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MEDICATION ADMINISTRATION

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MEDICATION ADMINISTRATION Topic 1A Drug Schedules * Orders should not be obliterated. Identify the schedules of drugs relevant to nursing practice It is the Poisons ... – PowerPoint PPT presentation

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Title: MEDICATION ADMINISTRATION


1
MEDICATION ADMINISTRATION
  • Topic 1A
  • Drug Schedules

2
Identify the schedules of drugs relevant to
nursing practice
  • It is the Poisons and Therapeutic Goods Act 1966
    ( NSW ) who impose some limitation on the use of
    many potent drugs by restricting their
    distribution to certain groups or persons trained
    in handling them and permitting their
    administration only on medical authority.

3
It is the Poisons and Therapeutic Goods Act
provides for the establishment of a Poisons List,
which consists of eight schedules.
4
SCHEDULED DRUGS
  • ( DANGEROUS POISONS )
  • Extreme danger to life. Only available from
    Medical Practioners
  • e.g. Atropine, Arsenic

5
2. Medicinal Poisons Poisons for therapeutic use
which are available to the public only from
pharmacies. Dangerous to life if misused or
carelessly handled. e.g. Panadol, Aspirin,
Codeine
6
3. Potent Substances
  • Poisons for therapeutic use, which are dangerous
    or liable to abuse. Their availability to the
    public is restricted to supply by pharmacists and
    medical practioners/ dentists/ vets.
  • e.g. Insulin

7
4. Restricted Drugs
  • Substances which in the public interest should
    be supplied only on the written prescription of a
    medical practitioner, dentist or veterinary
    surgeon.
  • e.g. Oral hypoglycaemic agents, Cortisone
  • Barbiturates.

8
4D. Prescribed Restricted Substances
  • Substances which are also only available to the
    public on the prescription of an authorised
    person. These substances are treated differently
    because of their potential for misuse and abuse.
  • e.g. Diazepam, Midazolam

9
5. Domestic Poisons
  • Poisons of a hazardous nature, which are readily
    available to the public but require caution in
    handling storage and use.
  • e.g. Bleach, Hydrogen peroxide

10
6. Industrial and Agriculture
  • Substances which should be readily available to
    the public for agricultural, pastoral,
    horticultural, veterinary, photographic or
    industrial purposes or for the destruction of
    pests.
  • e.g.Phenol

11
7. Special Poisons
  • Poisons which require special precautions in
    manufacture, handling, storage or use or special
    individual regulations regarding labelling or
    availability.
  • e.g. Insecticides

12
8. Drugs of Addiction
  • Substances which produce addiction or have such
    potential. A drug register must be kept.
  • e.g. Morphine, Pethidine

13
STORAGE
  • Nurse in charge of the ward is responsible for
    the storage of all drugs. Must met legal
    requirements that is security, temperature and
    stock rotation.
  • Storage should be such a way that it minimises
    errors

14
GENERAL SCHEDULE 4 MEDICATIONS
  • Must be stored out of patient and public access.
    ( locked cupboard, locked room or locked
    medication trolley ).
  • Keys kept by the nurse in charge of the ward or
    their delegate who must be a registered
    /authorised enrolled nurse.
  • Emergency or anaesthesia trolleys are exempt for
    locked storage

15
DRUG KEYS
Please note that Drug keys must be kept from
ward keys.
16
SCHEDULE 4 APPENDIX D
  • Liable to abuse
  • Stored separate from all other drugs except S8
  • No other goods should be stored in the same
    place ( e.g. cash, keys )
  • S4D Drug key and S8 keys can be kept together
    but with no other ward keys and carried by an RN.

17
SELF MEDICATIONS
Stored in a secure bedside storage that is
inaccessible to other patients or visitors e.g.
locked bedside drawer to which the patient may
hold the key.
18
STORAGE IN ORIGINAL PACKS
  • All drugs should be stored in their original
    packs or containers as received from Pharmacy

19
MEDICATION INCIDENT REPORTING
  • Part of quality improvement programs, should
    have a system in place.
  • All disciplines should be encouraged to report
    incidents even near miss incidents
  • Drug committee for review.
  • Circular Incidents Reportable to the
    Department 97/58.

20
MEDICATION ORDERS
What do you think should be included on the
medication order ?
21
Medication Order
  • Must use a patient medication chart ( area
    health logo )
  • Allergies/ adverse drug reactions
  • Clear, legible and unambiguous
  • Patient full name, DOB,MRN and or address.
  • age, weight of a paediatric patient

22
Medication Order
  • Name of medication ( what name trade chemical or
    generic ?? )
  • Strength of medication
  • Form of medication
  • Dose, route, and frequency
  • Date of cessation, total number of doses or
    finite time period of administration.

23
Medication Orders
  • Signature and date. Each individual medication
    order must be written in a separate box and each
    medication order must be signed.
  • To cease a medication order the MO must draw a
    line across the area of the chart where
    administration is recorded ( after the last entry
    ) and sign and date adjacent to this line.

24
Medication Orders
  • If a drug is not to be given on certain days,
    the prescriber must cross out those days on the
    medication chart, to prevent errors.
  • Medication orders must not be duplicated so the
    drug is not administered twice in error/

25
Medication Orders
  • A MO should confirm their intention to order any
    dose that could be considered to be unusually
    high by underlining and initialling the dose.
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