THIS PATIENT GROUP DIRECTION HAS BEEN AGREED BY THE FOLLOWING ORGANISATIONS: CLINICAL COMMISSIONING GROUP: Doncaster CCG, Lancashire CCGs including East Lancashire, Fylde and Wyre and North Lancashire CCGs 9/9/2015 Page 1 of 8
Change history Version number Change details Date 02 Review and minor editing 28/08/2017 9/9/2015 Page 2 of 8 CLINICAL CONTENT OF PATIENT GROUP DIRECTION FOR ASPIRIN 300MG Patient Group Direction Details Date comes into effect 1 st October 2017 Date of expiry and review 30 th September 2019 Staff characteristics: Qualifications Registered nurse, Paramedic practitioner, Emergency Care Specialist competencies or qualifications Continuing training and education Clinical Details Indication Practitioner (paramedic) and Nurse Practitioner Received training to undertake administration and supply of medicines under PGD Has undertaken appropriate training to carry out clinical assessment of patient, leading to diagnosis. Also that such diagnosis requires treatment according to the indications listed in this PGD. 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 and to work within the limitations of individual scope or practice. Emergency treatment of cardiac type chest pains to improve outcomes in acute coronary presentations Inclusion criteria Patients aged 16 years and over presenting with the above Exclusion criteria Hypersensitivity to aspirin, salicylates, NSAIDs including coxibs, or a constituent of the product Active significant bleeding Haemophilia or other major bleeding disorders History of serious adverse reaction, e.g. severe bronchospasm or major bleeding, with aspirin use Pregnancy Breast feeding PGDs should be used only where appropriate, suitable and legal. PGDs should not be routinely used when an independent prescriber is available.
Precautions Aspirin increases the risk of bleeding so caution may be needed in some groups, e.g. peptic ulceration, severe hypertension, receiving drugs that increase bleeding risk, e.g. antiplatelets, anticoagulants, SSRIs, NSAIDs, corticosteroids Some patients with asthma can be sensitive to aspirin where it may cause bronchospasm However in the context of potential thrombotic cardiac events the benefits Management of excluded patients Action for patients not wishing / unable to receive care under this PGD usually outweigh the risks of a single dose use of aspirin Discuss with GP or Clinical Lead or refer. Ensure that a 999 ambulance has been called before taking this step do not delay care! Make patient aware of risks and potential consequences of not taking medicine. Discuss any alternatives if available. Discuss alternative options with GP or Clinical Lead. Document discussion with patient. 9/9/2015 Page 3 of 8
CLINICAL CONTENT OF PATIENT GROUP DIRECTION FOR ASPIRIN 300MG Description of Treatment Name of medicine Formulation and route Strength Dosage Repeated dose instructions Duration of treatment Quantity to supply Legal status Special Precautions Adverse effects Aspirin Oral dispersible tablet 300mg 300mg single dose to be chewed or dispersed in water and swallowed Not applicable Once only 300mg GSL Explain indications, contraindications and cautions (refer BNF) Generally mild and infrequent include: Bronchospasm Gastro-intestinal irritation Gastro-intestinal Haemorrhage (occasionally major) also other Haemorrhage (e.g. Subconjunctival) This is not a complete list. Refer to BNF or SPC (summary of product characteristics) for full information. Advice necessary Provide the patient with the manufacturer s Patient Information Leaflet. Give advice on practical self-care if appropriate, including management of likely symptoms (including fever management where appropriate). Make patient aware of potential adverse effects and the action to take if they occur. Provide appropriate worsening advice describing the range of signs and symptoms to monitor for and the action to take if they occur. Consider whether the provision of health promotion material is appropriate e.g. on smoking or lifestyle factors. Provide any advice relevant to the patient from the Precautions section above. Other advice not relevant as patient will be transferred to hospital via 999 ambulance. 9/9/2015 Page 4 of 8
Prescribing guidance Local CCG guidelines. Relevant NICE guidelines and advice from Clinical Knowledge Summaries. Records and Follow Up Referral arrangements Inform GP as soon as possible Following commencement of treatment arrange acute secondary care transfer Records to be kept Patient s name, address, date of birth and consent given Contact details of GP (if registered) Diagnosis Dose and form administered Batch and expiry details Advice given to patient (including side effects) Signature / name of staff who administered or supplied the medication 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) Any serious side effects attributable to drug should be recorded and MHRA advised via yellow card system found in BNF Follow up Call ambulance for acute transfer to hospital Patient Group Direction, organisation and individual authorisation signatures can be found on the managerial content sheet along with other non-clinical details relating to this patient group direction. 9/9/2015 Page 5 of 8
MANAGERIAL CONTENT OF PATIENT GROUP DIRECTION FOR ASPIRIN 300MG Patient Group Direction Owner Details of Patient Group FCMS (NW) Ltd Direction owner Newfield House Vicarage Lane Blackpool FY4 4EW Patient Group Direction Details Date comes into effect 1 st October 2017 Date of expiry and review 30 th September 2019 Staff characteristics Qualifications Specialist competencies or qualifications Continuing training and education Registered nurse, Paramedic practitioner, Emergency Care Practitioner (paramedic) and Nurse Practitioner Received training to undertake administration and supply of medicines under PGD Has undertaken appropriate training to carry out clinical assessment of patient, leading to diagnosis. Also that such diagnosis requires treatment according to the indications listed in this PGD. 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 and to work within the limitations of individual scope or practice. Patient Group Direction Authorisation Lead Doctor Lead Pharmacist Lead Nurse Dr Jonathon Bundy Magnus Hird Alison O Connor 9/9/2015 Page 6 of 8
Organisational Authorisation for East Lancashire CCG Patient Group Direction for Aspirin 300mg Organisational Authorisation by Gillian Gregory Patient Group Direction Peer Reviewed By Name Position Signature Wendy Lambert Nurse Practitioner 9/9/2015 Page 7 of 8
MANAGERIAL CONTENT OF PATIENT GROUP DIRECTION FOR ASPIRIN 300MG Individual Authorisation BY SIGNING THIS PATIENT GROUP DIRECTION YOU ARE INDICATING THAT YOU AGREE TO ITS CONTENTS AND THAT YOU WILL WORK WITHIN IT. PGDs DO NOT REMOVE INHERENT PROFESSIONAL OBLIGATIONS OR ACCOUNTABILITY. IF THIS IS AN UPDATED OR REPLACEMENT PGD ENSURE THAT ALL OLDER VERSIONS ARE WITHDRAWN FROM USE WITH IMMEDIATE EFFECT. IT IS YOUR RESPONSIBILITY TO MAKE SURE YOU ARE USING THE CURRENT VERSION. NOTE TO AUTORISING MANAGERS: AUTHORISED STAFF SHOULD BE PROVIDED WITH AN INDIVIDUAL COPY OF THE CLINICAL CONTENT OF THIS PGD AND A PHOTOCOPY OF THE AUTHORISATION SHEET SHOWING THEIR AUTHORISATION. Name of Professional Signature Authorising Manager Date 9/9/2015 Page 8 of 8