Larsson et al concluded that there was no difference in effectiveness between colloid and crystalloid solutions in ensuring adequate oxygen perfusion to the kidneys. Smorenberg and Groeneveld studied the effects of fluid therapy on 42 septic and non-septic patients who had been assessed as hypovolaemic. Their study compared the urine output of those receiving crystalloid and colloid solutions and determined that patients receiving crystalloids had higher output volumes than those receiving colloids. Perel et al performed a Cochrane systematic review of 78 randomised controlled trials comparing colloids and crystalloids as plasma volume expanders in patients who were critically ill. They concluded that colloids did not prove more effective than crystalloids in reducing the risk of death in patients with trauma or burns and in patients post-operatively.

It included 28 studies that had investigated the physiological effects of crystalloid solutions in several different clinical situations. The review concluded that crystalloid solutions can have negative effects on electrolyte balance, coagulation and liver and kidney function. This lack of definitive conclusions was due to the fact that the 28 studies has been performed in different clinical settings. Making use of these studies is problematic because they were conducted across diverse clinical environments using different research methods, with alternative hypotheses and, therefore, also with potentially different outcomes. One size does not fit all, meaning the answer may not be the same for all clinical environments: colloids may be better suited to some clinical situations and crystalloids may be better in others.

Nurses and midwives administering IV fluids should be aware of the variations between the different fluid types as well as any potential complications. They also have a duty of care to understand the effects, side-effects, precautions and contraindications Nursing and Midwifery Council, of each. As with any medication, patients undergoing infusion therapy should be closely monitored to avoid fluid and electrolyte imbalances. This may mean weighing them daily, as this is a reliable method of monitoring fluid status NICE, Tagged with: Newly qualified nurses: assessment skills Newly qualified nurses: self-assessment. Sign in or Register a new account to join the discussion. You are here: Critical care.

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