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Administration of medicines in the patient hotel

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									     NOTTINGHAM UNIVERSITY HOSPITALS NHS TRUST
             MEDICINES CODE OF PRACTICE
   ADMINISTRATION OF MEDICINES IN THE PATIENT HOTEL

Reference                                           CL / MM/ 016
Date approved                                       17 March 2008
Approving Body                                      Directors’ Group
Implementation date                                 17 March 2008
Version                                             1
Supersedes                                          NCHT Medicines Code of Practice 4th
                                                    Edition 2006
                                                    QMC Medicines Code of Practice 2005
Consultation undertaken                             Medicines Code of Practice Review
                                                    Group
Target audience                                     All NUH staff who deal with medicines
Supporting procedure(s)                             NIL
Review Date                                         Dec 2009
Lead Executive                                      Medical Director, NUH
Author/Lead Manager                                 MMC, NUH
Further Guidance/Information                        Pharmacy Medicines Information

16.1 SUPPLY OF MEDICATION

All Hotel guests must administer their own medicines.
For elective admissions, the guest must provide their own supply
of medicines via their G.P.

Guests transferred from episodes of inpatient care must bring their
supplies of discharge medication with them, (See procedure 3 of
this Medicines Code of Practice.)        Any further supplies of
medicines should be obtained from their G.P where possible, or
from the City Campus pharmacy, once the relevant medical team
has issued a prescription. The guest or an available member of
the Hotel team should collect the medication from the City Campus
pharmacy once it has been dispensed. ‘Out of Hours’ collection
may be requested via the Helpdesk (Maternity Porters).

All medication used by Hotel guests must be clearly labelled with
their name and include directions for use.


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16.1.2 Monitored dosage systems
Guests may have their medication in a monitored dosage system
(dosette, Medidose, Venalink). These are generally filled for one
week.
The monitored dosage system may be refilled by the guest, their
carer, retail Pharmacist, G.P. or District Nurse. Hotel staff must
not re-fill monitored dosage systems.

If the guest cannot arrange to have the monitored dosage system
filled by another party, arrangements must be made for the
monitored dosage system to be re-stocked by the City Campus
pharmacy. A “PRIDE” form (discharge prescription) must be
written by the relevant medical team before this can occur.

Guests must ensure that the monitored dosage system
accompanies them for appointments at NUH, so that any
alterations to medication can be dealt with appropriately. The
Hotel Nurse Co-ordinators cannot alter the medication in the
monitored dosage system once dispensed.

16.2 MEDICINES ADMINISTRATION

All guests in the Patient Hotel must administer their own
medicines.

Where guests are prescribed subcutaneous injections they are be
expected to self-administer this medication. They will be provided
with a sharps bin for the safe disposal of needles and syringes.

 Guests who require insulin are expected self administer their
insulin and are responsible for monitoring their own blood glucose
levels. For these guests the hotel will provide a sharps bin for the
safe disposal of needles and syringes. There is a blood glucose
monitoring device within the Hotel and all Hotel Nurse Co-
ordinators are competent in its use and can assist if necessary.

Any persons accompanying the guest who are also receiving
medication must administer their own medication.


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16.2.1 Assistance with administration of medicines
There may be occasions when a normally independent person
may need assistance with the administration of their medication. In
this instance the Hotel Nurse Co-ordinator may assist the guest
with self-administration.

If self-administration of subcutaneous injections, including insulin,
is not possible the Hotel Nurse Co-ordinator may administer the
injection, following the administration procedure described in
Procedure 8 of this Medicines Code of Practice. A prescriber must
write an in-patient prescription chart or insulin chart for the
medicine, and there must be a second practitioner available to
check the medicine. If this is not possible, the guest must be
returned to the referring ward for administration of the medication.
Thromboprophylactic doses of low molecular weight heparins for
subcutaneous injection do not require a second practitioner to
check the medicine, but they must be prescribed on an inpatient
prescription chart if the Hotel Nurse Co-ordinator is to administer
the dose. See Procedure 8 of this Medicines Code of Practice.

