Monitoring & Supporting use

Session 3 Describe what is involved in ordering prescriptions and collecting medicines from the pharmacy. Describe how medicines should be stored correctly and disposed of safely Explain how service users should be monitored after medicines have been administered Explain how to protect and promote service users’ rights Describe the importance of Patient Information Leaflets

Monitoring & Supporting use Repeats Changes of medication or dose Verbal orders – phone Emergency prescriptions

Re-ordering repeat medication Do not let the service user run out of medicines Allow at least 48hrs for prescriptions to be ready at the Drs - some require more time. Remember to allow dispensing time at the Pharmacy – i.e. 72hrs minimum E.g. order on Wednesday morning    pick up on Friday afternoon

Running out of Medication For whatever reason, there may be occasions when a medicine runs out. Every effort should be made to prevent such occurrences, but if it does happen then you can either: Contact the doctor’s surgery and get an urgent prescription issued Contact the pharmacist who may issue an emergency supply of the medicine if the prescriber cannot be contacted and the need for the medicine is crucial. As the law concerning the supply of medicines is so strict there are specific requirements that need to be met in all of the above options.

Activity 16 & 17 Page of workbook

Stock control How much is there? Where is it? Use in date rotation Expiry dates – specific attention to eye preparations, GTN tablets, Dipyridamole SR Capsules – other examples

Storage of medicines Refrigerated Homely remedies – Over the counter Internal and external Security Oxygen

Disposal of Medicines Out of date No longer required Death of client – procurator fiscal Record keeping In Care at Home dropped or refused doses can be disposed of in the normal household waste. Medication should be safely and securely wrapped before disposing in the outside waste bin. Under no circumstances should medication be flushed down the toilet. Ideal practice would be to return to the community pharmacy to be destroyed.

Activity 18 Page 56 of workbook

SIDE EFFECTS: WHAT TO LOOK FOR Always suspect a side effect when a service user reports a new symptom Especially if a new medicine has been added Look in the Patient Information Leaflet Drowsiness or dizziness risk of falls Constipation Diarrhoea Nausea and vomiting Rashes Discuss with Community Pharmacist/ GP / Service user or OOH, NHS24 / Line Manager

Activity 19, 20, Page 59 & 61 of workbook

Consent  Service users who can understand and respond to information about their medicines must consent to their treatment  If the assessor feels that the service user no longer has the ability to give informed consent, they will consider further assessment under Adults with Incapacity Act (Scotland) 2000

Confidentiality  All information must be kept secure and not disclosed to anyone without consent  Regulated by Data Protection Act 1998

Freedom of Choice  When service users rely on support from staff It is important to ensure that within this support as much choice as possible is retained for service users.  Choice = Feel good about yourself  No choice = reduced compliance  Self administration of medication is an effective way of giving service users control and choice.

Activity 21 & 22 Page 63 of workbook

Patient Information Leaflet (PIL) All medicines must be supplied with a patient information leaflet. This lists examples of what the medicine may be for There will be contra-indications listed – when you should not take this medicine Side-effects will also be listed – gives an idea of whether to contact doctor when a new symptom occurs

What if there are changes out of hours? At times there needs to be changes to the service user’s medicines out of normal hours An evening or a weekend An emergency procedure form may be needed If you are filling one in remember to double check each thing written on the emergency form If there is one with the service user’s MAR make sure the MAR is updated as soon as the Pharmacy or GP can do so.

Service User Name Address Verbal information (if applicable) Received from Designation Date/Time Form completed by: Designation Date MEDICINE MANAGEMENT: EMERGENCY PROCEDURES FORM (Appendix 5) _____________________________MEDICAL PRACTICE MEDICATION TO BE ADMINISTERED CodeCode Medication name, form and strength Numbr of dose units to be given Administration timesSpecial Instructions Breakf ast Midd ay meal Teati me Bedti me Othe r times ADDITIONAL INFORMATION

MCQ’s