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Northumbria Healthcare NHS Foundation Trust Medicines Administration Assessment Log Northumbria Healthcare NHS Foundation Trust uses a system of continuous learning for nurses to build upon current and previous studies to provide a learning opportunity to aid competency in medicines administration. The log covers medicine assessment, medicine administration, pharmacology and risk. All Trust Nurses must achieve and demonstrate competence in all sections of the log, if applicable to the clinical area, before she/he can carry out unsupervised medicine administration or act as a second signatory for Controlled Drug (and routine drugs) and I.V. fluid checks. Students and their mentors should refer to the relevant sections of their practice Assessment Document when using this competency log and link their learning with the on line training provided through Northumbria University (Authentic World - Safe Medicate). The Trust’s Medicines Management and Medicines Calculations e-learning packages should also be successfully completed. The Medicines Management e-learning package should be updated every 2 years as part of your mandatory training programme. Knowledge of the Trust’s medicine policies and the NMC Standards for Medicines Management is required by the nurse. Some of the relevant policies include: MM 28 Medicine Management Policy MM 29 Safe and Secure Medicines Handling and Supply MM 31 Adminstration of medicines MM 32 Cytotoxic Medicines MM 33 Controlled Drugs MM 34 Reconsiliation of patients medicines on admission to hospital The log is used to: - demonstrate a thorough understanding of Trust medicine related policies - demonstrate knowledge and competence in relation to medicine administration, and - show competency in carrying out unsupervised medicine administration 1 2008 revised 2013 KW Version 2 GUIDE TO STUDENT NURSES AND MEDICATION Students need the opportunity to experience and participate in procedures relating to medications to achieve competencies and prepare them for when they are qualified practitioners. The following are guidelines for students, mentors and other healthcare professionals, relating to Nursing, Midwifery and Operating Department Practitioner students. These guidelines must be used in conjunction with the student’s practice assessment document and they do not reflect whether student competencies are met or unmet. Knowledge and Responsibility The registered nurse delegating the procedure of administering and checking medication to a student will remain responsible and accountable for the correct administration of medications. The student must be able to demonstrate that they have knowledge and understanding of the Trust’s medication related policies. The student nurse must ensure they have a sound up to date knowledge of the common indications, actions, side effects and normal dosages of medicines that they administer. Drugs must not be administered unless all of these details are known. Students must take very opportunity to develop and enhance their medicine management skills and competence. A student nurse will be able to… Prior to commencing placement all students should have accessed the safe medicate, on line medicine management training at Northumbria University and be able to share evidence of this with the mentors All student must have completed the trusts on line Medicine Management training (Level 2) prior to any involvement in medicine management and provide evidence of the completion of this with their mentor To be actively involved in medicine management, relevant to their stage of training e.g. first year student, first hub to focus on fundamental nursing skills, first year second hub student will start to become involved in basic medicine management. Student will be able to second check a controlled drug from second year, once they have undertaken the relevant on line medicine management training and demonstrated competence. administer subcutaneous and intramuscular medication under supervision once they have Completed the trusts on line Medicine Management training (Level 2) and demonstrated competence second check an IV drug once they have attended the IV study day and demonstrated competence, but not administer (Third year only). 2 2008 revised 2013 KW Version 2 A student nurse must NOT… Administer medication independently Administer Intravenous Medication or fluids Administer medication through a central line Administer medicines following a verbal order. Administer or check cytotoxic medications. Hold the drug keys Name: 3 2008 revised 2013 KW Date: Version 2 The assessor and the nurse/student should discuss and agree how many observed medicines rounds should be completed. As a minimum six drug rounds must be completed per hub placement for students and two drug rounds per spoke placement, if this is possible. The following form should be completed by the assessor placing a tick ( competent) or a cross ( not achieved) in each box. Competency criteria 1 The nurse/student demonstrates care of the medicine trolley/individual patient locker/home i.e. kept locked when not near it, kept clean and tidy The nurse/student checks the inpatient treatment chart for the patient name, Trust number and date of birth The nurse/student reads the whole treatment chart and checks each prescription for: date medicine dose time to be given time last given whether the medicine has already been given allergies appropriate route of medication prescribers signature Compatibility of medications 4 2008 revised 2013 KW Version 2 2 3 4 5 6 Comments Competency criteria 1 The nurse/student demonstrates knowledge of each medicine including the common uses, side effects, contraindications and usual dosage (Check in BNF if not sure) The nurse/student demonstrates safety in checking medicines which he/she does not know (Check in BNF if not sure) The nurse/student demonstrates the ability to question prescriptions for : legibility dose amount side effects or contraindications in relation to the patients condition The nurse/student checks the container, checks correct strip of medication (where applicable), dose and expiry date The nurse/student adheres to infection control policy whilst administering medicines and demonstrates that they wash hands and use alcohol gel appropriately. 