SELF ADMINISTRATION OF MEDICATIONS PROGRAMME FOR REHABILITATION & RECOVERY SERVICES AND LOW/MEDIUM SECURE SERVICES

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1 MENTAL HEALTH DIRECTORATE POLICY SELF ADMINISTRATION OF MEDICATIONS PROGRAMME FOR REHABILITATION & RECOVERY SERVICES AND LOW/MEDIUM SECURE SERVICES Originator: Mental Health Policies and Procedures Group Reviewed by: Mental Health Policies and Procedures Group Date reviewed: May 2014 Next review: August 2017 Ratified by: Directorate Healthcare Governance Committee Date ratified: 3 December 2014 Date circulated: 15 December 2014 Paper copies of this document should be kept to a minimum and checks Page made 1 with of 20 the electronic version to ensure that the printed version is the most recent

2 SELF ADMINISTRATION OF MEDICATIONS PROGRAMME FOR REHABILITATION & RECOVERY SERVICES AND LOW/MEDIUM SECURE SERVICES 1. INTRODUCTION PURPOSE RESPONSIBILITIES DISCUSSION WITH THE PATIENT SELF ADMINISTRATION OF MEDICATIONS PROGRAMME REFERENCES... 8 APPENDIX 1 RISK ASSESSMENT... 9 APPENDIX 2 CONSENT FORM APPENDIX 3 PERSONAL WEEKLY ADMINISTRATION RECORD APPENDIX 4 (A) SELF ADMINISTRATION OF MEDICATIONS PROGRAMME: STAGE 1 MONITORING RECORD APPENDIX 4 (B) SELF ADMINISTRATION OF MEDICATIONS PROGRAMME: STAGE 2 MONITORING RECORD APPENDIX 5 SELF ADMINISTRATION OF MEDICATIONS PROGRAMME: STAGE 3 COMPLIANCE MONITORING RECORD APPENDIX 6 SELF ADMINISTRATION OF MEDICATIONS PROGRAMME: TRANSFER OF MEDICINES TO COMPLIANCE AIDS APPENDIX 7 HANDY HINTS TO HELP WITH THE ASSESSMENT APPENDIX 8 PATIENT INFORMATION SHEET INTRODUCTION 1.1 The aim of this programme is that patients learn to administer their own medicines to prepare them for the future. This should be of benefit for the patient s rehabilitation, enhancing understanding of their medicines and reducing re-admission to hospital due to poor medication compliance. 1.2 Self medication allows medication to be taken at the correct time, instead of waiting for a medication round. It provides an opportunity to assess the patient s understanding of their medication and their ability to safely administer their own medication in preparation for regular leave periods and eventual discharge into the community. The process should lead to a more seamless discharge into the community, as the patient has already been assessed and reviewed on their medication administration ability and provided with the necessary information about their medicines. 2. PURPOSE 2.1 This policy outlines the Mental Health Directorate responsibility to ensure that self administration of medications is safe in accordance with the ABMU Health Board Medicines Management Policy, legislative requirements, NHSLA Standards and best practice. 2.2 The policy has been prepared in line with the NMC Standards for Medicines Management (2006) and the Healthcare Commission Report Talking about Medicines The Management of Medicines in Trusts Providing Mental Health Services (2007) which Paper copies of this document should be kept to a minimum and checks Page made 2 with of 20 the electronic version to ensure that the printed version is the most recent

