1. 1. 1 A prescription is a written instruction from a physician, dentist, etc. , to a pharmacist stating the form, dosage strength, etc. , of a drug to be issued to a specific patient. 1. 2 If social care worker collects medicines for the service user they must ensure that any written policies and procedures for every aspect of handling medicines are adhered too. The registered provider is responsible for ensuring that when care workers give medicines they have the right training and are competent to do so. 1.
1 There are many procedures in place for ensuring the safe transit, distribution and obtaining of medication i. e. Transferring medication from setting to another – a service user may be transferred to another care setting which could include: Hospital admission, Respite care in a social care setting and Permanent move to a care home. When a service user is transferred the Care Manager must ensure that the service user’s medication is sent with them to the new service as the new care service may not have all the current medication available.
The Care Manager will provide the new care service with a copy of the Medication Administration Record as soon as possible. This will inform the new care service which medicines have been taken regularly and whether the person refuses to take any. Obtaining medication in an emergency situation – If you urgently need medication, contact your prescriber immediately to arrange for a prescription. If this isn’t possible, you may be able to get medicine from a pharmacist (chemist) in an emergency, subject to certain conditions.
You must have been prescribed the medicine before by a doctor, dentist or other healthcare professional that is registered in the UK. Also, the pharmacist: * will usually need to see you face-to-face * must agree that you need the medicine immediately * must be satisfied with the dose you have been prescribed before The pharmacist may provide an emergency supply of up to 30 days’ treatment for most prescription medicines, with these exceptions: Obtaining medication as and when required – PRN is an abbreviation that comes from the Latin term “pro re nata.
” Its actual translation to English is “for the thing born,” but its common medical meaning is “as needed. ” It used to identify a medication that can be taken as the patient needs it rather than on a fixed schedule. Many PRN medications can be purchased over-the-counter, and some are available only by prescription. The instructions for over-the-counter PRN medications should be clearly printed on the box or bottle or included on a package insert. When a doctor prescribes PRN medication, the instructions will be printed on the bottle and included on a patient information sheet.
Renewal of prescriptions – When a prescription is written, your doctor may include refills. If you have remaining refills, you can continue to get that prescription filled until you exhaust the number of refills or the prescription expires. If you run out of refills or the prescription expires, you will need to get a new prescription from your doctor. Due to dispensing guidelines, not all prescriptions can be renewed without an appointment with your GP. ??? There are different requirements for the storage of medication in different settings. These are:
Clinical Setting – Medications should be stored in accordance with manufacturer recommendations and/or based on pharmacist experience and instructions. Pharmacy access should be restricted at all times based on employee identification. . Residential setting – In residential care, you can choose to provide medicine storage for individuals in their own rooms and this is essential when the person looks after and takes their own medicines. If you Choose to store medicines centrally, the cupboards must be big enough, well constructed and have a good quality lock.
If the people you care for have bottles of liquid medicines, make sure that the shelf height is suitable or have adjustable shelving. You should not store anything other than medicines in these cupboards. Also the storage of medicines needs to be in the right place. Filing cabinets are not suitable for storing medicines, neither are: Kitchens, bathrooms, toilets, sluices, windowsills or areas next to heaters. These places are too damp or too warm (or both) or unhygienic for storing medicines. The designated place for storing medicines must be secure and only those staff who handle medicines should have access.
It is good practice to make sure that nothing else is stored in a medicine cupboard. Day Services – Every establishment must have a locked medicine cupboard available for the storage of medicines and any over the counter preparations that have been brought to the centre by service users. The decision of where to store medicines should take into account the size of the establishment and the nature of the medicines to be stored but the temperature of the area should not exceed 25 degrees centigrade.
Irrespective of the system in use, all medicines retained and stored by centre staff for service users must be stored in packages/containers as dispensed by the pharmacist or doctor which record: The name of the person, The name of the medicine (preferably the generic and not the trade name), the prescribed dosage, The frequency of administration, The quantity, The date when the medicine was dispensed Domiciliary Care – care and support workers must at all times leave medication in a safe place which is know and accessible to the service user unless it is inappropriate for the service user to have access.
The storage of medicines is usually a matter for service users and their families however special procedures may need to be exercised in some cases to protect a vulnerable service user. Where it is inappropriate for the service user to have access this will identified in the care plan and medication must be kept in a safe place which is known and accessible to relative, care/support workers, health professionals and domiciliary care staff. Non care setting – Medications are often stored and administered in a variety of non-health care settings.
These settings include: primary and secondary schools, Child day care centres, Board and care homes, Jails and prisons. In all these settings, employees frequently are responsible for handling and administering prescription and over-the-counter medications to clients or residents. Some organizations may employ licensed health professionals to directly manage the medication administration process. However, many of these settings have no licensed health professionals involved. Where medications are stored and administered to individuals, written policies and procedures should address the following:
Acquisition of medications (e.g. , from parents, caregivers, pharmacies), Specification of which personnel are allowed access to medications and allowed to administer medications to students, clients or residents, Labelling and packaging of medications managed for students, clients or residents, Storage of medications, including medications that may require refrigeration, Secure storage and accountability of controlled drugs, Limitations on the type(s) of medications permissible for use or storage in the organization. 2.
2Clinical setting – Controlled substances must be secured in a locked room inside the pharmacy and held in a secured device or refrigerator. Personnel gain access to the controlled substance devices via password authentication. Residential setting – In care homes, CDs must be stored in cupboards that meet the requirements of the Misuse of Drugs (Safe Custody) Regulations 1973 as amended unless the resident is keeping and looking after the CDs prescribed and dispensed for themselves. The regulations specify the quality, construction, method of fixing and lock and key for the cupboard.
