GG&C PGD ref no: 2011/841 YOU MUST BE AUTHORISED BY NAME, UNDER THE CURRENT VERSION OF THIS PGD BEFORE YOU ATTEMPT TO WORK ACCORDING TO IT
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1 GG&C PGD ref no: 2011/841 YOU MUST BE AUTHORISED BY NAME, UNDER THE CURRENT VERSION OF THIS PGD BEFORE YOU ATTEMPT TO WORK ACCORDING TO IT Clinical Condition Indication: Inclusion criteria: Exclusion criteria: To increase the ph and/or reduce the volume of gastric contents before general anaesthesia All women in labour, or of greater than 20 weeks gestation or less than 3 days postpartum who require emergency general anaesthesia Hypersensitivity to ranitidine Cautions/Need for further advice/circumstances when further advice should be sought from the doctor: Action if patient declines or is excluded: Referral arrangements for further advice / cautions: Renal impairment (egfr less than 50ml/min) Obstetric anaesthetist to be informed Document refusal in patient casenotes Obstetric anaesthetist to be informed Review August 2012 Expiry February 2013 Template Version: Page 1 of 7
2 Drug Details Name, form & strength of medicine: Route/Method of administration: Dosage (include maximum dose if appropriate): Frequency: Duration of treatment: Maximum or minimum treatment period: Quantity to supply/administer: Black Triangle Drug:* Legal Category: Is the use outwith the SPC:** Storage requirements: Ranitidine (as hydrochloride) 25mg/mL ampoule (2 ml) Intramuscular injection 50mg in 2ml Once only Immediate One dose only One dose only No POM No Do not store above 25 degrees C Protect from light * The black triangle symbol ( ) identifies newly licensed medicines that are monitored intensively by the MHRA/CSM ** Summary of Product Characteristics Review August 2012 Expiry February 2013 Template Version: Page 2 of 7
3 Warnings including possible adverse reactions and management of these: Advice to patient/carer including written information provided: Monitoring (if applicable): Follow up: Obstetric anaesthetist should be informed immediately. Please refer to current BNF or SPC for full details Use the Yellow Card System to report adverse drug reactions. Yellow Cards and guidance on its use are available at the back of the BNF or online at Explain treatment and course of action. Give patient a copy of relevant patient information leaflet. If condition worsens or symptoms persist then seek further medical advice Not applicable Not applicable Review August 2012 Expiry February 2013 Template Version: Page 3 of 7
4 Staff Characteristics Professional qualifications: Registered midwives with current NMC registration Registered nurses with current NMC registration Specialist competencies or qualifications: Has undertaken appropriate training to carry out clinical assessment of patient leading to diagnosis that requires treatment according to the indications listed in this PGD Has undertaken appropriate training for working under PGDs for the supply and administration of medicines Registered nurses with NMC current registration working as anaesthetic nurses within the maternity unit. Continuing education & training: The practitioner should be aware of any change to the recommendations for the medicine listed. It is the responsibility of the individual to keep up-to-date with continued professional development Referral Arrangements and Audit Trail Referral arrangements If patient has any further questions contact obstetric Records/audit trail: anaesthetist. Patient s name, address, date of birth and consent given; Contact details of GP (if registered); Diagnosis; Dose, form administered and batch details; Advice given to patient (including side effects); Signature/name of staff who administered or supplied the medication, and also, if relevant, signature/name of staff who removed/discontinued the treatment; Details of any adverse drug reaction and actions taken including documentation in the patient s medical record; Referral arrangements (including self-care) References/Resources and comments: Notes: SPC Summary of Product Characteristics BNF British National Formulary Review August 2012 Expiry February 2013 Template Version: Page 4 of 7
5 This Patient Group Direction must be agreed to and signed by all healthcare professionals involved in its use. The original signed copy will be held at PPSU, Queens Park House, Victoria Infirmary. The PGD must be easily accessible in the clinical setting. Organisation: NHS Greater Glasgow & Clyde Professionals drawing up PGD/Authors * Dorothy Finlay Designation and Contact Details Designation: Senior Charge Midwife M Tracey Dr S Millar Dr A Quinn CA Harkins dorothy.finlay@rah.scot.nhs.uk Designation: Directorate pharmacist maria.tracey@rah.scot.nhs.uk Designation: Lead anaesthetist Simon.millar@rah.scot.nhs.uk Designation: Lead obstetrician Andrew.quinn@rah.scot.uk Designation: Lead midwife cathy.harkins@rah.scot.uk * Lead Author Review August 2012 Expiry February 2013 Template Version: Page 5 of 7
6 AUTHORISATION: NHSGG&C PGD & Non-medical Prescribing Sub-Committee of ADTC Chairman in BLOCK CAPITALS Dr Matthew Walters Lead of the professional group to which this PGD refers: in BLOCK CAPITALS Pharmacist representative of PGD & Non-Medical Sub-Committee of ADTC in BLOCK CAPITALS Antimicrobial use If the PGD relates to an antimicrobial agent, the use must be supported by the NHS GG&C Antimicrobial Management Team (AMT). A member of this team must sign the PGD on behalf of the AMT. Microbiology approval Designation: (on behalf of NHS GG&C AMT) Review August 2012 Expiry February 2013 Template Version: Page 6 of 7
7 Local Authorisation: Service Area for which PGD is applicable: Description of Audit arrangements: Frequency of checks: Names of auditor(s): (Generally annually) Nominated individual who agrees to keep staff training and list of practitioners operating under the PGD current and up to date (Lead Professional) Designation: contact address: PGDs DO NOT REMOVE INHERENT PROFESSIONAL OBLIGATIONS OR ACCOUNTABILITY. It is the responsibility of each professional to practice only within the bounds of their own competence and in accordance with their own Code of Professional Conduct. Note to Authorising Managers: authorised staff should be provided with an individual copy of the clinical content of the PGD and a photocopy of the document showing their authorisation. I have read and understood the Patient Group Direction. I acknowledge that it is a legal document and agree to supply/administer this medicine only in accordance with this PGD. Name of Professional Signature Date I agree that the professionals listed above are authorised to supply/administer medicines in accordance with this PGD to patients cared for in this service area. Lead Clinician for the service area (Doctor) contact address: Review August 2012 Expiry February 2013 Template Version: Page 7 of 7
Expiry Date: January 2009 Template Version: Page 1 of 7
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