3 highlights that people wishing to self administer should be encouraged to do so or, if deemed inappropriate, should be advised as to the reasons why. 2.3 It applies to patients currently receiving inpatient care within the Rehabilitation/Recovery and Secure Services (low & medium). 2.4 To be able to offer self administration to patients, we need to ensure there is no unacceptable increase in risk to the patient or others. As such, there must be an assessment of competency to self administer. 2.5 Opportunities during the self-medication assessment process are extended to provide education to the patient regarding the importance of medication in their treatment, and for the patient to discuss any concerns they may have about their medication and possible side effects. Increased knowledge and understanding should increase confidence and compliance. 2.6 Self medication should therefore reduce the number of re-admissions to hospital linked to medication problems and will provide increased contact and communication between patients, healthcare staff on the wards and pharmacy staff. 3. RESPONSIBILITIES 3.1 It is the responsibility of the clinical team to ensure that patients are offered the self administration scheme, where clinically appropriate, and to ensure that the safe systems in place are adhered to throughout, enabling a patient to become self reliant and competent to administer their own medication. 3.2 As a registrant you are responsible for the initial and continued assessment of patients who are self administering, and have continuing responsibility for recognising and acting upon changes in a patient s condition with regard to safety of the patient and others. (NMC 2006) 4. DISCUSSION WITH THE PATIENT The patient should be given a Self Administration of Medicines Information Leaflet for their perusal (Appendix 8) and a member of staff should discuss with the patient how the system works, the process of consent and the conditions attached. If the patient wishes to continue with self-administration, then a risk assessment of their suitability should be undertaken (Appendix 1). 5. SELF ADMINISTRATION OF MEDICATIONS PROGRAMME 5.1 Assessment The patient must be assessed by their named nurse, consultant (or delegate) and pharmacist to establish: Mental state Intellectual capacity Sensory perception Observation Likelihood of stay in hospital being long enough to progress through the programme at a pace suitable to the service user Risk Confusion, risk or self-harm, suicidal thoughts, disorientation, risk to self or others Level of understanding Visual or hearing problems, manual dexterity problems Imminent discharge may require an element of fast tracking the process which can affect success Paper copies of this document should be kept to a minimum and checks Page made 3 with of 20 the electronic version to ensure that the printed version is the most recent

4 There are some helpful hints to help staff carry out the assessment in Appendix 6. Patients with a past history of substance misuse do not have to be excluded from self administration of their medication but the need for extra supervision and reinforcement of education should be highlighted and documented. These service users should spend more time on levels 1 and 2 to ensure they receive adequate supervision and education. They may never get to administer at level 3 but they can still be educated at levels 1 & 2. NMC (2006) Risk Assessment (Appendix 1) must be successfully completed and signed by the service user and the multidisciplinary team; a copy should be given to the patient and the original must be placed in the patient s medical notes. The documentation should be available as an integral part of the care and treatment plan and readily accessible for MDT review. Consent Form (Appendix 2) must be completed and signed by the patient and a member of the multidisciplinary team as a witness. A copy should be given to the patient and the original must be placed in the medical notes and a second copy placed with the patient s medication chart. Withdrawal of Consent can take place at any stage, and the consent form (Appendix 2) amended to this effect. Multi Disciplinary Team (MDT) should complete an assessment of each stage of the programme and record using Appendix 1, before the patient moves to the next stage. Approved Patient Medication Leaflets Supply of Medicines When patients are assessed as eligible to start the programme, pharmacy must be contacted to discuss when is the best time to start the programme so medications can be ordered in advance. For all patients who have been assessed as suitable to commence STAGE 2 or STAGE 3 self medication, only individually labelled medicines may be used (i.e. no stock medications). Each item should be individually labelled as for an outpatient prescription including clear instructions. Patients who have been participating in the programme on their previous ward/unit should have their Self Administration of Medicines records checked to confirm their suitability to continue on the programme. If the patient is awaiting a supply of their individually labelled medicine and there is a stock supply of the medicine on the ward/unit, doses should be administered from this supply by the registered nurse not the individual patient until an individual supply is obtained from the supplying pharmacy. 5.3 Implementation Only Registered Nurses can supervise service users participating in the programme. Medicines must be prescribed on the prescription chart. Charts MUST be clearly marked that the patient is taking part in the Self Administration of Medications Programme, and what stage they are on. Stickers are available from pharmacy to place on the front of the charts, and inside at the top of the charts. NB: This is also important for pharmacy when ordering medicines. This patient is SELF MEDICATING Stage (circle) Date started.. Date stopped.. This patient is SELF MEDICATING Stage (circle) Date started.. Date stopped.. This patient is SELF MEDICATING Stage (circle) Date started.. Date stopped.. This patient is SELF MEDICATING Stage (circle) Date started.. Date stopped.. Paper copies of this document should be kept to a minimum and checks Page made 4 with of 20 the electronic version to ensure that the printed version is the most recent

