Prepacks - Procedure For Supply (68KB pdf) - Newcastle Hospitals

The Newcastle upon Tyne Hospitals NHS Foundation Trust
PROCEDURE FOR THE SUPPLY OF
PREPACKS
Effective: July 2007
July 2009
Review date:

Written direction authorises supply of medication
to patient
Notes
What is a written direction?
A signed out-patient prescription, an interim
discharge letter, or patient group direction (PGD)
• Drugs can also be borrowed, see Appendix)
Medication is available as prepacked (PP) drug
and the drug is ‘in date’
Authorised nurse selects PP from drug cupboard
Authorised nurse endorses PP label (in space provided):
• Patient name
• Date of supply
• Number of days to be take for
• Expiry date (e.g. reconstituted antibiotic)
Authorised nurse annotates written direction with:
• The batch number (BN) on the PP dispensing overlabel
• ‘PP’ to signify a prepack has been supplied
• The quantity of prepacks supplied
• Finally signs the written document to confirm supply
made, in the case of the interim discharge letter in the
‘transcribed by ‘ box
Where appropriate:
• ‘POD’ to signify any of the patient’s own medication
returned to them on discharge
• OSD for medication supplied via the ‘One stop
dispensing’ system
Document and drug reconciliation
The authorised nurse must ensure that each item
prescribed or to be supplied is accounted for and given to
the patient before they are discharged, transferred or leave
the Hospital.
If a supply of any kind is not given to the patient the reason
must be annotated on the written direction e.g. ‘patient
indicated they had sufficient supply at home’
Authorised nurse provides the patient with
information regarding their drugs.
This should include:
• What the drug is for, common side effects, referral
mechanism if problems occur and planned follow up
• The dose & frequency
• Identify the presence of the Patient Information
Leaflet inside or attached to the PP
How do nurses become authorised
• Pre-requisite
• 1 st level Registered Nurse
on part RN/ RNA, RN8 / RNC, RM of the NMC register.
• 6 months experience
working in the clinical area and must have successfully
completed a period of preceptorship or induction.
• Maintain continuing
professional development pertaining to the practitioner’s
area of practice (including written directions) and in line
with current evidence.
• Proven competence to administer drugs
against prescription
• Received instructions on the procedure for
the supply of prepacked (PP) drugs by Pharmacy
Staff
• Named on the official Ward/ unit list of staff
authorised by pharmacy to supply PP drugs
(nurses may appear on more than one list)
Criteria for approval of wards/ units
• The Assistant Chief Pharmacist,
Pharmaceutical Governance has agreed the
supply of PP drugs will benefit the patients without
compromising safety and has approved the written
direction document, if appropriate
• Directorate approval (Clinical Director,
Professional Lead, Directorate Manager)
Prepack supply
• PPs can only be supplied on approved
wards/ units against approved written directions
• The PP consists of an agreed quantity of
drug and directions on the label
• Under no circumstances must the labelling
instructions or the quantity of medication in the PP
be changed
• Some wards or units may require a second
registered nurse to confirm supply
Stock availability
• Where available stock will be replenished via
‘top up’ stock system by Pharmacy Staff or the
temporary stock system as appropriate, however
the overall responsibility lies with the ward/ unit
manager to ensure there is sufficient PPs available
• Any medication not available either as a PP,
POD (patients’ own drug) or supplied via OSD (one
stop dispensing) system must be dispensed by the
Pharmacy Department or if the pharmacy is closed
by utilising the ‘out of hours’ dispensing procedure
Written direction storage
• The top copy of the written direction should
be sent to the main dispensary to be filed

List Of Medicines Available As Prepacks
DRUG
Amoxicillin 500mg
capsules
Co-amoxiclav
250/125 tablets
Codeine phosphate
30mg tablets
Ciprofloxacin
500mg tablets
Diclofenac 50mg
tablets
Erythromycin
500mg tablets
Flucloxacillin
500mg capsules
Paracetamol
500mg tablets
Penicillin V 250mg
tablets
Trimethoprim
200mg tablets
PACK
SIZE
DIRECTIONS ON THE
LABEL
Ward
Stock
21 Take ONE THREE times a day F1,F2,F3
21 Take ONE THREE times a day F10, R39,
R45,
R47,R20
28 Take ONE to TWO every 4-6 F19, F20
hours when required
10 Take ONE TWICE a day FEAS
21/28 Take ONE THREE times a day
when required
N19, R46,
R39, R45,
R47,
F19,F20
20 Take ONE FOUR times a day R43, R36,
R47, R20
20 Take ONE FOUR times a day R46, R48,
R43, R36
32 Take ONE to TWO every 4-6
hours when required
28 Take ONE FOUR times a day R52
F19, F20,
N19, R46,
R52, R48
14 Take ONE TWICE a day F1,F2,F3