Standard Operating Procedure

Transcription

1 Medicines Management within CWPT Crisis Resolution and Home Treatment Teams Standard Operating Procedure Revision Chronology Version Number Effective Date Reason for Change Version 1.0 Version: Author: Designation: Responsible Director: Target Audience: V1 Amanda Kelso Deputy Chief Pharmacist Medical Director Approved By: Approval Date: January 2015 Review Date: January 2017 All staff working within CWPT crisis and resolution home treatment teams Mental Health Drug and Therapeutics Committee 1

2 CONTENTS Standard Operating Procedure Title SOP Number 1 Version 1 Effective Date Review Date Superseded Version Number & Date (if applicable) Author Medicines Management within CWPT Crisis Resolution and Home Treatment Teams Amanda Kelso (Deputy Chief Pharmacist Mental Health) CONTENT: 1. Purpose 2. Procedure for the supply of medication 3. Procedure for the storage of medication 4. Procedure for the issue of pre packed medication against a prescription 5. Procedure for the issue of pre packed medication against a Patient Group Direction 6. Procedure for the use or disposal of patients own medication 7. Procedure for documenting administration, observation of medication administration and supply of small quantities of medication (e.g. one dose, one day etc.) 8. Procedure for use of a blister pack to supply small supplies of medication 9. Medicines reconciliation 10. Verbal prescription/remote prescribing 11. Appendices Responsible Personnel Name Date All CWPT Crisis Team Staff January

3 1. Purpose This standard operating procedure covers aspects of safe and secure handling of medication that specifically relate to Crisis Resolution and Home Treatment Teams (CRHT) across Coventry and Warwickshire Partnership Trust. The SOP must be read in conjunction with the Trust Medicines Policy 2012 and the associated Medicines Manuals (in particular MMG17). Also see Safe and Secure Safe Handling of Medicines: Essential Standards applicable to all CWPT Wards/ Teams Storing Medicines produced by the Medicines Management Team. 2. Procedure for the supply of medication to CRHT 2.1 CRHT hold medication within the team base as either; STOCK MEDICATION for administration only PRE-PACKS OF MEDICATION for issue/administration against a prescription or covered by a Patient Group Direction MEDICATION PRESCRIBED FOR A SPECIFIC PATIENT 2.2 Stock and pre packed medication are supplied against an agreed stock list by held by Lloyds Pharmacy. A designated nurse is responsible for ordering these medicines from pharmacy to maintain the agreed stock level using the team stock list or interim stock order pad. 2.3 Stock lists are jointly reviewed and agreed by the Medicines Management Team and appropriate staff within CRHT 2.4 Stock received must be checked against the order and signed to confirm that the items have been received. Any discrepancies must be reported to the supplying pharmacy. 2.5 Pre-packed medication received from pharmacy must be logged into the team using the form in appendix A 2.6 Medication prescribed for a specific patient can be supplied by a number of methods depending on the needs of the individual team. This includes; FP10 prescriptions Trust out patient prescription for dispensing at Lloyds Pharmacy Trust prescription/administration sheets alongside short term leave cards for dispensing at Lloyds Pharmacy. 2.7 When CRHT hold patients own medication to be supplied on a doseby-dose basis the prescribing and therefore dispensing arrangements must reflect this. Medication packs should not be split/re packaged by CRHT. Prescriptions dispensed by Lloyds pharmacy using Trust outpatient prescriptions or short term leave can be dispensed as specified by the team e.g. 1 day, 2 day etc. Instalment dispensing via 3

4 FP10s is not permitted so if short period dispensing is required a separate prescription for each supply period is required. 2.8 Prescribed medication must be recorded in the patient notes by either a copy of the prescription or recording the medication and length of prescription supplied 3. Procedure for the storage of medication 3.1 All medicines must be stored in line within the Trust Medicines Policy 3.2 Patients own medicines must be kept separately from stock, a separate part of the same cupboard is appropriate. 3.3 Pre-packs must be kept separately from stock medication, a separate part of the same cupboard is appropriate. 4. Procedure for the issue of pre packed medication against a prescription 4.1 A pre pack may be issued by a qualified nurse against prescription written out of hours for an item that is available as a pre-pack 4.2 The qualified nurse must Select the correct pre-pack from the CRHT stock of pre-packed medicines Add patient name and date of supply to the pre-pack Record on the prescription prepack issued on (date), quantity (number) Record the details on the pre-pack medication log (appendix A) to book out the pre pack used File the original prescription in the notes and a copy in the designated folder which is stored with the pre pack medication log 5. Procedure for the issue of pre packed medication against a Patient Group Direction 5.1 Follow patient group direction 5.2 If supply/administration is to be undertaken; Select the correct pre-pack from the CRHT stock of pre-packed medicines Add patient name and date of supply to the pre pack Record the details on the pre-pack medication log (appendix A) to book out the stock used File the original Record of use of PGD (appendix C from the PGD) in the patients notes and file a copy in the designated folder which is stored with the pre-pack medication log 4