5 Patients at Stage 2 or 3 of the programme should record their medication times on a personal administration record (Appendix 3). Stage 2 custody of the keys will remain with the registered nurse. If individual lockable storage is not available then all medicines must be stored in the ward/unit medicine cupboards to which only designated practitioners / pharmacy staff have access. Stage 3 patients should be supplied with a secure, lockable medicines container which must be able to accommodate all of the medication for storage of their individual medicines. If individual lockable storage is not available then the patient cannot progress to Stage 3. Initially, PRN (as required), once only, variable dose medicines, Controlled Drugs, will continue to be administered by Registered nurses. However, inhalers (even if prescribed PRN) are suitable for the self-administration process. Drugs liable to misuse (e.g. benzodiazepines and Z drugs and injections) must be assessed in individual cases based on risk If required, additional instructions should be provided for the patient (large or bold printed labels). These can be requested from the supplying pharmacy. 5.4 Compliance Aids The use of compliance aids such as dosette boxes to transport medication when service users are away from the ward for a period of time, i.e. activities will be subject to local risk assessment by the clinical team and documented in the clinical notes. Patients must fill the compliance aid themselves, and complete the transfer of medicines form (Appendix 6), under supervision of registered nurse or senior pharmacy technician/pharmacist. Please note that medication transferred will not be labelled and checked by pharmacy. 5.5 Discharge Medication There are two options when a patient on stage 2 or stage 3 of the programme goes on leave or is discharged: The medicines can be obtained in the usual way. A discharge prescription is written and sent to pharmacy to be dispensed, or The medicines dispensed for self medicating on the ward can be used. This option would allow a reduced workload for pharmacy, and potentially a more efficient and quick leave/discharge process. A discharge prescription is written, the medicines on the ward are checked either by nursing or pharmacy staff. Staff must check it is the correct drug, formulation, dose, label (directions, patient name), expiry date and quantity in the container, and they must document this check in the notes, sign and date. The quantity prescribed on the prescription should then match the quantity the patient is given to take out on leave. This process must be agreed on a local ward level. Please note, if the quantity of medicine remaining in the supply is considered too great a risk to take out of the hospital, a leave prescription must be written, and the medicines obtained from the pharmacy in the usual way (Option 1). 5.6 Patient s Personal Record Appendix 3 is for patients to record when they have self administered medication. This is not compulsory, and staff or the patient may decide it will or will not be used. It is hoped that by using the form, patients will feel more included in the process. Paper copies of this document should be kept to a minimum and checks Page made 5 with of 20 the electronic version to ensure that the printed version is the most recent

6 5.7 Stages of Self Administration of Medicines Stage 1: Assessment Stage 2: Self administration with direct supervision Stage 3: Self Administration without direct supervision Stage 1: Assessment Staff will use stock medications to assess a patient s ability to: Approach staff at the correct time and request their correct medication. Registered nurse will then select the appropriate medication, and administer the medication in the usual way. The registered nurse will draw attention to any discrepancies noted, e.g. incorrect medication requested or any not requested, and will administer these in the usual way. The registered nurse must initial the drug chart and record any refusals etc. in the usual way, then complete the monitoring record and note any concerns (Appendix 4A). It is recommended that this stage lasts for 28 days, unless exceptional circumstances dictate otherwise and the period of time is extended. Once the 28-day period is completed, an assessment of the service user s progress must be undertaken by the multidisciplinary team to determine their suitability to move on to Stage 2. The consultant will authorise moving to Stage 2, if appropriate, by signing the authorisation at the end of the assessment in Appendix 1. Patients receiving Depot injections will be given appointment cards and will be expected to request their injection from nursing staff at the appropriate time on the day indicated. Any discrepancies should be noted on the monitoring record, along with any other concerns (Appendix 3), including nurse unavailability at the appropriate time. Stage 2: Self Administration with Direct Supervision Pharmacy will supply an original pack of all regular medications (usually 28-days) which is individually labelled. This must be stored in the ward/unit medicine cupboard. Stock medications must NOT be used. The patient should: (A) Approach staff at the correct time and request their medication. (B) Select the appropriate medication, read the instructions to them, select the correct dose and return the container to the registered nurse, who will then observe the selection and administration of the correct medication. Registered nurse in charge will retain custody of the medicine locker key, but the patient is expected to contact the nurse at the correct time to take their medicine. The registered nurse will draw attention to any discrepancies noted, e.g. incorrect medication or any not selected, and will administer these in the usual way. The patient should be advised to complete their personal administration record (Appendix 3). The registered nurse must initial the drug chart and record any refusals etc. in the usual way, then complete the monitoring record and note any concerns (Appendix 4B). If self administration does not happen within an agreed timescale (usually 30 minutes either side of the administration time), it will be the designated practitioner s Paper copies of this document should be kept to a minimum and checks Page made 6 with of 20 the electronic version to ensure that the printed version is the most recent