5 2008 revised 2013 KW Version 2 2 3 4 5 6 Comments Competency criteria 1 The nurse/student places the medicines into a clean container The nurse/student (under supervision) is able to administer the following medication types appropriately and correctly checks the patients name, DOB and hospital number and allergies again prior to administration. The nurse/student checks the patients identity, i.e. check the patients wristband wristband. (not all routes may be able to be assessed – however the nurse/student should be able and prepared to discuss with assessor issues surrounding each method if unable to be observed) oral (including syrups and liquids) intramuscular rectal vaginal sub cuteanous PEG tube/Nasogastric tube Eye/ear drops and creams/lotions/ointments The nurse/student demonstrates the safety reasons why the medicine must be administered and not left 6 2008 revised 2013 KW Version 2 2 3 4 5 6 Comments Competency criteria 1 The nurse/student demonstrates a thoughtful approach to medicine administration The nurse/student (counter signatory) records medicine administration correctly and demonstrates the ability to record reasons why the medicine is not administered The nurse/student demonstrates an understanding of their accountability for medicine administration The nurse/student demonstrates safe storage and care of medicines 7 2008 revised 2013 KW Version 2 2 3 4 5 6 Comments Competency criteria 1 The nurse/student demonstrates knowledge of the signs and symptoms of anaphylactic shock The nurse/student demonstrates knowledge of the actions which must be taken with a patient who has anaphylactic shock The nurse/student demonstrates knowledge of the action required when coming across a drug that is unlicensed to use for use with a particular group of patients Nurse/Student demonstrates their knowledge of actions required when a drug is recalled by Pharmacy or MR?? Nurse/Student I demonstrates an awareness of the protocols to follow when encountering a patient participating in clinical trials 8 2008 revised 2013 KW Version 2 2 3 4 5 6 Comments Nurse/student demonstrates an awareness of the protocols when administering Patient Groups Directives 9 2008 revised 2013 KW Version 2 General Comments: The nurse/student must demonstrate knowledge of the uses, usual dosage, side effects, contraindications and special directions for the following baseline medicines: (Student Nurses can collate this information throughout their placements but in the final placement of their 3rd year this section must be completed) These completed competency booklets should be retained as evidence and throughout all of your placements should be shared with all of your mentors 3 common oral antibiotics a b c 3 common diuretics a b 10 2008 revised 2013 KW Version 2 c 11 2008 revised 2013 KW Version 2 3 common anti emetics a b c 3 common cardiac drugs a b c 2 anticoagulants a b 12 2008 revised 2013 KW Version 2 3 analgesics include their mode of action a b c 3 medicines used for constipation and their mode of action a b c 3 common controlled drugs a. b. c. 13 2008 revised 2013 KW Version 2 3 common non oral medicines (include how they should be administered and if any special directions need to be followed) a. b. c. 5 other medicines particular to the current area of work a b c d e 14 2008 revised 2013 KW Version 2 Medicine Administration - Storage and Ordering Competency criteria 1 The nurse demonstrates the ability to use ward/clinical area top up systems, or ordering drugs in a timely manner in the home The nurse demonstrates how fridges should be monitored Acute Trust only The nurse demonstrates where movable patient own lockers should be located and why Acute Trust only The nurse demonstrates what to do when a pharmacy delivery arrives on the ward and it is unable to be put away immediately The nurse demonstrates knowledge of the Law and Trust Policy regarding the storage of medications 15 2008 revised 2013 KW Version 2 2 3 4 5 6 Comments The nurse demonstrates the ability to order medication out of hours Competency criteria 1 The nurse demonstrates knowledge of the contents of the emergency cupboard or location of emergency drugs if appropriate The nurse demonstrates how to access the emergency cupboard The nurse demonstrates knowledge of Controlled Drugs ordering, storage and administering procedures The nurse can name and provide examples of the Controlled Drugs Schedules currently used in England 16 2008 revised 2013 KW Version 2 2 3 4 5 6 Comments The nurse demonstrates knowledge on key policy and the custody of keys on the ward/department as appropriate Comments: 17 2008 revised 2013 KW Version 2 Name, signature and position of assessor and date 1. 4. 2. 5. 3. 6. 18 2008 revised 2013 KW Version 2 NOTES 19 2008 revised 2013 KW Version 2 YEAR 1 First HUB Students to complete trust on line medicine management (Level 2) No expectation at this stage of the student being involved in drug rounds SPOKES Again there is no expectation that student are involved in drug rounds, however there may be the opportunity for students to observe medicine management Second HUB From second HUB onwards, students would utilise the medicines administration competency log on every placement, completing 6 drug assessments on each HUB placement, retaining the evidence of completion within their PPDF Students work with their mentors to start gathering evidence of their medicine management knowledge, observe and participate in basic medicine management 20 2008 revised 2013 KW YEAR 2 YEAR 3 First contact/Supporting long term care/Acute/Critical Care Student will attend the face to face IV administration training as part of the final placement programme of education. By the end of the first contact placement, the student should have completed the trust e-learning package for drug calculating doses via Moodle eLearning Print certificate of completion and share this with their mentor. By the end of year 2 all students should have completed the Adverse Drug Reactions eLearning training via Moodle eLearning Students will continue work with their mentors to start gathering evidence of their medicine management knowledge, and participate in all aspects of medicine management, under direct supervision of a registered nurse/ODP/Midwife Version 2 Students will continue work with their mentors to enhance the evidence of their medicine management knowledge, and participate in all aspects of medicine management, under direct supervision of a registered nurse/ODP/Midwife ACCESSING MOODLE TRAINING VIA THE TRUST INTRANET PAGE Before commencing this e-learning you will need your user name and password that was provided at induction Go to the trust home intranet page Click on the learning centre, down the left hand side of the home page Along top banner click on the e Learning tab Read the information on the screen and run through the check to ensure that you computer is up to date to access this training Progress to the “ready to start” section Scroll down the page until you come across a section that is:o “Other courses available” o “Moodle E-Learning” o Go to right hand side of the screen and click on “log in” o As you are a new user click on the button to create a new account o Once logged in this will then take you into a list of e-learning course that you can undertake at any point within you three years training. You will be able to access this training at work, university or at home. Remember to print out a certificate or evidence of completion of the training, share with your mentor and retain within your PPDF as evidence. 21 2008 revised 2013 KW Version 2 22 2008 revised 2013 KW Version 2