Loading Dose Worksheet - the Royal Cornwall Hospitals Trust ...

Document Title
Loading Dose Worksheet – Phenytoin IV
Type of document
Brief summary of contents
Executive Director responsible for
Clinical Guideline:
Directorate / Department responsible
(author/owner):
Corporate: Clinical
Guidance on the prescribing and
administration of intravenous phenytoin
Medical Director
Ian Nicholls, Medication Safety Lead
Pharmacist
Contact details: 01872 253531
Date original version written: October 2011
Date revised:
This document replaces (exact title of
previous version):
Approval route (names of
committees)/consultation:
Divisional Manager confirming approval
processes
Name and Post Title of additional
signatories
Equality Impact Assessment appended
Approval must not be given if the EIS is
not attached
Signature of Executive Director giving
approval
Publication Location (refer to Policy on
Policies – Approvals and Ratification):
Document Library Folder/Sub Folder
New
New document
Loading dose NPSA working group &
Pharmacy Medicines Information
Peter Trethewey
Not Applicable
Yes
{Original Copy Signed}
Internet & Intranet Intranet Only
Clinical / Pharmacy
Date of final approval: 23 November 2011
Date guideline becomes live: 23 November 2011
Date due for revision: 23 November 2014
Links to key external standards
Related Documents:
Suggested Keywords:
Governance Team can advise
Medicines Policy
‘Loading dose’, ‘Loading’ ‘phenytoin’
‘worksheet’

Training Need Identified?
No
This document is only valid on the day of printing
Controlled Document
This document has been created following the Royal Cornwall Hospitals NHS Trust
Policy on Document Production. It should not be altered in any way without the
express permission of the author or their Line Manager.
This version supersedes any previous versions of this document.
All or part of this document can be released under the Freedom of Information Act
2000
This document is to be retained for 10 years from the date of expiry.
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LOADING DOSE WORKSHEET – PHENYTOIN IV
1. Purpose of this Guideline
1.1. This loading dose worksheet is intended to guide medical, nursing and
pharmacy staff in the safe and appropriate prescription and administration of
intravenous phenytoin loading doses
2. The Guidance
2.1. See the next page(s).
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3. Monitoring compliance and effectiveness
Element to be
monitored
Lead
Tool
Frequency
Reporting
arrangements
Acting on
recommendations
and Lead(s)
Change in
practice and
lessons to be
shared
Compliance with prescribing and administration in accordance with
this guideline (or other safe practice)
Pharmacy
No specific tool
As required according to clinical incident reports
Via Medicines Practice Committee
Matrons/ward managers
Matrons/ward managers
4. Equality and Diversity
4.1. This document complies with the Royal Cornwall Hospitals NHS Trust service
Equality and Diversity statement.
4.2. Equality Impact Assessment
The Initial Equality Impact Assessment Screening Form is at Appendix 1.
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Appendix 1.Initial Equality Impact Assessment Screening Form
Name of service, strategy, policy or project (hereafter referred to as policy) to be
assessed: Loading Dose Worksheet – PHENYTOIN IV
Directorate and service area:
Is this a new or existing Guideline?
All Clinical Areas
New
Name of individual completing
Telephone:
assessment: Ian Nicholls
01872 253531
1. Policy Aim* This loading dose worksheet is intended to guide medical,
nursing and pharmacy staff in the safe and appropriate
prescription and administration of intravenous phenytoin
2. Policy Objectives* To ensure RCHT complies with the requirements of the NPSA
RRR018 Preventing fatalities from medication loading doses
3. Policy – intended
Outcomes*
4. How will you
measure the
outcome?
5. Who is intended to
benefit from the
policy?
6a. Is consultation
required with the
workforce, equality
groups etc. around
this policy?
b. If yes, have these
groups been
consulted?
c. Please list any
groups who have
been consulted about
this policy.
Reduction in the risk associated with the prescribing and
administration of intravenous phenytoin loading doses
Review of Clinical Incident Reports
All inpatients within the Trust
Yes
Yes
The Medication Practice Committee, Nursing, Medical and
Pharmacy staff.
7. The Impact
Please complete the following table using ticks. You should refer to the EIA guidance
notes for areas of possible impact and also the Glossary if needed.
Where you think that the policy could have a positive impact on any of the equality
group(s) like promoting equality and equal opportunities or improving relations
within equality groups, tick the ‘Positive impact’ box.
Where you think that the policy could have a negative impact on any of the equality
group(s) i.e. it could disadvantage them, tick the ‘Negative impact’ box.
Where you think that the policy has no impact on any of the equality group(s) listed
below i.e. it has no effect currently on equality groups, tick the ‘No impact’ box.
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Equality
Group
Positive
Impact
Negative
Impact
No
Impact
Reasons for decision
Age √ This policy describes activities
within the capability of relevant
staff
Disability √ Only staff are required to comply
with this policy and if they had a
disability that prohibited them
from complying the Trust would
make suitable alternative
arrangements to assist them
Faith and
Belief
√ This policy describes activities
not affected by faith and belief
Gender √ This policy describes activities
not affected by gender
Race √ This policy describes activities
no affected by race
Sexual
Orientation
√
This policy describes activities
no affected by sexual
orientation.
You will need to continue to a full Equality Impact Assessment if the following have
been highlighted:
A negative impact and
No consultation (this excludes any policies which have been identified as not
requiring consultation).
8. If there is no evidence that
the policy promotes equality,
equal opportunities or improved
relations - could it be adapted
so that it does? How?
Please sign and date this form.
Keep one copy and send a copy to the Human Resources Team, c/o Royal Cornwall
Hospitals NHS Trust, Human Resources Department, Lamorna House, Penventinne Lane,
Truro, Cornwall, TR1 3LJ They will arrange for a summary of the results to be published
on the Trust’s web site.
Signed ________________________________________
Date __________________________________________
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