7 responsibility to prompt and supply the locker key and observe the selection and administration of the correct medication. Failure to attend at the correct time should be noted on the monitoring record, along with any other concerns (Appendix 4B). It is recommended that this stage should last for a minimum of 28 days. A further MDT assessment of the patient s progress must be undertaken and the consultant will authorise moving to Stage 3, if appropriate, by signing the authorisation at the end of the assessment in Appendix 1. Patients receiving Depot injections will be given appointment cards and will be expected to request their injection from nursing staff at the appropriate time on the day indicated. Any discrepancies should be noted on the monitoring record, along with any other concerns (Appendix 4B). If secure individual storage facilities are not available, this should not be a barrier to commencing the self administration process. However, all medicines will need to be stored securely in the ward/unit medicine cupboards. The patients can still prompt staff to have access to their medicines at the correct times. Stage 3: Self Administration without Direct Supervision Pharmacy will supply seven days of all regular medications which is individually labelled. This must be stored in the patient s secure medicine locker. Stock medications must NOT be used. The patient will have custody of their locker key and their medicines stored in the locker, if available. (If not, custody of the medicines must remain in the ward/unit drug cupboard.) At this stage the patients must have been assessed as competent of self administering their correct medication at the correct time with minimum intervention/supervision from nursing staff, and for their awareness of the security implications for safe storage of their personal medication. Monitoring of the patient s compliance should be carried out by doing spot checks and the Stage 3 monitoring record (Appendix 5) completed. Spot checks must be completed at least once in a 48-hour period, and they can be carried out by registered nurses or pharmacy staff. Registered Nurses are NOT required to sign the medicine chart unless they have administered the medication. They must mark the prescription chart with self for each time the patient has self administrated so that it is clear that the patient is self medicating. Nurses do not then have to write in the clinical notes for every self administration. 5.8 Errors in Medication If an administration error is found to have occurred (or a near miss observed), action should be taken to prevent any further harm to the service user. The patient must be assessed and immediate action taken to ensure their safety. The patient should be re-assessed to determine whether they are able to continue self administration. All incidents and errors should be reported using the ABMU HB Incident reporting process Datix. For all nursing related errors please refer to Mental Health Policy Framework on the Management of Nursing Medication Errors. Paper copies of this document should be kept to a minimum and checks Page made 7 with of 20 the electronic version to ensure that the printed version is the most recent

8 5.9 Accountability ABMU accepts responsibility for the degree of risk involved in allowing normal medicines practices to be waived, but consider that the risk can be minimised by: Careful selection of patients in order to identify and possibly exclude those who may endanger themselves or others. Particular vigilance on the part of staff involved in the operation of this scheme, especially nursing staff within whose professional responsibility medicine administration rests. Ensuring procedures are adhered to and all relevant documentation is completed accurately and filed correctly. Ensuring patients are provided with accurate information to make an informed decision. The nurse is responsible for the initial and continued assessments of patients involved in self-administration. He/she is also responsible for recognising and acting upon changes in a patient s cognitive and/or physical wellbeing that may prejudice their safety in continuing with the scheme. Responsibility for subsequent actions or omissions by the patient rests with the patient. 6. REFERENCES ABMU Health Board Policy on Prescribing, Supply, Ordering, Storage, Security, Administration and Disposal of Medicines. (January 2014) ABMU Health Board Guidance for the Self Administration of Medicines (June 2014) ABMU Mental Health Directorate Policy Framework on the Management of Nursing Medication Errors (May 2014) The Healthcare Commission Talking about Medicines The Management of Medicines in Trusts Providing Mental Health Services (2007) Paper copies of this document should be kept to a minimum and checks Page made 8 with of 20 the electronic version to ensure that the printed version is the most recent

