Out of hours supply of medication by nurses on the children s ward.

Transcription

1 Out of hours supply of medication by nurses on the children s ward. Next review Page 1 of 5

2 Protocol: Executive Summary: Out of hours supply of medication by nurses on the children s ward. This protocol is to enable nursing staff to dispense over-labelled packs of approved medication and previously labelled medication on the children s ward. Supersedes: Description of Amendment(s): This protocol will impact on: nursing staff and patients. This process will allow the timely discharge of patients by minimising any delays due to medication supply, particularly out of hours. Financial Implications: None Procedural area: Children s ward Document Reference: Version Number: 1 Effective Date: January 2017 Issued By: Author: Sally Chartres Lead Pharmacist Sally Chartres Lead Pharmacist APPROVAL RECORD Review Date: January 2019 Committees / Group/Job title Date Consultation: Paediatric SQS Jan 2017 Approved by Chief Pharmacist: Approved by Clinical Director Medicines Management Group Dec 2016 Joanne Shippey, Matron Nov 2016 Paediatric Consultants Nov 2016 Kashif Haque (MMG) Dec 2016 Dr Mudiyir Gopi (SQS) Jan 2017 Nurse supply of medication Page 2 of 5

3 1. References to other standards and procedures: Refer to: Safe and Secure Handling of Medicines Policy Discharge Policy ednf Policy 2. Overview The standard should be that discharges are written and dispensed during pharmacy opening hours. However, on the children s ward, patients are often admitted and then discharged during evenings and weekend afternoons when pharmacy is shut. This protocol describes the process for nurses to dispense patient labelled packs of agreed medication from ward stock, out of pharmacy opening hours for patients being discharged from the ward or POBS patients. The authorisation to supply this medication is via a completed electronic notification discharge form (ednf) which is signed by the prescriber. 3. Objective To ensure that patients can be safely discharged with the appropriate quantities of agreed medications in a timely manner. 4. Procedure Prescribing The details of all medication required by the patient on discharge should be added to the ednf (electronic discharge notification form) by the prescriber. The ednf must be signed by a qualified prescriber and completed in a timely manner. The discharge prescription should be completed in accordance with the Trust Medicines policy. The prescriber must check whether the patient has any allergies or other contraindications before prescribing medication. The prescriber must be aware of the patient s usual medication, so that suitability for newly prescribed medicines can be assessed e.g. for drug-drug interactions. Supply of medication Nurses must not issue medication to patients unless the ednf is completed and signed by the prescriber. A permanent, qualified member of nursing staff can supply medication from the following approved list of PLPs (pre-labelled packs of medication). They can also dispense medication that has been previously labelled by pharmacy, for that patient. The full course of antibiotics should be given to the patient. If this is not possible (e.g. for antibiotic liquids with a short expiry date) the patient should be asked to come back to the hospital pharmacy to collect the rest of the course. In this case, the pharmacy should be notified of the ednf and, by ringing the dispensary on ext giving the name and hospital number of the patient and details of the medication required. Patients should not, routinely, be told to get further supply from their GP. However, this may be appropriate if they live a long way from the hospital and for some reason were unable to collect. This should be the exception rather than the rule. Nurse supply of medication Page 3 of 5

4 For antibiotic liquids, the appropriate amount of water (as directed on the bottle) should be added and the bottle shaken well. The discharging nurse should select the required pre-labelled packs as indicated on the prescription and complete the labels with the patients name and the date in the designated area on the medication label. If an antibiotic liquid is being dispensed, the appropriate expiry date should be added to the label Medication previously labelled by pharmacy for the patient may also be dispensed on discharge out of hours. A self check should be performed to ensure: -the correct drug has been selected -the directions match those on the discharge prescription -the appropriate quantity has been dispensed -the product is within its expiry date The patient s identity and allergy status should also be checked in accordance with Trust policy. Medication packs should not be split. If the course of medication is limited and is less than the contents of the pack the patient should be counselled to stop taking the medication at the required time and to dispose of the remaining medication appropriately When the medicines are assembled the nurse should open the medication tab on the ednf and in the pharmacy column annotate with the word ward. The second checking nurse must document their name and their role (i.e. second-checking Nurse) in the Additional Pharmacy Notes section. Two signatures need to be signed on the label ensuring no essential information is obscured. When each drug has the pharmacy column filled in then click the save change button at the bottom right hand of the screen. Select no, to the clinical check section, dispensing and accuracy check and Save changes as described above. This will sign the ednf off. The three copies can be printed off in the usual way. The medication should be given to the patient, and the appropriate counselling on administration directions and possible side effects Patients should also be given a copy of their discharge prescription The following medications are available on the children s ward in patient labelled packs: Acyclovir 200mg/5ml suspension Amoxicillin 125mg/5ml suspension Amoxicillin 250mg/5ml suspension Benzydamine throat spray Cephalexin 125mg/5ml suspension Cephalexin 250mg/5ml suspension Chlorphenamine 2mg/5ml suspension Co-amoxiclav 400/57mg/5ml suspension Co-amoxiclav 125/31.25mg/5ml suspension Erythromycin 250mg/5ml suspension Flucloxacillin 125mg/5ml suspension Gaviscon infant sachets Ibuprofen 100mg/5ml suspension Paracetamol 120mg/5ml suspension Paracetamol 250mg/5ml suspension Phenoxymethylpenicillin 250mg/5ml solution Nurse supply of medication Page 4 of 5

5 Prednisolone 5mg tablets Trimethoprim 50mg/5ml suspension There are some other patient-labelled packs of medicines in the reserve cupboard which can also be used for discharge if necessary. The list can be found on the Trust intranet page under hot topics emergency medicines list The patient-labelled packs are marked with (PLP). Other medication which is not available in patient-labelled packs, or is not already labelled with the correct instructions and patient s name, should not be given to patients out of hours. 5. Responsibilities Ward manager It is the responsibility of the ward managers to ensure that this protocol is adhered to on wards and departments where it is implemented. Prescribers It is the responsibility of the prescribers to ensure they complete the ednf in a timely manner. Pharmacy It is the responsibility of the Clinical Pharmacy Services manager to approve the medications that are appropriate to be dispensed by nursing staff as pre-packs within in each individual ward area. Training & Resources Training can be provided by the Pharmacy department where necessary/ requested by the ward manager. Nurse supply of medication Page 5 of 5