5 6. Procedure for the use or disposal of patients own medication 6.1 Any medicines that are prescribed by a GP/psychiatrist and dispensed by a pharmacy or under local protocols by nursing staff are the sole property of the patient. 6.2 Use of this medication for administration it may be deemed in the best interest of the patient for this medication to be kept at the team base and administered over a series of visits. The patient should consent to this procedure and this should be documented 6.3 Where this medication is no longer required it should be responsibility of the patient/carer to return no longer required medication to community pharmacy for destruction. However where there are safety issues around excessive medication or where overdose is considered likely, it may be deemed appropriate to remove the medication for the purpose of disposal. Permission should be sought and must be clearly documented in the patient s notes, along with date and time and signature of team member and patient/carer. If medication is removed without permission, reasons for this should be clearly explained along with date, time and signature of the team member taking responsibility for its removal. Medication can then be disposed of via the pharmaceutical waste bins (see appendix B) or by taking the patients own medication to a community pharmacy for destruction. 6.4 For controlled drugs see Medicines Manual 26 Controlled Drugs 7. Procedure for documenting administration, observation of medication administration and supply of small quantities of medication (e.g. one dose, one day etc.) 7.1 CRHT patients that are fully self-administering do not require a prescription/administration sheet to be written by a prescriber (unless used for supply via a short term leave prescription) 7.2 CRHT patients that are not fully self administering i.e. those patients to which CRHT visit to administer, observe administration or supply small quantities of medication require a prescription/administration sheet to be written by a prescriber. See Medicines Manual 2 for prescription writing guidance. 7.3 This record must include all the patients medication. If the physical health medication is not being managed by CRHT (e.g. GP continuing to supply) document GP supply for those items. 7.4 These prescription/administration sheets are used to record daily administration, observation or short-term supply of medication. 5

6 7.5 They must be stored in a folder containing the all team s prescription/administration sheets. 7.6 The prescription administration sheets must be clearly marked to indicate what is being recorded; administration medication is individually handed to the patient for immediate observed consumption (as on wards). Only a qualified nurse in CRHT must under take administration. For each item sign to document the administration on the prescription/administration sheet and record in EPEX medication administered see kardex observation staff observe the patient taking the medication but do not handle it. Any appropriate member of CRHT can under take this. For each item record SA for self-administration on the prescription/administration sheet and record in EPEX- medication observed see kardex supply staff provide the medication for taking later, unobserved. Any appropriate member of CRHT can under take this.for each item and dose supplied record TTO on the prescription administration sheet and record on EPEX medication supplied for (number) dose/days see Kardex. If supply is for one week or longer the use of a prescription administration sheet is not required and clear documentation in patient notes is acceptable e.g. one weeks medication has been given to the patient 8. Procedure for use of a blister pack to supply small supplies of medication 8.1 Blister packs may be requested when patient specific medication is prescribed and supplied to aid CRHT to provide small quantities of medication to patients 8.2 Required days are cut from the blister pack using clean dry scissors ensuring time of day and day of week are still visible. Ensure if mid week strips are removed, that the remaining days are maintained and still attached to the front cover. 8.3 Photocopy labels and medication description information from blister pack supplied by pharmacy. 8.4 Staple photocopied information to cut out section of the blister pack for supply to patient. 8.5 Document supply as in section above. 9. Medicines Reconciliation 6

7 9.1 It is good practise that the Trust Medicines Reconciliation procedure is followed for all patients admitted for care under CRHT 9.2 Once completed the medication history form should be scanned and uploaded onto EPEX 10. Verbal prescription/remote prescribing 10.1 The procedure as defined in the Medicines Manual 3 verbal prescription must be followed. Then follow section 2,4 or 7 of this SOP as appropriate. 11. Appendices A - Log B Waste 7

8 Appendix A Record of Pre-Packs Supplied from Home Treatment/Crisis Team Date Enter number of packs received into stock Enter number of packs removed from stock Please tick if you are doing a weekly stock check? Enter total balance remaining on shelf. PLEASE COUNT Enter name of Prescriber/or nurse following Enter clients PGD name Enter name of staff removing item/undertaking stock Please record if check/booking stock the balance is into cupboard correct? Yes/No Prescription PGD Verbal Prescription/Orders 8

9 Appendix B 9

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