9 APPENDIX 1 RISK ASSESSMENT Self Administration of Medications Programme Risk Assessment Service User: Ward: Current Medication: (any medicines not appropriate for self administration, e.g. CDs?) Knowledge of Prescribed Medication Does the patient: a. Know the names of the medications that they are taking? Yes No b. Familiar with the number of tablets or capsules to take and the frequency? Yes No c. Know what they are taking the medicines for? Yes No d. Is able to identify the tablets or capsules correctly? Yes No If any of the above answers are No, then a decision has to be made as to whether the patient is able to self medicate at this stage, or whether education and a later review is more appropriate. Administration Ability a. Can open containers, bottle-tops, blister packs and cartons? Yes No b. Is able to read the labels? Yes No c. If inhalers, eye drops or other devices are used, can the service user use them correctly? Yes No If any of the answers are No, then a decision has to be made whether comprehensive administration/compliance aids may need to be considered. Other Information a. Does the patient take any non-prescription medication? Yes No b. Does the patient know how to dispose of unwanted medication? Yes No c. Has the patient been told how to obtain further supplies of medicines? Yes No Page 1 of 3 Paper copies of this document should be kept to a minimum and checks Page made 9 with of 20 the electronic version to ensure that the printed version is the most recent

10 Risk Assessment Risk Yes No Level of Risk Comments Tick Tick (high medium, low) Mental health is stable enough to administer their own medicines Understands the importance of taking medicines as prescribed Knows how and when to take their medicines, can read labels and has no obvious visual, hearing or manual dexterity problems Likely to conceal medicines they should have taken Likely to misappropriate medicines and possibly pass on to other patients History of non-compliance The patient has been assessed as suitable/unsuitable (delete as appropriate) to join the self administration of medications programme and agreed to take medicines as prescribed, at appropriate times and to store medicines in safely lockable facilities. Patient s signature: Date: Consultant s signature: Date: Named Nurse s signature: Date: Pharmacist s signature: Date: Risk Levels: HIGH MEDIUM LOW Unlikely to succeed with self administration Likely to succeed with high levels of support Likely to succeed with support Page 2 of 3 Paper copies of this document should be kept to a minimum and checks Page made 10 with of 20 the electronic version to ensure that the printed version is the most recent

11 After MDT review and assessment of patient s progress, it has been agreed that: (Name): should commence: Stage One Doctor s signature: Date: Print name: Comments, if applicable Stage Two Doctor s signature: Date: Print name: Comments, if applicable Stage Three Doctor s signature: Date: Print name: Comments, if applicable It is advised that each stage should last for a minimum of 28 days Page 3 of 3 Paper copies of this document should be kept to a minimum and checks Page made 11 with of 20 the electronic version to ensure that the printed version is the most recent

12 APPENDIX 2 CONSENT FORM Self Administration of Medications Programme Consent to administer own medicines As an essential part of your long-term rehabilitation, the multidisciplinary team has determined that you have reached a stage in your treatment when it would be helpful to you to administer your own medicines. Name: Ward: Consent to administer own medicines The self administration of medications programme has been explained to me and I am willing to take part. I have been made aware that I can withdraw my consent at any time and return to nurseadministered medicines. Patient s signature: Date: Witnessed by: Name: Designation:.. Withdrawal of consent I no longer wish to be involved in the self administration of medications programme and, therefore, I withdraw my consent and wish to return to nurse-administered medicines. Patient s signature: Date: Witnessed by: Name: Designation: Page 1 of 1 Paper copies of this document should be kept to a minimum and checks Page made 12 with of 20 the electronic version to ensure that the printed version is the most recent

13 APPENDIX 3 PERSONAL WEEKLY ADMINISTRATION RECORD Self Administration of Medications Programme Patient s Personal Weekly Administration Record Name: Ward/Unit: Week commencing: Put a tick or your initials in the correct box each time you have taken your medicines Breakfast Time Monday Tuesday Wednesday Thursday Friday Saturday Sunday Lunch Time Tea Time Night Time Comments: Page 1 of 1 Paper copies of this document should be kept to a minimum and checks Page made 13 with of 20 the electronic version to ensure that the printed version is the most recent

