Background In response to a perceived increase in patient needs and associated increase in workload, a simple analysis of nursing activity highlighted a need to revisit working practices and procedures. Of particular note for this poster was that each day 15 hours of registered nurse (RN) time was dedicated to the administration of ‘as required’/PRN controlled drugs (CDs) along with additional (unmeasured) time required to administer those on a recurring prescription.
Optimise symptom management
Administer CDs alongside other medications
Improve response time to requests for PRN CDs
Create efficiencies in RN time management.
Established a time limited working party to consider and modernise CD working practices. The group comprised:
Two staff nurses
Ward manager and sisters
CD Accountable Officer/registered manager
Consider relevant aspects of The Misuse of Drugs Regulations 2001, Controlled drugs regulations and associated guidance
Developed a robust and safe approach to CD management
In conjunction with NHS England, a thorough risk assessment was completed.
Results A system has been devised which will make greater use of named patient CDs (oral/transdermal) rather than ‘stock’ CDs; this will enable:
Storage of named patient CDs (regular prescriptions and PRN) in high quality medicines cupboards at each individual patient’s bedside
Secure and prompt access to the cupboards by registered nurses
Single nurse administration of these CDs supported by a robust system of checks and balances
Fully revised Standard Operating Procedures (CDs)
Scope does not include parenteral medications.
Rapid access to PRN medications when needed
Timely administration of regular prescription CDs and non-CDs; thus, a more responsive approach to much needed symptom management
Reduced time locating stock cupboard keys
Reduced risk of incorrect administration.
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