Medication Administration Flashcards
what are 2 acts governing medicines management
The Medicines Act 1968
The Misuse of Drugs Act 1971
who are drugs categorised for general supply to the public
- Prescription Only medicines (POM)
- Pharmacy Only medicines (P)
- General Sales List medicines (GSL)
what does The Medicines Act 1968 do
established a licensing system for medicines restricting who can manufacture, supply & distribute medicines
what does The Misuse of Drugs Act 1971 do
For public safety controls the import, export, production, supply, possession and manufacture of controlled drugs
Also governs safe storage, destruction and supply of controlled drugs
Additional statutory measures for the management of controlled drugs are laid down in the Health Act 2006
The process of medicines administration will always be accompanied by a degree of risk due to errors for example in what 3 things?
- Prescribing
- Dispensing/Labelling/Packaging
- Administration Process
what should you consider in relation to side effects
Medicines have therapeutic benefits but also the potential to cause harm. Patients may also experience side-effects from the medication. Whilst a side-effect is not considered to be an adverse event it is judged to be secondary to the main or therapeutic effect, but the treatment may still be allowed to continue.
what is the purpose of Standards for Medicines Management (NMC, 2010)
To set standards for safe practice in the management and administration of medicines by RNs, midwives & specialist community public health nurses.
Standards are the minimum expected standards
They are the benchmark upon which best practice will be measured.
Should refer to local & national policies/protocols for more information.
10 Sections to this document - 26 Standards are included. Summary (10 things)?
- Methods of supplying &/or administration of medicines
- Dispensing
- Storage & Transport
- Standards for practice of administration of medicines
- Delegation
- Disposal of Medicinal Products
- Unlicensed medicines
- Complementary & alternative therapies
- Management of adverse events (errors or incidents) in the administration of medicines
- Controlled Drugs
How does the nurses accountability to drug administration relate to the profession
The NMC has the authority to remove a nurse from the register through the Nursing & Midwifery Order 2002. The professional standard is highlighted through the Code of Conduct and in relation to drug administration through the Standards for Medicines Management (NMC, 2007).
A total of 214 nurses were issued with a striking off between 2007-2008 – 14% were concerned with direct patient care & 9.87% with maladministration of medicines
How does the nurses accountability to drug administration relate to their employer
nurses have legally binding contracts with their employers. An employer will hold an employee to account through disciplinary procedures and policies. Employers are held vicariously liable through these contracts
How does the nurses accountability to drug administration relate to the patients
Patients who feel that they’ve been harmed by nurses can seek redress through the civil court system.
How does the nurses accountability to drug administration relate to society
we are all accountable to society through the criminal law system. A nurse can be prosecuted if they are found to break the law. The Medicines Act 1968 and the Misuse of Drugs Act 1971 are the statutes concerned with the regulation of medicines and carry criminal penalties if breached.
what are the components of a valid medicine prescription chart
Demographic Data, The Drug, Drug Directions, Signature of the prescriber, Date that the medicine has been commenced (ensure that it has not been discontinued), Known Sensitivitiy Section – must be completed
The chart should be completed in black ink & block capitals
what demographic data should be on the kardex
- Patient’s Name
- Patient’s Address
- Hospital Number/Community Health Index number (CHI)
- Patient’s Sex
- Patient’s Date of Birth
- Patient’s Ward
how should the drug be on the kardex
- Internationally approved drug name (eg Ibuprofen not ‘Nurofen’ and in block capitals and no abbreviations)
- Dose of Drug required
- Formulation
- Strength of drug – eg Phenytoin 30mg/5mls; or 90mg/5mls
what should the drug directions be like on the kardex
- Should be clear & concise
- Drugs written up for ‘as required’ should have a ‘minimum dose interval’ specified eg Paracetamol 1g every 4-6 hours up to a maximum of 4g (4 doses) in 24hours
- Times of Administration should be clearly ticked
describe a CD book
A controlled drug (CD) book must be kept within each clinical area to identify the exact quantity of drugs present
The CD book details how many controlled drugs have been ordered, the names of the controlled drugs and the nurses who were responsible for the administration.