14 APPENDIX 4 (A) SELF ADMINISTRATION OF MEDICATIONS PROGRAMME: STAGE 1 MONITORING RECORD Name: Ward/Unit: Week commencing: For each dose administered CORRECTLY put a TICK in the box. For each dose administrated INCORRECTLY put a CROSS in the box. Monday Tuesday Wednesday Thursday Friday Saturday Sunday *see key below B L T N B L T N B L T N B L T N B L T N B L T N B L T N Requests medicines at correct time Knows the correct medication, dose and when to take medication Takes medicine(s) Initials of Registered nurse KEY: I = independently performs tasks P = needs prompting N/A = not applicable B = Breakfast (morning) medication L = Lunchtime medication T = Teatime medication N = Night-time medication Please record any comments overleaf Paper copies of this document should be kept to a minimum and checks Page made 14 of with 20 the electronic version to ensure that the printed version is the most recent Medications Programme For Rehabilitation and Recovery Services and Low- Medium Secure Services (2015).doc

15 APPENDIX 4 (B) SELF ADMINISTRATION OF MEDICATIONS PROGRAMME: STAGE 2 MONITORING RECORD Name: Ward/Unit: Week commencing: For each dose administered CORRECTLY put a TICK in the box. For each dose administrated INCORRECTLY put a CROSS in the box. Monday Tuesday Wednesday Thursday Friday Saturday Sunday *see key below B L T N B L T N B L T N B L T N B L T N B L T N B L T N Requests medicines at correct time Selects correct medicine(s) Reads instructions on labels correctly Selects correct doses Takes medicine(s) Returns medicine(s) to appropriate container Initials of Registered nurse KEY: I = independently performs tasks P = needs prompting N/A = not applicable B = Breakfast (morning) medication L = Lunchtime medication T = Teatime medication N = Night-time medication Paper copies of this document should be kept to a minimum and checks Page made 15 of with 20 the electronic version to ensure that the printed version is the most recent Medications Programme For Rehabilitation and Recovery Services and Low- Medium Secure Services (2015).doc

16 APPENDIX 5 SELF ADMINISTRATION OF MEDICATIONS PROGRAMME: STAGE 3 COMPLIANCE MONITORING RECORD Spot Checks MUST be carried out AT LEAST once in a 48-hour period. Record findings below. Name: Ward/Unit: Week commencing: Name (or letter) of drug dose and frequency Number of doses received Number of doses remaining Monday Tuesday Wednesday Thursday Friday Saturday Sunday Actual Expected Initials Actual Expected Initials Actual Expected Initials Actual Expected Initials Actual Expected Initials Paper copies of this document should be kept to a minimum and checks Page made 16 of with 20 the electronic version to ensure that the printed version is the most recent Medications Programme For Rehabilitation and Recovery Services and Low- Medium Secure Services (2015).doc

17 APPENDIX 6 SELF ADMINISTRATION OF MEDICATIONS PROGRAMME: TRANSFER OF MEDICINES TO COMPLIANCE AIDS Date Service User Ward/Unit Leave Details (if applicable) No. of Days Prepared by Print/Sign (Service User) Checked by Print/Sign (Witness) Medication/Dose/Time to be taken Medication/Dose/Time to be taken Medication/Dose/Time to be taken Medication/Dose/Time to be taken Medication/Dose/Time to be taken Medication/Dose/Time to be taken Medication/Dose/Time to be taken Authorised by: Sign: Paper copies of this document should be kept to a minimum and checks Page made 17 of with 20 the electronic version to ensure that the printed version is the most recent Medications Programme For Rehabilitation and Recovery Services and Low- Medium Secure Services (2015).doc

