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|Guidelines for student nurses, midwives and allied health professionals on the management of medicines |

These guidelines do not replace local trust policies, which take precedence. Local policy must be adhered to at all times.

Introduction

This Guideline summarises the University of Southampton’s advice regarding medicines management.

All student nurses, student midwives and Allied Healthcare Professionals (AHP) students (except Occupational Therapy students) must observe and/or participate in the administration of medicines

during their programme of education.

These guidelines and local medicine administration policies should be discussed at the beginning of each practice placement experience.

Registered practitioners and students must be aware that whenever a student is involved in the administration of medicines, the registered practitioner maintains the responsibility and accountability for all related activity including: the ordering, receipt, storage, preparation, administration and disposal of medicines and the maintenance of all associated documentation

.

Professional regulatory body guidance must be adhered to at all times.

Statement of Intent

The University of Southampton confirms its commitment to partnership working with placement providers. The aim of the Guideline is to ensure that Professional regulations are upheld and that adverse events are avoided during learning experiences; the guideline does not supersede or replace Local Trust Policies.

Responsibility of the student

With the direct supervision of the registered practitioner, the student should follow the 6 rights of administration (right person, right drug, right dose, right route, right time, and right documentation) by:

• . identifying the correct service user

• . selecting the prescribed medicine

• . calculating the required dosage

• . identifying the correct timing of the prescribed medicine

• . preparing and administering medicine

• . recording the administration appropriately

• . challenging incorrect documentation

The student must demonstrate an understanding of the 5 rights of their own knowledge base (action, side effects, and contraindications, patient education and right to refuse) by:

• . identifying the reason for prescribing, supplying and administering the medicine

• . understanding the action of the medicine

• . having an awareness of possible adverse effects & contraindications

• . the ability to recognise adverse effects & contraindications

• . discussing medication appropriately with patient and families

Responsibility of the Mentor

During each practice placement the mentor should assess the student’s proficiency in administering medicines. The student’s level of proficiency must be recorded in their assessment document.

The student should increase their level of proficiency in all aspects of medicine administration, including the signing of the prescription sheets where applicable, but always under the direct supervision of the qualified practitioner. The prescription sheet must be countersigned by the registered practitioner.

Profession Specific Guidance

|Students cannot be involved in |With the direct supervision of a |Related activities in which students|Under the direct supervision of a |

|administering medicines via the |midwife or first level nurse the |cannot participate but may observe: |registered podiatrist the student |

|following routes: |student should be involved in | |should be involved in the |

| |administering medicines via the | |administration of medicines via the |

| |following routes: | |following routes |

|Intra-dermal |. oral |Verbal orders to administer medicine|Parenteral administration of |

|peripheral cannula |sublingual |without a written prescription |relevant medicines for subcutaneous |

|central venous cannula |buccal |Patient group directives |digital nerve block |

|flushing lines with transducers |nebulised |Cytotoxic medicine administration. |Direct application to the skin, |

|epidural |inhaled |Ultraviolet therapy |nail, or nail bed/matrix |

|intra-thecal |intranasal |arterial cannulation |Direct application of dressings to |

|intra-osseous |topical | |skin and/or wounds |

|intra vesicle |trans-dermal | | |

|arterial lines |intramuscular | | |

| |subcutaneous | | |

| |vaginal | | |

| |rectal | | |

| | | | |

| | | | |

| |Oxygen must be prescribed and | | |

| |students may be involved in the | | |

| |administration of oxygen in | | |

| |accordance with local trust policy. | | |

| | |NB Student Midwives with the direct |NB Student Podiatrists, under the |

| | |supervision of a registered |direct supervision of a registered |

| | |practitioner should be involved in |podiatrist, may be involved in the |

| | |Patient group directives |supply or sale of medicines under |

| | |Ultraviolet therapy |statutory exemptions |

Guidelines for specific situations

• Keys: Under no circumstances are students permitted to be responsible for the practice placement’s medicine keys.

• Patient group directions (PGD): All students, except midwifery students, may observe but cannot participate in the following:

• Supply or administration of medicines under patient group directions (PGD) including supplementary prescribing via clinical management plan.

Controlled Medicines:

• Administration of controlled drugs should involve 2 practitioners, one of whom should be a registered nurse or midwife. All students may act as a second checker if local policy allows. In practice with direct supervision of the person administering the drug, the student may:

• “Sign out” controlled medicines in the controlled medicine register as the second person

• Participate in the administration of controlled medicines

• Students must not order, receive or dispose of controlled medicines

• Administration of Fluids (nursing and midwifery only): Students may administer prescribed, pre-prepared 0.9% sodium chloride or dextrose saline via an existing intravenous or subcutaneous line. This activity must be checked and the connection supervised by a midwife or first level nurse who has deemed the student competent to perform this skill.

• This is the only situation where the student can participate in the administration of intravenous or subcutaneous fluid.

• Oral Suspensions (nursing and midwifery only): Students may participate in the preparation / reconstitution of oral medicines such as suspensions with the direct supervision of the midwife or first level nurse.

• Return to practice nursing students (RTPS): RTPSs attend a study day on medicine administration early in their course. Following attendance at the study day, RTPS’s should be involved in the administration of medicines in accordance with the guidance in the RTPS assessment of practice document.

Other policies to be read in conjunction with these guidelines

• Medical devices (related to infusion devices)

• Vena-section

• Central venous line monitoring

• Blood transfusions

• Complementary medicines/therapies

• Statutory exemptions for podiatrists

• Health Professions Council Standards of Proficiency

References

Health Professions Council (2009), Standards of Proficiency Chiropodists/Podiatrists, London: Health professions Council.

National Prescribing Centre (2007) 2ndEd. A guide to good practice in the management of controlled medicines in primary care (England). National Prescribing. Centre. Liverpool

Nursing and Midwifery Council (2008) Standards for medicine management. NMC. London

Royal College of Nursing. (2005) Standards for Infusion Therapy, RCN. London

Royal Pharmaceutical Society of Great Britain (2005) The Safe and Secure Handling of Medicines, A Team Approach; A Revision of the ‘Duthie Report 1988’. Royal Pharmaceutical Society of Great Britain.

|Status: |Approved |

|Originated by: |Cathy Sullivan, Practice Learning Committee |

|Date of Approval |2011/12 academic year |

|Updated |May 2012 – Updated Branding |

|Effective from (date) |Immediate Effect |

|Date for review |2012/13 academic year |

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