Legal issues and medication in mental health nursing

1. Legal issues and medication in mental health nursing • (Victorian) Drugs Poisons and Controlled Substances Regulations 2006 aims to maximise the benefits and minimise misuse and abuse of licit drugs and poisons

2. Poisons Control Plans and Health Services Permit • PCP = contains details of how each health provider intends to comply with the DPCS regulation. Is developed by health service provider and reviewed by DoH • HSP = legal mechanism by which health services obtain permission to possess drugs

3. Poisons Schedules • Schedule 1 Traditional Chinese herbs • Schedule 2 Pharmacy Medicines • Schedule 3 Pharmacist only medicines • Schedule 4 Prescription only medicines • Schedule 5 Household Poisons • Schedule 6 Agricultural, veterinary & industrial poisons • Schedule 7 Dangerous poison • Schedule 8 Controlled Drug • Schedule 9 Prohibited Substances • Schedule 11 Drugs of Dependence (Victoria only)

4. Who is a nurse? • Registered nurse means a person registered under the Health Practitioner Regulation National Law 2009: a) to practise in the nursing and midwifery profession as a nurse; and b) in the registered nurses division of that profession

5. Definitions • Supply medicines • Possess medicines • Administer medicines

6. Possessing and administration of a medicine A nurse is authorised to possess and administer S 4 and S 8 poisons necessary for a patient under the care of that nurse, in accordance with: • The instructions and authorisation of a medical practitioner, dentist or nurse practitioner for that patient • The conditions of a Health Services Permit issued by the DoH • The approval of the Secretary of DoH in specified circumstances

7. Administration cont’d • A medical practitioner, NP, dentist or authorised optometrist who orders the administration of an S4, S8 or S9 poison to a person must provide that instruction in writing in a legible and durable form and must date and confirm that order with his or her signature • S4 poisons must not be administered if the instructions were given more than 12/12 ago • S8 and S9 poisons must not be given if the instructions were given more than 6/12 ago

8. Administration cont’d A nurse must not administer an S4, S8 or S9 poison to a person other than • In accordance with the directions for use on a container supplied by a medical practitioner, NP, pharmacist, dentist or authorised optometrist (this applies in circumstances where the prescriber’s written or oral instructions are not available but where the patients lawfully supplied medications are available to be administered) • On the written instruction of a medical practitioner, NP, dentist or authorised optometrist

9. Administration cont’d c) On the oral instruction of a medical practitioner, NP or dentist to the nurse, if in the opinion of the medical practitioner or dentist an emergency exists (the prescriber must confirm the oral instructions in writing asap) d) On the written transcription of the oral instructions referred to in paragraph (c) by another nurse who received those instructions e) In accordance with conditions on an HSP or an approval of the Secretary of DoH (relates to special circumstances/situations)

10. Whose drugs are they? • Medication that are supplied on prescriptions for a specific patient belong to that patient; it is an offence to administer them to any other person! • Ward stock in a hospital belongs to the hospital and may be administered to any person for whom its administration has been ordered.

11. References • www.legislation.vic.gov.au • www.health.vic.gov.au/dpu • Drugs Poisons and Controlled Substances Regulations 2006 • Health Practitioner Regulation National Law Act 2009 on http://www.ahpra.gov.au/en/Legislation-and-Publications/Legislation.aspx