Medicines Management Policy - Dudley Primary Care Trust

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9. Administration Registered healthcare professionals will normally undertake the administration of medicines. Exceptions are Community Health Care Staff and Social Services staff that have been trained in, and assessed as competent in, the administration of medication (with the exception of CDs which are not to be personally administered by these staff). Documentation of training should be maintained by the Team Leader/Coordinator who has responsibility for ensuring such training is completed. A record of this training should be held in the staff member’s personnel file. Only medicines that have been authorised by a medical or dental practitioner, or other authorised prescriber or a healthcare professional authorised via a Patient Group Direction must be administered to patients/clients. This authorisation must be in writing, in the form of a prescription, in advance of the administration of the medicine, (see section 2, Prescribing of medicines). In areas where there are no resident prescribers and in cases of clinical urgency a verbal instruction is acceptable (see section 12), except for schedule 2 and 3 controlled drugs, other than Phenobarbital for epilepsy. See section 10 for further guidance on the administration of controlled drugs . 9.1 Administration must be carried out in accordance with the patient/client’s prescription. This can be ascertained by having present at the time of administration one of the following: a) A clear written direction from an independent prescriber or a PGD. b) A duplicate copy of the discharge medication. c) Verbal prescription in extreme circumstances only. (Section 12) If there is any uncertainty regarding the prescriber’s intention this must be clarified prior to administration, e.g. clarification of abbreviations not included in 2.7.6 9.2 The healthcare professional responsible for the drug administration must ensure the following elements of the procedure are achieved: - i) The patient/client is correctly identified and informed consent gained before taking their medication or there is authorisation of administration. ii) The patient/client is assessed to ensure they are able to receive the medication and that it is safe to administer it. iii) The correct drug and formulation is selected. iv) The correct dose (i.e. strength or quantity) is selected. v) The correct route is used to administer the drug. 24
vi) vii) viii) ix) The drug is being given at the correct time and on the correct date. The drug has been prescribed by an authorised prescriber or is administered in accordance with an approved PGD. The drug has not passed its expiry date. Administration is completed to the correct patient/client* *Generally, completion means that the patient/client has swallowed the medication or received an injection or suppository. There are a few exceptions, e.g. sub-lingual tablets, syringe drivers. 9.3 Orally administered medicines must be offered to the patient/client accompanied by a drink (excluding sub-lingual administration), if appropriate. 9.4 Medicines must not be crushed, broken or mixed with food or liquid unless specified by the prescriber, as per manufacturers’ instructions or in consultation with a pharmacist or speech and language therapist. This changes the pharmaceutical qualities of the medication and may be construed as covert administration. This includes administering medicines via PEG feeds. As a general principle, by disguising medication in food or drink, the client or patient is being led to believe that they are not receiving medication, when in fact they are. The health professional will need to be sure that what they are doing is in the client’s best interests and be accountable for that decision. .See NMC documents on covert administration:- http://www.nmc-uk.org/aDisplayDocument.aspxDocumentID=3602 and http://www.nmc-uk.org/aDisplayDocument.aspxdocumentID=3954 9.5 Medicines should not be administered to or taken by any member of staff unless purchased for personal use, prescribed by occupational health or prescribed by a practitioner with whom that person is registered. 9.6 Only those medicines supplied by a pharmacy or assessed as suitable by pharmacy shall be administered to patients/clients. All samples/clinical trial medicines must be supplied only via a pharmacy. 9.7 Once a drug has been given the person administering the drug must make a record. This record should be made at the time of administration and be in the patient/client’s records or on an appropriate Medication Record Card which must be filed in the patient/client’s records once complete. Home Care Staff must sign a Medication Administration Record (MAR) sheet to confirm administration. The record must include: 25
Page 1 and 2: Medicines Management Policy Documen
Page 3 and 4: CONTENTS Section Page 1. Introducti
Page 5 and 6: 1. Introduction This policy deals w
Page 7 and 8: 2. Prescribing of medicines 2.1 Int
Page 9 and 10: Nurse and Pharmacist Independent Pr
Page 11 and 12: 2.7.1 Clarity The prescription form
Page 13 and 14: 2.7.8 Recognised abbreviations Only
Page 15 and 16: 3. Supply of prescription Pads N.B.
Page 17 and 18: 4.0 Security and Safe Handling of P
Page 19 and 20: 6. Transport of Medicines 6.1 All m
Page 21 and 22: 7.7 All medicines shall be returned
Page 23: 8. Responsibilities of the person a
Page 27 and 28: • Insulin injections by District
Page 29 and 30: • Are subject to safe custody req
Page 31 and 32: 10.3 Prescribing Controlled Drugs 1
Page 33 and 34: 10.5.2 Stock held at PCT premises o
Page 35 and 36: 11. Management of errors or inciden
Page 37 and 38: 12. Verbal orders for the Administr
Page 39 and 40: 14 Alcohol 14.1 Patient/client unde
Page 41 and 42: may imply dealing, as breach of con
Page 43 and 44: 17. General Notes on the Handling o
Page 45 and 46: 19. Compliance aids All compliance
Page 47 and 48: 21. Syringe Drivers Please refer to
Page 49 and 50: 23. Prescribing of Oxygen Please re
Page 51 and 52: This policy was produced by Special

Medicines Management Policy - Dudley Primary Care Trust

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