Administration of Drugs Regulations, Drug storage, Calculations, Administration

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Administration of DrugsRegulations, Drug
storage,Calculations, Administration Patient
Identification

• 01.10.09

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The administration of drugs involves

• Ensuring
• correct drug
• at the correct time
• is given to the correct patient
• it has the expected and desired
• outcome, with no ill effects

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The administration of drugs includes

• Monitoring the efficacy of the drug
• Identifying side effects
• Not giving a drug to a patient who is allergic to
  it

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The administration of drugs by nurses is
Controlled by the NMC

• It requires professional thought and judgement.
• Ensuring the prescription is correct
• The timing is appropriate.
• Ensuring the patient understands what they are
  taking
• Reinforcing the positive effects of the treatment

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• Drugs given legally in hospital must be
• Correctly prescribed
• Dispensed appropriately
• They must then be
• Administered at the correct time
• Taken by the patient in the presence of the nurse
• Recorded on the medicine chart

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Prescription of medication

• Medications must be prescribed by a Registered
  Medical Practitioner
• Should be clearly written, typed or computer
  generated, and be indelible and dated
• If a drug replaces a previously prescribed drug
  then the outdated one must be cancelled, signed
  and dated.
• Information regarding changes in medication must
  be communicated to all who need to know,
• Nursing staff
• Patient

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• Prescriptions for medication in hospital
• must include the following information
• Clear identification of the patients
• Name
• Date of Birth
• Registration number
• Number of doses or length of treatment

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• Prescriptions for medication in hospital
• must include the following information
• Clear identification of the patients
• Name
• Address
• Length of course (either in days or number of
  tablets to be dispensed)

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All prescription of medication must give the
following information

• The substance to be administered (drugs name)
• Its form (e.g. tablet, capsule, suppository,
  injection, liquid)
• Amount of active ingredient (i.e. dosage)
• Timing frequency
• Route of administration
• All prescriptions must be signed and dated by the
• prescribing doctor

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DRUG classifications

• Drug use and supply in Britain is controlled by
  The Medicine Act of 1968 Poisons Act 1972 The
  Misuse of Drugs Act 1971
• Drugs are divided into the following categories
• General Sale Medicines GSL
• Pharmacy Medicines P
• Prescription only medicines POM

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DRUG classifications

• The Misuse of Drugs Acts 1971 controls any drugs
  which may cause addiction, and which are open to
  misuse and is divided into five Schedules.
• Drugs covered by the Schedule 2 are also
• known as Controlled Drugs

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Scheduled Drugs

• Schedule 1
• Drugs which may not be used for medicinal
  purposes, but can be used for Research in under
  special conditions
• Schedule 2
• The CONTROLLED DRUGS - Opiates such as Heroin and
  major stimulants such as Amphetamines which can
  be supplied by a pharmacist on receipt of a
  prescription from a Registered practitioner such
  as a Doctor or Dentist
• Special regulations control the safe custody,
  use and destruction of these drugs.

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Scheduled Drugs

• Schedule 3
• Minor stimulants and barbiturates, such as are in
  this group. Records such as invoices and
  prescriptions should be kept for two years
• Schedule 4
• Benzodiazepines are in this group. As are
  Anabolic steroids and Androgenic steroids
• Schedule 5
• Weak preparations of controlled drugs with
  minimal risk of abuse. Invoices must be kept for
  two years

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Controlled Drugs

• All details must be completed in the Doctors own
  handwriting
• Name of drug
• Dose of drug
• Number of doses or length of course
• Signature of prescribing doctor and date

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Storage of Controlled Drugs

• They must be kept in a locked cabinet
• or cupboard
• The keys to the cabinet must be in the possession
  of an authorised person
• Authorised person, refers to Ward Manager or
  deputy who must be a Trained Nurse or Midwife
• Students should not be responsible for the
  controlled drug cupboard keys

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Recording of Controlled Drug Use

• Records in the form of CONTROLLED DRUG REGISTERS
  must be kept
• Each drug must have its own specified page which
  is Headed with the Drugs name and Strength
• The Number of Ampoules of a drug must be entered
  and updated with every use

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Recording of Controlled Drug Use

• Must record
• Date
• Time
• Dose of every administration
• Name of receiving patient/client
• Number of ampoules at start and finish of
  administration
• Entry must be signed by 2 people one of who
• must be registered
• No alterations must be made to the entry
• All entries must be in Black Ink

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Giving of drugs in Emergency situations

• A local protocol agreed by Medical
• Practitioners, Nurses, Midwives and
• pharmacists may allow a Qualified Nurse
• to give a specific Dose of a specific drug
• in emergency situations

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Giving of drugs in Emergency situations

• Drugs should not be given in response
• to telephone messages
• They may, in an emergency be given on
• a faxed order or E-mail if the drug has
• previously been supplied to that patient.

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Standards for administering medicines

• Revision
• Correct drug
• At correct time
• Given to the correct patient
• Has expected and desired outcome, with no ill
  effects

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Standards for administering medicines

• The accountable nurse must therefore ensure
• that he/she
• Has an understanding of the drug they are giving,
  this includes understanding its therapeutic
  purpose
• Must be able to justify their actions
• Is prepared to be accountable for their actions

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• Is certain of the identity of the patient
• Aware of current patient needs, the programme of
  care and other drugs the patient is currently
  receiving
• Pay due regard to the environment in which care
  is being given
• Ensure prescription/medicine container agree and
  all writing is clear, unambiguous and complete

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• That the patient is not allergic to the drug
• That the drug has not reached its expiry date
• If there has been a withdrawal notice issued by
  pharmacy, that it does not relate to the drug
  being given

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Management of Drug Errors

• All errors or incidents occurring during the
  administration of drugs must be reported to the
  line manager immediately

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Drug calculations

• To calculate a drug dose, use the following
• formula
• What you want X The amount its in
• What you have got

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• What you want X The amount its in
• What you have got
• Example If you need to give 1000mgs of a drug
  which comes as 500 mgs tablets, how many tablets
  will you need to give the patient
• 1000 X 1 2 X 1 2 Tablets
• 500 1

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• What you want X The amount its in
• What you have got
• Example If you need to give 250mgs of a drug
  which comes as 125 mgs in 5mls liquid format,
  then you need
• 250 X 5 2 X 5 10 mls
• 125 1

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• What you want X The amount its in
• What you have got
• Example If you need to give 24mgs of a drug
  which comes as 30 mgs in 5mls liquid format, then
  you need
• 24 X 5 4 X 5 4 mls
• 30 5