The Newcastle upon Tyne Hospitals NHS Foundation Trust

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1 The Newcastle upon Tyne Hospitals NHS Foundation Trust Procedure for registration and supply of prophylaxis to the immediate household contacts of patients admitted with meningococcal disease Version.: 2.2 Effective From: 24 March 2017 Expiry Date: 24 March 2019 Date Ratified: 11 January 2017 Ratified By: Medicines Management Committee 1 Introduction This guideline outlines the process for registration and supply of prophylaxis to the immediate household contacts of patients admitted with meningococcal disease. For full details refer to the Health Protection Agency Guidance for public health management of meningococcal disease in the UK, March Scope This procedure relates to the treatment of immediate household contacts of patients admitted to the Newcastle upon Tyne Hospitals NHS Foundation Trust with meningococcal disease. 3 Aims To clarify the process and appropriate treatment of household contacts of patients admitted with meningococcal disease. 4 Duties and responsibilities 4.1 The Executive Team is accountable to the Trust Board for ensuring Trust-wide compliance with policy. 4.2 Directorate managers and heads of service are responsible to the Executive Team for ensuring policy implementation. 4.3 Managers are responsible for ensuring policy implementation and promoting awareness of this policy amongst their employees. 4.4 The pharmacy department are responsible for ensuring that pre-labelled packs of ciprofloxacin tablets and syrup are available as stated. 5 Definitions 5.1 PHE: Public Health England (formally the health protection agency) Page 1 of 4

2 6 The Policy Probable or confirmed case of meningococcal infection Arrange prophylaxis for immediate household contacts (as advised by the PHE) Register Contacts Refer to flow chart below for: Urgent registration - Contacts of patients with meningococcal disease Write prescription First choice agent for prophylaxis: Pregnancy and breastfeeding Chemoprophylaxis should be recommended to pregnant and breastfeeding women Ciprofloxacin stat dose Adults and children >12yrs 500mg Children 5-12yrs 250mg Children <5yrs 30mg/kg (max 125mg) Ciprofloxacin contraindicated For example, allergy Ciprofloxacin (as above) or azithromycin PO 500mg stat or ceftriaxone (250mg IM injection reconstituted with 2ml 1% lignocaine) Rifampicin twice daily for 2 days Adults and children >12 years: 600 mg Children 7-12 years: 300mg 5-6 years: 200mg 3-4 years: 150mg 1-2 years: 100 mg 3-11 months: 40mg 0-2 months: 20mg Pre-labelled packs of ciprofloxacin tablets and syrup are available on A&E, Assessment Suite, Ward 1A, Ward 6 and PICU Page 2 of 4

3 Urgent registration Contacts of patients with meningococcal disease RVI/FH Ward Clerk to register patient and obtain PAS number if patient not already registered Ward Clerk to then follow the Registration process, including IFIT creation and tracking processes Ward Clerk to add onto PAS as an OP attendance outside of ward (clinic) Raise prescription and write up R4B on relevant ward Ward clerk to ensure that documents, R4B and copy prescription placed in casenotes see te below te For this group of patients only, if the patient is already registered on PAS and the casenotes are held within the medical records library, the ward clerk must retrieve the casenotes and ensure that all documents are then filed in the casenote folder. If the casenotes are outwith the library the ward clerk should request the casenotes from the holder and file documentation upon receipt, then return casenotes to medical records to be filed Page 3 of 4

4 7 Training There are no specific training requirements for this policy. 8 Equality and diversity The Trust is committed to ensuring that, as far as is reasonably practicable, the way we provide services to the public and the way we treat our staff reflects their individual needs and does not discriminate against individuals or groups on any grounds. This document has been appropriately assessed. 9 Monitoring compliance Compliance with this policy will be monitored by the Directorate of Pharmacy and Medicines Management. Standard / process / issue Monitoring and audit Method By Committee Frequency Registration of contacts (100% compliance) Appropriate chemoprophylaxis recommended (100% compliance) Identification of patients via PHE records Antimicrobial pharmacist and PHE. Medicines Management committee Once every year Both only apply where the chemoprophylaxis is supplied by the Trust 10 Consultation and review This policy has been updated by Kathy Gillespie on behalf of the Directorate of Pharmacy and Medicines Management in consultation with Clinical Informatics (Andrew Allen), The Out Patient Services Manager (Debbie Banks) and Public Health England (Jon Lawler) 11 Implementation (including raising awareness) specific actions are required as each case is dealt on an individual basis by the PHE in conjunction with Trust staff. 12 References Health Protection Agency Guidance for public health management of meningococcal disease in the UK March Associated documentation t applicable Page 4 of 4

5 The Newcastle upon Tyne Hospitals NHS Foundation Trust Equality Analysis Form A This form must be completed and attached to any procedural document when submitted to the appropriate committee for consideration and approval. PART 1 1. Assessment Date: Name of policy / strategy / service: Procedure for registration and supply of prophylaxis to the immediate household contacts of patients admitted with meningococcal disease 3. Name and designation of Author: Kathy Gillespie Antimicrobial Pharmacist 4. Names & designations of those involved in the impact analysis screening process: Steven Brice, Assistant Director of Pharmacy 5. Is this a: Policy X Strategy Service Is this: New Revised X Who is affected Employees X Service Users Wider Community 6. What are the main aims, objectives of the policy, strategy, or service and the intended outcomes? (These can be cut and pasted from your policy) This Policy outlines the process for registration and supply of prophylaxis to the immediate household contacts of patients admitted with meningococcal disease. 7. Does this policy, strategy, or service have any equality implications? Yes X If, state reasons and the information used to make this decision, please refer to paragraph 2.3 of the Equality Analysis Guidance before providing reasons: This Policy states what is expected of all Trust staff involved in the registration and supply of prophylaxis to the immediate household contacts of patients admitted with meningococcal disease.

6 8. Summary of evidence related to protected characteristics Protected Characteristic Race / Ethnic origin (including gypsies and travellers) Evidence, i.e. What evidence do you have that the Trust is meeting the needs of people in various protected Groups Staff are expected to comply with policy irrespective of their race / ethnic origin. Does evidence/engagement highlight areas of direct or indirect discrimination? If yes describe steps to be taken to address (by whom, completion date and review date) Sex (male/ female) As above Religion and Belief As above Sexual orientation including As above lesbian, gay and bisexual people Age As above As above Disability learning difficulties, physical disability, sensory impairment and mental health. Consider the needs of carers in this section Gender Re-assignment As above Marriage and Civil Partnership As above Maternity / Pregnancy As above. 9. Are there any gaps in the evidence outlined above? If yes how will these be rectified? Does the evidence highlight any areas to advance opportunities or foster good relations. If yes what steps will be taken? (by whom, completion date and review date) 10. Engagement has taken place with people who have protected characteristics and will continue through the Equality Delivery System and the Equality Diversity and Human Rights Group. Please note you may require further engagement in respect of any significant changes to policies, new developments and or changes to service delivery. In such circumstances please contact the Equality and Diversity Lead or the Involvement and Equalities Officer. Do you require further engagement? Yes X 11. Could the policy, strategy or service have a negative impact on human rights? (E.g. the right to respect for private and family life, the right to a fair hearing and the right to education?

7 PART 2 Name: Steven Brice, Assistant Director of Pharmacy Date of completion: (If any reader of this procedural document identifies a potential discriminatory impact that has not been identified, please refer to the Policy Author identified above, together with any suggestions for action required to avoid/reduce the impact.)