1. ZOE MENEILLY LABOUR WARD SISTER SUPERVISOR OF MIDWIVES SOUTH EASTERN TRUST Supervision In Action Guiding Midwives Through The Medicines Maze

2. 2010 New medicine kardex introduced province wide Training rolled out Medicines workshops for SOM’s Audit of kardex included in SOM record keeping audit

3. Som workshops Midwives and medicines LSA medicines management for midwives working party set up The medicines nerd is born!

4. Meanwhile, back at the ranch.......... THE EXTENT OF THE PROBLEM out of date PGDs No PGD register No midwife able to give exact details of existing PGDs No formal PGD/ exemptions training Midwives not utilising exemptions legislation No agreed method of documenting admin under exemptions

5. PGD working group (2011) Supervisor representation Included: PD midwife, governance MW, pharmacy governance, medical representation Streamline number of PGD’s / eliminate unnecessary Update required PGD’s Reduce duplication of medicines covered by exemptions legislation / increase use of exemptions by midwives Create PGD registers for all areas Agree exemptions recording method Look at training needs

6. 16/01/12 PETHIDINE 100MG IM MW EXEMPTION 16/01/12 PHENERGAN 50 MG IM PGD

7. Medicine Kardex Audit AREA AUDITEDYES %NO % PATIENT LABEL/ NAME ON ALL IN USE PAGES 2872 ALLERGY STATUS RECORDED 964 NAMED CONSULTANT RECORDED 8416 TIME RECORDED ON ALL ENTRIES 6832 ALL ENTRIES DATED 8812 ALL REGULAR PRESCRIPTIONS GIVEN AS PRESCRIBED 693 REASON FOR OMITTED DRUGS CORRECTLY RECORDED 0100 ALL ADMINISTERED MEDICINES SIGNED FOR 6040 USE OF PGD CORRECTLY RECORDED 7228 USE OF MIDWIVES EXEMPTION CORRECTLY RECORDED 6139 MEDICINE CORRECTLY IDENTIDIFIED AS PGD OR MIDWIVES EXEMPTION 5248 STAFF GROUP RECORDED FOR MEDICINES GIVEN UNDER PGD OR MIDWIVES EXEMPTION 0100

8. More work was needed More training sessions planned Rolled out to midwifery led units Medicines and PGD folders created for all areas Laminated aide memoires created

9. Medicines Training (2012) Agreement from HOM to role out medicines and exemptions training for midwives, trustwide. Sessions arranged in ulster maternity, lagan valley and Downpatrick MLU’s and community Certificates of attendance given Drawbacks – not made mandatory so no time given for staff to attend. Not always staff who need it most that attend

10. 2012 – Small Interruption In Progress!

11. 2013- Back on Track Some confusion still evident Formal training programme negotiated and starting in FEB All year groups at QUB now receiving consistent exemption and PGD training

12. Dreams……. Northern Ireland midwives formulary Province wide maternity medicine kardex Pharmacology module at QUB

14. Questions?