18 APPENDIX 7 HANDY HINTS TO HELP WITH THE ASSESSMENT The Assessment must take place in a quiet, safe environment where the conversation cannot be overheard by others. A chaperone should be available if the assigned practitioner in charge identifies that a one-to-one session is inappropriate, or if requested by the patient. The following items must be available during the assessment: Medication administration chart (the prescription chart) All the patient s medication including any appropriate PRN (as required) medication Approved patient information leaflets for all medicines being taken (see A self administration of medicines consent to administer own medicines form (Appendix 2) Content of the assessment Talk through the details of the medication administration chart (the prescription chart). The assessment should involve discussion of the following: What a self-medication programme involves Why the patient has been considered suitable to undertake the scheme To confirm whether the patient would like to self administer medicines Assessment of the patient s knowledge and discussion to clarify the medicines they are prescribed, including strengths, doses and timing of doses Assessment of the patient s knowledge and discussion to clarify the reasons for taking each medicine Any side effects experienced and level of concern The possible outcomes of stopping taking medication or not taking as prescribed What to do if a dose is missed Information about the length of time they will be taking the medication The effects of drinking alcohol whilst taking prescribed medication Ability to read a label or whether large print labels are required Ability to open child-resistant containers ( clic-loc caps) or foil packs Counting out tablets and/or measuring liquids Taking medicines with adequate volumes of water (e.g. 100 ml) How to dispose of unwanted medicines How to order repeat medicines from the GP service (if going out into community care) Explanation of each stage of the self-medication scheme and the essential monitoring that will be required by both the patient and staff Reflection time Following the assessment, time must be allowed for the patient to absorb the information and ask questions. If the patient is unable to think of any questions, the following prompts may be helpful: Does my medicine have any other names and what are they? Why am I taking it? How much should I take and how often? Is there a best time to take it? How long will I need to take it? Are there potential side effects, and what should I do if they happen? What should I do if I miss a dose? Does this medication interact with any other medications or with any foods? Does this medication replace anything else I have been taking? Page 18 of 20 Medications Programme For Rehabilitation and Recovery Services and Low-Medium Secure Services (2015).doc Paper copies of this document should be kept to a minimum and checks made with the electronic version to ensure that the printed version is the most recent

19 Where and how should I store it? How soon should I start to feel better? When should I report back to my healthcare professional? Should I avoid any liquids, foods, other substances or activities while using this medicine? Could I become tolerant, dependent or addicted to this medicine? If so, how can I avoid this? Where can I get more information about this medicine? If the directions state I should take the medication every three or four hours, does that mean throughout the night as well as during the day? Is this medication available in a child-resistant container? What is this medication s expiration date? If the service user agrees to participate in the scheme, consent to administer own medicines form should be completed (Appendix 2) and a record made in the medical notes. Patients should be advised they can withdraw from the scheme at any time. A withdrawal of consent form should then be completed (Appendix 2). Page 19 of 20 Medications Programme For Rehabilitation and Recovery Services and Low-Medium Secure Services (2015).doc Paper copies of this document should be kept to a minimum and checks made with the electronic version to ensure that the printed version is the most recent

20 APPENDIX 8 PATIENT INFORMATION SHEET SELF ADMINISTRATION OF MEDICINES Why am I being asked to think about taking my own medicines in hospital? As part of your recovery plan being able to take your own medicines, when you need to, means better care for you. Continuing to take your own medicines also allows you to maintain your independence while in hospital. What will happen if I do want to take my own medicines? A member of the nursing /medical team will need to ask you some questions to make sure it is safe for you to take your own medicines on the ward. You will be asked to consent to taking your own medication to make sure you feel ready to do so. What will happen to my own medicines? Your own medicines will be kept safely in your locked facility. This may be in a locked drawer / locked cabinet in your room. It will usually be possible for you to have a key to this locker. What if I don t have enough of my own medicines, or I start to take something new? Further supplies of your current medicines, or new medicines, will be ordered from pharmacy. These will be fully labelled with instructions and, as well as taking them on the ward, you will be given them to take home. What if I become unwell? If your condition changes, your nurse will assess whether you are still able to take your own medicines. If not, she will take over giving you your medicines until you recover. How can I be sure all this is safe? Make sure you always lock your medicines in your bedside locker and keep the key somewhere safe. Never take more than the dose on the label, and never share your medicines with anyone else. If you are not sure how to take your medicines, ask the nurse, doctor or pharmacist on the ward. If anyone else tries to take your medicines, please contact one of the nurses immediately. What happens when I go home? The doctor will write a prescription for all the medicines you are taking. The ones you have been taking will either be inspected on the ward, or sent to pharmacy. This is to make sure there are enough supplies and they are correctly labelled. Your medicines will be given back in time for you to go home. If you have any questions about the medicines you are taking home, do ask the nurse, doctor or pharmacy staff. Page 20 of 20 Medications Programme For Rehabilitation and Recovery Services and Low-Medium Secure Services (2015).doc Paper copies of this document should be kept to a minimum and checks made with the electronic version to ensure that the printed version is the most recent

21 CID75 published 21 July 2011 Last Review: May 2014 Next Review: August 2017 Paper copies of this document should be kept to a minimum and checks made with the electronic version to ensure that the printed version is the most recent

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