Related Experiment Video
Updated: Oct 22, 2025
06:59
A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
30.7K
Survey of Nurses' Experiences Applying The Joint Commission's Medication Management Titration Standards
Judy E Davidson1, Neal Doran2, Amber Petty3
1Judy E. Davidson is a nurse scientist, University of California San Diego Health, San Diego, California.
Summary
Critical care nurses report that The Joint Commission (TJC) medication titration standards cause patient care delays and moral distress. Nurses advocate for revised standards to improve patient outcomes and reduce distress.
Area of Science:
- Nursing Practice
- Patient Safety
- Healthcare Regulation
Background:
- Critical care nurses routinely titrate continuous medication infusions.
- The Joint Commission (TJC) implemented restrictions on titration practices in 2017, impacting nurses' autonomy.
Purpose of the Study:
- To explore nurses' practices and perceptions of the 2017 TJC accreditation standards for medication titration.
- To assess the impact of these standards on patient care and nurse well-being.
Main Methods:
- A validated survey was electronically distributed to members of the American Association of Critical-Care Nurses.
- The survey assessed nurses' experiences with medication titration and TJC standards.
Main Results:
- 80% of nurses perceived TJC standards caused patient care delays.
- 93% experienced moral distress, with suboptimal care and delays strongly predicting it.
- Significant percentages of nurses faced challenges complying with titration orders, leading to deviations or requests for revisions.
Conclusions:
- Nurses perceive TJC medication titration standards negatively impact patient care and increase moral distress.
- Despite 2020 updates, issues of delayed care and compliance challenges persist, contributing to moral distress.
- Advocacy for revised TJC standards is needed to address unintended consequences and improve patient care.
Related Concept Videos
01:15Drug Dosing: Geriatric Patients
39
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
39
01:28Dosage Regimens: Designs and Approaches
56
Designing a dosage regimen, which refers to the manner of drug administration, is a complex process involving the selection of drug dose, route, and frequency. This process is underpinned by pharmacokinetic parameters derived from tests and population averages. These parameters are then tailored to patient-specific variables such as diagnosis, demographics, and allergy status. Once therapy commences, therapeutic response monitoring is critical and achieved through clinical and physical...
56
01:24Dosage Regimen: Individualization
24
Individualization in dosing regimens is the customization of medication doses for individual patients. Its necessity arises from the goal of maximizing therapeutic benefits while minimizing risks. This approach is pivotal because human responses to drugs can vary widely; what is effective for one person may be inadequate or excessive for another. Interpatient (intersubject) variability refers to differences in drug responses between individuals, while intrapatient (intrasubject) variability...
24
01:15Drug Dosage Regimen: Overview
4.0K
A drug dosage regimen describes the specific instructions and schedule for administering a drug to a patient. It considers factors such as drug dosage, frequency, route of administration, and duration of treatment. Designing an appropriate dosage regimen for a patient aims to achieve a target drug concentration at the site of action.
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...
4.0K
01:23Dosage Regimen Designs: Nomograms and Tabulations
37
Nomograms and tabulations are vital tools used by clinicians to design accurate and individualized dosage regimens. These instruments provide a straightforward method for adjusting dosages based on individual patient characteristics, including age, weight, and physiological condition. The foundation of a drug's nomogram is population pharmacokinetic data collected and analyzed using specific models. This data simplifies complex equations, presenting them diagrammatically or tabularly for easy...
37
01:25Determination of Multiple Dosing Parameters: Loading and Maintenance Doses
39
A loading dose is an essential pharmacological strategy to rapidly achieve the target plasma drug concentration necessary for an immediate therapeutic effect. This approach is especially critical for drugs characterized by slow absorption or extended half-lives, where delaying therapeutic plasma levels could compromise treatment outcomes. By administering a loading dose, clinicians ensure a prompt onset of drug action, even for agents with complex pharmacokinetic profiles.Achieving steady-state...
39