16.3 MEDICINES STORAGE

All medication including any controlled drugs must be stored safely
by the guest. A lockable drawer is provided for storage of personal
medication in each Hotel bedroom.

Where medication must be stored at a low temperature, a lockable
medicine fridge is available for use in the Clinical Room next to the
Hotel reception. Keys to the medicine fridge are held by the Hotel
Nurse Co-ordinator who should accompany the guest when the
medication is required and ensure that the correct medication is
removed. The temperature of the medicine fridge will be checked
and recorded nightly by the Hotel Nurse Co-ordinators in
accordance with Procedure 4 ‘Safety and Security of Medicines’ of
this Medicines Code of Practice.

16.3 ORAL ANTICOAGULANTS

Guests taking warfarin or other oral anticoagulants must have all
their anticoagulation medication correctly dosed on their
anticoagulation dosing sheets. Should any further testing be
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required, the guest will be sent to the ward/clinic at the correct time
by the Hotel Nurse Co-ordinator who must ensure that they take
the anti-coagulation card or booklet with them. This must be
completed and returned to the guest before they take any further
anticoagulation medication.

16.4 VERBAL ORDERS
A prescriber may give a verbal order e.g. warfarin dosage, directly
to the guest by phone. The prescriber must ask the guest to
repeat the dose back to them to ensure they have understood the
dose to be taken. The Hotel Nurse Co-ordinator must not take
verbal orders for medication on behalf of the guest.

16.5 CONTROLLED DRUGS
The Patient Hotel does not have the facilities for the central
storage, recording or assisted administration of CDs. Guests must
store their own CDs in their individual lockable drawers and must
be capable of self-administering their medication, including CDs.
Guests who require assistance with self-administration of
controlled drugs do not fulfil the criteria for admission to the Patient
Hotel.

16.6 POST-NATAL GUESTS
A supply of medicines is available for newly delivered mothers.
This list is agreed by the Supervisor of Midwives and the Head of
Pharmacy in accordance with Part III of the Midwives Act 1968
(prescriptions only) order.

16.7 RESUSCITATION - EMERGENCY MEDICINES
Medicines used for resuscitation purposes are supplied by the City
Campus pharmacy in a sealed box which is checked daily by
nursing staff as per hospital policy. Expired or opened boxes must
be returned to the City Campus pharmacy and replaced on a one
to one basis.

16.8 RETURN AND DISPOSAL OF MEDICINES
A guest’s medication is their own property. The Hotel Nurse Co-
ordinator may only return medication to City Campus pharmacy
with the agreement of the guest, or if the medication has been left
behind for more than 48 hours following discharge of the guest
from the Hotel.
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For details of how to return medicines to City Campus pharmacy
see Procedure 11 of this Medicines Code of Practice.

16.9 DISPOSAL OF CONTROLLED DRUGS

If the guest has supplies of controlled drugs that are no longer in
use, they should be asked to give their consent for either:
• Return of the controlled drugs with a relative or friend to take to
    the issuing community pharmacy
Or
• Return of the controlled drugs to City Campus Pharmacy for
    destruction.
A record of the action taken should be documented in the patient’s
notes. If the controlled drugs are to be returned to City Campus
pharmacy, the Hotel Nurse Co-ordinator must take the medicines
to the City Campus pharmacy situated next to Hogarth Ward. If
this is not possible the Hotel Nurse Co-ordinator should phone City
Campus pharmacy and ask for a pharmacist to collect the
medicines from the Hotel. The pharmacist and the Hotel Nurse
Co-ordinator must complete a “returned to pharmacy” form.

16.10 ILLEGAL SUBSTANCES

See procedure 12 of this Medicines Code of Practice




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Employee Record of having read the Policy


            MEDICINES CODE OF PRACTICE
ADMINISTRATION OF MEDICINES IN THE PATIENT HOTEL

I have read and understand the principles contained in the named
policy.


PRINT FULL NAME                                    SIGNATURE      DATE




Medicines Code of Practice
Administration Of Medicines In The Patient Hotel
Version 1
March 2008

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