• The security of the location also needs careful consideration • For safe practice the CD cupboards should only be used for the storage of CDs. Items of Value such as jewellery or money should not be placed here • Only those with authorised access should hold keys to the CD cupboard • If a person in a residential setting is self-administering they can hold their own individually-dispensed supply of CDs in their personal lockable cupboard. Day service setting -If controlled drugs are kept on the premises then a Controlled Drugs cupboard must be provided.
This cupboard must have a certificate for its use from the provider, must be of a certain thickness and fixed to a permanent wall. Domiciliary care setting – All healthcare providers will have and comply with an approved Standard Operating Procedures (SOPs). The SOPs is to be agreed by the relevant Controlled Drugs (CDs) accountable officer, SOPs must cover the following: • Ordering and receipt of CDs • Assigning responsibilities • Storage • Who has access to CDs • Record keeping • Disposal and destruction • Who to alert if complications arise.
Non Care Setting -Medications are often stored and administered in a variety of non-health care settings. E. g. Primary/secondary schools, Child day care, Adult day service centres, Prisons. Without adequate safeguards and supervision, medications present significant risks. Medication errors result if doses of medication are omitted, or if medication is administered to the wrong person, or given in the wrong dose. Controlled medications (e. g. Ritalin, morphine) may be stolen or diverted. Where controlled medications are stored, safeguards should be in place to prevent and detect theft and diversion of controlled drugs.
2. 3Storing medicines the right way and in the right place is vital to ensure that they continue to work properly and that you and your family stay safe. Although many people store their medicines at home in a medicine cabinet, often these are located in the worst possible rooms in the house for the medicine itself – the kitchen or the bathroom. Many manufactured drugs will start to break down in the presence of heat, cold, moisture and light. Since both kitchens and bathrooms can become very warm or damp these are not the best places to keep medicines.
For the same reason, if the bottle or packet calls for refrigeration, it is important that the medicine is stored in a box in the fridge. 2. 4Some medications have specific storage requirements to preserve their effectiveness, some products need storage in an access-controlled environment. It is important to identify products that are at risk of theft or abuse or have the potential for addiction, and to provide increased security for those items. This includes products that are in high demand or have the potential for resale (black market value).
Typical examples are: Narcotics: morphine, opium preparations, pethidine, diamorphine, papaveretum, hydrocodone and oxycodone, dipipanone, and tramadol. Other opioid and strong analgesics: pentazocine, codeine, dihydrocodeine, dextroproproxyphene, dextromoramide, and buprenorphine. Psychotropic drugs: usually the group of drugs called “benzodiazepines,” the more common being diazepam, temazepam, nitrazepam, flunitrazepam, and oxazepam. Clonazepam, used to treat epilepsy, may be found under a different class, and is not always under the same control.
??? There are many possible reasons for the disposal of medication. E. g. Medication remaining after a service user has died, medication that has been stopped by the prescriber, refused doses of medication, medication that has gone beyond the ‘use by’ date. 3. 2Nursing care setting – A care home (nursing) is required to safely dispose of clinical waste from the premises. It will now be necessary for the care home to make arrangements for the collection of waste medication as well as other clinical waste products with a licensed waste disposal company.
Disposal of medicines on site through the sewage system is not appropriate. Care setting & domicilliary care setting – All care settings should have a written policy for the safe disposal of surplus, unwanted or expired medicines. When care staff are responsible for the disposal, a complete record of medicines should be made. The normal method for disposing of medicines should be by returning them to the supplier. The supplier can then ensure that these medicines are disposed of in accordance with current waste regulations.
In England, care homes (nursing) must not return medicines to a community pharmacist but use a licensed waste management company. Controlled Drugs – Special arrangements apply to the disposal of CDs in care homes registered to provide nursing care in England & Wales: • If supplied for a named person: denature CDs using a kit designed for this purpose and then consign to a licensed waste disposal company • If supplied as a ‘stock’ for the care home (nursing): an authorised person must witness the disposal.
For all other social care settings, the CDs should be returned to the pharmacist or dispensing doctor who supplied them at the earliest opportunity for safe denaturing and disposal. When CDs are returned for disposal, a record of the return should be made in the CD record book. It is good practice to obtain a signature for receipt from the pharmacist or dispensing doctor. 3. 3Each year enormous quantities of unused and expired medications are dumped into bins or flushed down toilets and sinks.
The effects on the environment and human health are still unclear but evidence is pointing to the presence of chemicals from prescriptions and over-the-counter medications in soil, drinking water and the surrounding environment. Just as proper medication administration is important, so is safe and cautious disposal. Effects of Unsafe Drug Disposal on the Environment After medications are dumped into the bin or flushed down the sink or toilet, they can make their way into the water supply and soil.
Despite the chemical levels being low, this can still be sufficient enough to cause harmful effects on our health and the environment. The potential for these chemicals to end up in sources of drinking water is also cause for concern. Safe Use and Disposal of Medications – Because there is a great deal of evidence indicating that flushing over-the-counter and prescription drugs into the water system have a harmful effect on the environment, it’s important that each person does his or her part to safely dispose of drugs in an environmentally-safe manner.
Recycling – Some medication bottles, particularly natural health supplements, can be recycled. Bottles will need to be cleaned and labels should usually be removed. You may be fortunate to find a location close to your home or it may be that you need to travel to a nearby town. Contact your local recycling depot for information on recycling empty bottles.