Transcript Mike Cooke - Health Partnerships Learning & Development

Medicines Management
Band 3 Training
Medicines Management
Nigel Buck
Learning and Development Facilitator
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Aim
Within your role you will play your
part in the safe supply,
administration, handling and storage
of medicines.
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Objectives
At the end of the session you will be able to -
say what a medicine is
understand some of the legal aspects
relating to medicines
state who can prescribe medicines
understand the principles of safe
transport and storage of medicines
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Objectives (continued)
Understand how to administer
medications safely (including record
keeping)
Understand how to support patients in
their use of medicines
Know what to do if something goes wrong
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What medicines do
Can you name any medicines?
Do you know what they do?
How can you find out – BNF
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BNF
British National Formulary for all
medicines (current / childrens)
http://bnf.org/bnf/bnf/current/
Contraindications
Cautions
Side Effects
Interactions
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BNF
Use the BNF find Calpol
Cautions – What are the cautions
when taking Calpol?
Side Effects?
Interactions?
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BNF
Use the BNF find Nurofen
Cautions – What are the cautions
when taking Nurofen?
Side Effects?
Interactions?
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What is a medicine?
“Any substance or combination of substances...........
(a) presented as having properties for treating or
preventing disease in human beings;
(b) ……to restoring, correcting or modifying
physiological functions by exerting a
pharmacological, immunological or metabolic
action, or to making a medical diagnosis
Medicines and Healthcare products Regulatory Agency
MHRA Guidance Note No. 8 Revised June 2007
A GUIDE TO WHAT IS A MEDICINAL PRODUCT
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Legal aspects
Medicines Act 1968 & Human Medicines Regs. 2012
Marketing Licence (MHRA)
The Safe and Secure Handling of Medicines 2005
(revision to the Duthie Report 1988 CD’s)
Health and Safety Regulations
Policy for the supply, administration, safe
handling and storage of medicines CPPG/MM01
*Registering bodies guidelines*
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Legal aspects
There are 3 classifications of medicines
GSL – (general sales list)
Medicines sold in general shops as well as pharmacies
P – (pharmacy medicine)
Medicines sold in pharmacies by or under the
supervision of a pharmacist
POM – (prescription only medicine)
Medicines only obtained on a prescription through a
pharmacy
Can you name some?
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Controlled Drugs (CD’s)
Misuse of Drugs Act 1971
Drugs liable to abuse
Controlled drugs
E.g..
Controlled Drugs Regulations 2006 – “all
significant events involving CD’s should be
reported to Chief Pharmacist.
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Prescription
P.O.M. must be given as instructed by
the authorised prescriber.
Changing dose or giving medicines to
a different person without the
prescribers permission is against the
law.
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Who can prescribe?
Doctors – GMC Registered, (& Dentists GDC)
Suitably trained, experienced, qualified……………………………
 Independent Prescriber – Suitably trained and competent
Nurses & Pharmacist- licensed medicines only (CD’s limited)
 Supplementary Prescriber- needs a clinical management plan
(CMP) & be a…. ……….nurses, pharmacists,
physiotherapists, chiropodists/ podiatrists, radiographers or
optometrists
 Extended Nurse Prescriber
 Limited Nurse Prescriber
 Specific List Prescribers (RN prescribers)
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What information must a
prescription have?
Clearly written black ink or computer generated
Patientsfull name &
address
Age (by law for the under 12’s),
Date
Prescribers signature
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What information must a
prescription have? (continued)
Medicine
Name (Generic)
Form (tablet / capsule)
Strength (note liquids)
Dose (best to avoid abbreviations)
Frequency
Route
NB CD’s
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Who can give medicines?
Section 6.2 “The law states who can prescribe
medicines it allows anyone to administer
them………………... provided they follow the
authorised prescriber’s instruction”
Section 6.3 Non- registered healthcare
professionals may only administer medicines after
receiving appropriate training & assessment at
local level in accordance with local guidance to a
named patient only.
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Get it Right -Checks
Right Patient (Name & D.O.B.) & prescription
Right Medication (name form strength)
Right Dose
Right Route
Right Date & Time (Last dose given?)
Right Duration (over what time)
Appropriate member of staff
Expiry Date
Drug sensitivity
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Patients at high risk
Taking 4 or more medications
Post discharge from hospital
In care homes
Medicine- related problems identified
Children & Special Needs & over 75’s
Following adverse change in health
Note side effects of medication
GP Medicines review may be needed
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Medicines & Children
Children & Special Needs
Children’s metabolism – reduce drug clearance –
report adverse drug reactions
Many children require medicines not specifically
licensed for paediatric use or for unlicensed
applications (‘Off Label’).
Writing of prescriptions –Age, Strength of capsules
Doses in children – Body Weight (Overweight /
Ideal weighted dose) or Body Surface area
Children’s BNF
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Medicines & Children
Oral Syringes
Out of reach?
Rare Conditions
Sugar Free?
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Help with medications
Large print labels
Clic-loc tops
Reminder charts
Prompt sheets
Volumatic devices
Medicines Information
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Side Effects
Can you name some side effects of
medications?
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Side Effects
Over Sedation
Medication interaction
D&V
Dehydration
Constipation
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Sedation
Keep to regular bedtimes - don't sleep or doze
during the day.
Hidden Caffeine
Have a set time for getting up in the morning.
Make sure your bed and bedroom are
comfortable; not too cold or too warm.
Sleeping problems are common.
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Falls
What medicines could contribute to the risk of
falls?
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Analgesics - Painkillers
• Constipation
• Many stronger painkillers such as co-codamol
(eg Solpadol, co-dydramol, and morphine (eg
MST) cause constipation as a side effect, so a
laxative may also be needed.
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Analgesics continued
Aspirin and non-steroidal anti-inflammatory drugs
(NSAIDs) -ibuprofen (eg Brufen, Nurofen), naproxen
(eg Naprosyn, Synflex) & others can cause bleeding
from the stomach or bowel.
More than one NSAID should not be taken at the
same time. (note cold & flu remedies)
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Storage of Medicines
Follow manufacturers instructions
E.g.
Vaccines and the cold chain +2 to +8 degrees C
Keep in original containers, do not mix batches
Expiry dates do not over order
Lockable cupboards
Check them in and store them
Patients medication is the patients property
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Documentation
Record at the time of administration
Sign to say it has been given
“R” refused
“O” omitted
Note CD’s
When things go wrong..
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Disposal of Medication
P.29 section 21.
In general return to pharmacist
Not the domestic sewage system
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Administration
P22 section 11.2.1
Only Following training &
Assessment- HCA working with an
individualized planned package of
care…naming both the patient & the
HCA.
Routes of administration
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The Gut A&P
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Bristol Stool Chart
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Eye Drop administration
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Eye infections
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P.E.G. Tube
Percutaneous Endoscopic Gastrostomy Tube
P.26 & separate policy
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When things go wrong
Prevention- follow the policy
Prevention- are you competent?
Prevention- Get it right checks
Trust’s Incident Reporting Policy and Procedure
Notify supervising staff / line manager
Community Pharmacist
GP - prescriber
Medicines manufacturer e.g. loss of refrigeration
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