Administration of Drugs Regulations, Drug storage, Calculations, Administration & Patient Identification

1. Administration of DrugsRegulations, Drug storage,Calculations, Administration &Patient Identification 01.10.09

2. The administration of drugs involves Ensuring: • correct drug • at the correct time • is given to the correct patient • it has the expected and desired • outcome, with no ill effects

3. The administration of drugs includes • Monitoring the efficacy of the drug • Identifying side effects • Not giving a drug to a patient who is allergic to it

4. The administration of drugs by nurses is Controlled by the NMC • It requires professional thought and judgement. • Ensuring the prescription is correct • The timing is appropriate. • Ensuring the patient understands what they are taking • Reinforcing the positive effects of the treatment

5. Drugs given legally in hospital must be: • Correctly prescribed • Dispensed appropriately They must then be: • Administered at the correct time • Taken by the patient in the presence of the nurse • Recorded on the medicine chart

6. Prescription of medication • Medications must be prescribed by a Registered Medical Practitioner • Should be clearly written, typed or computer generated, and be indelible and dated • If a drug replaces a previously prescribed drug then the outdated one must be cancelled, signed and dated. • Information regarding changes in medication must be communicated to all who need to know, • Nursing staff • Patient

7. Prescriptions for medication in hospital must include the following information: Clear identification of the patient’s: • Name • Date of Birth • Registration number • Number of doses or length of treatment

8. Prescriptions for medication in hospital must include the following information: Clear identification of the patient’s: • Name • Address • Length of course (either in days or number of tablets to be dispensed)

9. All prescription of medication must give the following information • The substance to be administered (drug’s name) • Its form (e.g. tablet, capsule, suppository, injection, liquid) • Amount of active ingredient (i.e. dosage) • Timing & frequency • Route of administration All prescriptions must be signed and dated by the prescribing doctor

10. DRUG classifications • Drug use and supply in Britain is controlled by The Medicine Act of 1968Poisons Act 1972 & The Misuse of Drugs Act 1971 • Drugs are divided into the following categories: • General Sale Medicines GSL • Pharmacy Medicines P • Prescription only medicines POM

11. DRUG classifications • The Misuse of Drugs Acts 1971 controls any drugs which may cause addiction, and which are open to misuse and is divided into five Schedules. Drugs covered by the Schedule 2 are also known as Controlled Drugs

12. Scheduled Drugs Schedule 1 • Drugs which may not be used for medicinal purposes, but can be used for Research in under special conditions Schedule 2 • The CONTROLLED DRUGS - Opiates such as Heroin and major stimulants such as Amphetamines which can be supplied by a pharmacist on receipt of a prescription from a Registered practitioner such as a Doctor or Dentist Special regulations control the safe custody, use and destruction of these drugs.

13. Scheduled Drugs Schedule 3 • Minor stimulants and barbiturates, such as are in this group. Records such as invoices and prescriptions should be kept for two years Schedule 4 • Benzodiazepines are in this group. As are Anabolic steroids and Androgenic steroids Schedule 5 • Weak preparations of controlled drugs with minimal risk of abuse. Invoices must be kept for two years

14. Controlled Drugs • All details must be completed in the Doctors own handwriting • Name of drug • Dose of drug • Number of doses or length of course • Signature of prescribing doctor and date

15. Storage of Controlled Drugs • They must be kept in a locked cabinet or cupboard • The keys to the cabinet must be in the possession of an authorised person • Authorised person, refers to Ward Manager or deputy who must be a Trained Nurse or Midwife • Students should not be responsible for the controlled drug cupboard keys

16. Recording of Controlled Drug Use • Records in the form of CONTROLLED DRUG REGISTERS must be kept • Each drug must have its own specified page which is Headed with the Drugs name and Strength • The Number of Ampoules of a drug must be entered and updated with every use

17. Recording of Controlled Drug Use • Must record: • Date • Time • Dose of every administration • Name of receiving patient/client • Number of ampoules at start and finish of administration Entry must be signed by 2 people one of who must be registered No alterations must be made to the entry All entries must be in Black Ink

18. Giving of drugs in Emergency situations A local protocol agreed by Medical Practitioners, Nurses, Midwives and pharmacists may allow a Qualified Nurse to give a specific Dose of a specific drug in emergency situations

19. Giving of drugs in Emergency situations • Drugs should not be given in response to telephone messages • They may, in an emergency be given on a faxed order or E-mail if the drug has previously been supplied to that patient.

20. Standards for administering medicines Revision: • Correct drug • At correct time • Given to the correct patient • Has expected and desired outcome, with no ill effects

21. Standards for administering medicines The accountable nurse must therefore ensure that he/she: • Has an understanding of the drug they are giving, this includes understanding its therapeutic purpose • Must be able to justify their actions • Is prepared to be accountable for their actions

22. Is certain of the identity of the patient • Aware of current patient needs, the programme of care and other drugs the patient is currently receiving • Pay due regard to the environment in which care is being given • Ensure prescription/medicine container agree and all writing is clear, unambiguous and complete

23. That the patient is not allergic to the drug • That the drug has not reached its expiry date • If there has been a withdrawal notice issued by pharmacy, that it does not relate to the drug being given

24. Management of Drug Errors All errors or incidents occurring during the administration of drugs must be reported to the line manager immediately

25. Drug calculations To calculate a drug dose, use the following formula: What you want X The amount it’s in What you have got

26. What you want X The amount it’s in What you have got Example: If you need to give 1000mgs of a drug which comes as 500 mgs tablets, how many tablets will you need to give the patient 1000 X 1 = 2 X 1 = 2 Tablets 500 1

27. What you want X The amount it’s in What you have got Example: If you need to give 250mgs of a drug which comes as 125 mgs in 5mls liquid format, then you need 250 X 5 = 2 X 5 = 10 mls 125 1

28. What you want X The amount it’s in What you have got Example: If you need to give 24mgs of a drug which comes as 30 mgs in 5mls liquid format, then you need 24 X 5 = 4 X 5 = 4 mls 30 5