Monitoring & Supporting use

1. Monitoring & Supporting use

2. Session 3 • Describe what is involved in ordering prescriptions and collecting medicines from the pharmacy. • Describe how medicines should be stored correctly and disposed of safely • Explain how service users should be monitored after medicines have been administered • Explain how to protect and promote service users’ rights • Describe the importance of Patient Information Leaflets

3. Monitoring & Supporting use • Repeats • Changes of medication or dose • Verbal orders – phone • Emergency prescriptions

4. Re-ordering repeat medication • Do not let the service user run out of medicines • Allow at least 48hrs for prescriptions to be ready at the Drs - some require more time. Remember to allow dispensing time at the Pharmacy – i.e. 72hrs minimum • E.g. order on Wednesday morning pick up on Friday afternoon

5. Running out of Medication For whatever reason, there may be occasions when a medicine runs out. Every effort should be made to prevent such occurrences, but if it does happen then you can either: • Contact the doctor’s surgery and get an urgent prescription issued • Contact the pharmacist who may issue an emergency supply of the medicine if the prescriber cannot be contacted and the need for the medicine is crucial. • As the law concerning the supply of medicines is so strict there are specific requirements that need to be met in all of the above options.

6. Activity 16 & 17 Page 53+54 of workbook

7. Stock control • How much is there? • Where is it? • Use in date rotation • Expiry dates – specific attention to eye preparations, GTN tablets, Dipyridamole SR Capsules – other examples

8. Storage of medicines • Refrigerated • Homely remedies – Over the counter • Internal and external • Security • Oxygen

9. Disposal of Medicines Out of date No longer required Death of client – procurator fiscal Record keeping In Care at Home dropped or refused doses can be disposed of in the normal household waste. Medication should be safely and securely wrapped before disposing in the outside waste bin. Under no circumstances should medication be flushed down the toilet. Ideal practice would be to return to the community pharmacy to be destroyed. x

10. Activity 18 Page 56 of workbook

11. SIDE EFFECTS: WHAT TO LOOK FOR • Always suspect a side effect when a service user reports a new symptom Especially if a new medicine has been added • Look in the Patient Information Leaflet • Drowsiness or dizziness risk of falls • Constipation • Diarrhoea • Nausea and vomiting • Rashes • Discuss with Community Pharmacist/ GP / Service user or OOH, NHS24 / Line Manager

12. Activity 19, 20, Page 59 & 61 of workbook

13. Consent Service users who can understand and respond to information about their medicines must consent to their treatment If the assessor feels that the service user no longer has the ability to give informed consent, they will consider further assessment under Adults with Incapacity Act (Scotland) 2000

14. Confidentiality All information must be kept secure and not disclosed to anyone without consent Regulated by Data Protection Act 1998

15. Freedom of Choice When service users rely on support from staff It is important to ensure that within this support as much choice as possible is retained for service users. Choice = Feel good about yourself No choice = reduced compliance Self administration of medication is an effective way of giving service users control and choice.

16. Activity 21 & 22 Page 63 of workbook

17. Patient Information Leaflet (PIL) • All medicines must be supplied with a patient information leaflet. • This lists examples of what the medicine may be for • There will be contra-indications listed – when you should not take this medicine • Side-effects will also be listed – gives an idea of whether to contact doctor when a new symptom occurs

18. What if there are changes out of hours? • At times there needs to be changes to the service user’s medicines out of normal hours • An evening or a weekend • An emergency procedure form may be needed • If you are filling one in remember to double check each thing written on the emergency form • If there is one with the service user’s MAR make sure the MAR is updated as soon as the Pharmacy or GP can do so.

19. MEDICINE MANAGEMENT: EMERGENCY PROCEDURES FORM (Appendix 5) _____________________________MEDICAL PRACTICE Service User Name Address Verbal information (if applicable) Received from Designation Date/Time Form completed by: Designation Date MEDICATION TO BE ADMINISTERED Code Medication name, form and strength Numbr of dose units to be given Administration times Special Instructions Breakfast Midday meal Teatime Bedtime Other times ADDITIONAL INFORMATION

20. MCQ’s