Controlled drugs are kept within a double-locked cupboard
what should you never administer a drug without knowing
- Indications
- Cautions
- Contraindications
- Side effects
- Dose
- Potential interactions
describe the yellow card system
As a registrant, if a patient experiences an adverse drug reaction to a medication, you must take any action to remedy harm caused by the reaction. You must report this in the patient’s notes, notify the prescriber (if you didn’t prescribe it) and notify via the Yellow Card Scheme immediately.
what are the routes of administration
Oral Inhalation (PR) & (PV) Instillation Topical Oxygen therapy Injection Intravenous Infusion
is covert administration allowed, and why?
no, as well as the ethical and legal considerations the nurse or midwife needs to consider that administering medicines in this way may alter their therapeutic properties rendering them ineffective and not covered by their product licence.
Professional role of the nurse in medicines management is the safe handling and administration of medicines.
what does this encompass (4 things)
¥ Legal Aspects
¥ Professional Regulations
¥ Local Policy
¥ National Patient Safety Programme (NPSP)
what are legal aspects in the nurse’s professional role of drug administration
Medcine Act 1968 establishes a licensing system for medicines, controlling the distribution of medicines. Misuse of drugs Act 1971 for reasons of public safety this controls the import, export supply and possession of controlled drugs
what are professional regulations in the nurse’s professional role of drug administration
NMC standards for medicine management 2008. all important, section 4, standard 8 highlights. Will look at it in detail in a moment.
what can local policy encompass in relation to the nurse’s professional role of drug administration
particularly in relation to the storage and transportation of drugs, e.g community patients
what does NPSP include
launched guidance on 09 november 2006 and highlights right patient, right medicine, right dose, right time, right route.
what are the 5R’s and why do we need them
- Patient
- Drug
- Route
- Dose
- Time
It is important to follow these rules (the 5 rights of patient medication administration) to keep your patient safe and prevent harm. Nursing medication errors can happen and thinking about these points can help to avoid these errors.
what should the nurse do for right patient
Student checks the patients details on the wrist band against the details on the drug kardex (name, D.O.B, Hospital Number
Confirm if the patient has any allergies
what should the nurse do for right drug
Student checks that drug kardex is legible and that instructions are clear
Student identifies the date the drug was prescribed
Student identifies the medication that is due to be administered
what should the nurse do for right route
The student identifies the correct route that the prescribed medication is to be administered
Student checks “other instructions” that may relate to timing e.g. administer before food etc.
what should the nurse do for right dose
Student clearly identifies the prescribed dose
Student accurately calculates medication dose (if appropriate)
what should the nurse do for right time
Student identifies the time that the medication is due
Student checks to ensure that drug has not already been administered or given as a “once only”
what should you check in the BNF
Indications Cautions Contraindications Side Effects Dose
what should you do when dispensing medication
identifies the correct prescribed drug within the drug trolley
checks the expiry date of the drug
dispenses appropriate dose of medication into container using non-touch technique
what should you do when administering medication
re-checks name band and confirms with drug kardex
gives patient the prescribed drug with a glass of water
confirms that the patient has swallowed the drug
what should you do in terms of communication when administering medication
- Consider the information you read in the BNF
- Tell the patient in lay terms what the tablet is, why they are receiving it and what the possible side effects may be
- Advise the patient to call you if they require to following the procedure.
what should you do in terms of record keeping when administering medication
Make a clear, accurate and immediate record of all medication that has been: administered, witheld, refused.
All entries and signatures should be clear and legible.
As a student, administering medication, the Registered nurse must clearly countersign the student’s signature.
what should you do if you make an error
If you make an error you must take action to prevent any potential harm to the patient and report as soon as possible to the prescriber, your line manager or employer (according to local policy) and document your actions
