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NHS Greater Glasgow & Clyde Patient Group Direction (PGD) for Nurses Chloramphenicol 0.5% Eye Drops GG&C PGD ref no: YOU MUST BE AUTHORISED BY NAME, UNDER THE CURRENT VERSION OF THIS PGD BEFORE YOU ATTEMPT TO WORK ACCORDING TO IT Clinical Condition Indication: In the treatment of acute bacterial eye infections and prophylaxis of secondary infection in adults and adolescents. Inclusion criteria: Patients aged 13 years and above In the treatment of blepharitis conjunctivitis stye infected meibomian cyst Prophylaxis of secondary infection following diagnosis and treatment of corneal foreign bodies sub tarsal foreign bodies corneal abrasions conjunctival trauma chemical injury to the eye after incision/curettage of meibomian cyst or minor lid lesions Exclusion criteria: Patients under 13 years of age (see PGD for children) Patients with known aplastic anaemia or a blood dyscrasia Patients with known allergy to Chloramphenicol or any other component of the preparation Cautions/Need for further advice/Circumstances when further advice should be sought from the doctor: If patient is pregnant or breast feeding - must be used only if considered essential and not prophylactically or to treat minor infections Action if patient declines or is excluded: Patients not eligible for or refusing treatment under this PGD will be referred to an Ophthalmologist. Referral arrangements for further advice / cautions: Refer to Ophthalmologist Date Approved: Review Date: Template Version: Avoid prolonged use (over 5 days) as it may increase the likelihood of sensitisation and the emergence of resistant organisms Version: Expiry Date: Page 1 of 7 NHS Greater Glasgow & Clyde Patient Group Direction (PGD) for Nurses Chloramphenicol 0.5% Eye Drops Drug Details Name, form & strength of medicine: Chloramphenicol eye drops 0.5% Route/Method of administration: Topical ocular use Dosage (include maximum dose if appropriate): One to two drops applied topically to each affected eye up to six times daily or more frequently if required. Frequency: Up to six times daily or more frequently if required. Severe infections may require 1-2 drops every 2 hours initially, reducing gradually as the infection is controlled. Severe infections - every 2 hours initially, reducing to every 4 hours after 48 hours Duration of treatment: Infections – 48 hours after resolution or 5 days Prophylaxis – 5 days Maximum or minimum treatment period: Quantity to supply/administer: 5 days ▼Black Triangle Drug:* Legal Category: No Is the use outwith the SPC:** Storage requirements: No 1 bottle of chloramphenicol 10 ml Label has full dosage instructions. Patient name and date added at time of supply by nurse POM Store upright between 2 – 8 °C (in a refrigerator). Do not allow to freeze. Protect from light. Once opened should be destroyed after 4 weeks. * The black triangle symbol (▼) identifies newly licensed medicines that are monitored intensively by the MHRA/CSM ** Summary of Product Characteristics Date Approved: Review Date: Template Version: Version: Expiry Date: Page 2 of 7 NHS Greater Glasgow & Clyde Patient Group Direction (PGD) for Nurses Chloramphenicol 0.5% Eye Drops Warnings including possible adverse reactions and management of these: If patient feels unwell while using this drug contact GP or A/E dept. Advise on possible burning/ stinging, itching, skin irritation and dermatitis. Systemic effects: Several cases of major adverse haematological events (bone marrow depression, aplastic anaemia and death) have been reported following ocular use of chloramphenicol. Contact lenses should be removed during treatment. Use the Yellow Card System to report adverse drug reactions. Yellow Cards and guidance on its use are available at the back of the BNF or online at http://yellowcard.mhra.gov.uk/ Advice to patient/carer including written information provided: Explain treatment and course of action Explain how to administer eye drops:-Wash hands thoroughly; Look upwards , gently pull down the affected eyelid and gently squeeze the bottle until a drop of liquid falls into the gap between the eyeball and lower lid. (lower fornix) Do not touch eye with the tip of dropper Give patient a copy of any relevant patient information leaflet if available Contact lenses should be removed during the period of use Warn patients not to drive or operate hazardous machinery unless vision is clear. If condition worsens or symptoms persist then seek further medical advice Monitoring (if applicable): N/A Follow up: Patient advised to return 48/72 hours if not responding for referral to Ophthalmologist. Date Approved: Review Date: Template Version: Version: Expiry Date: Page 3 of 7 NHS Greater Glasgow & Clyde Patient Group Direction (PGD) for Nurses Chloramphenicol 0.5% Eye Drops Staff Characteristics Professional qualifications: Specialist competencies or qualifications: Registered nurse with current NMC registration Continuing education & training: Competent in treating ophthalmic conditions Has undertaken appropriate training to carry out clinical assessment of patient leading to diagnosis that requires treatment according to the indications listed in this PGD Has undertaken appropriate training for working under PGDs for the supply and administration of medicines The practitioner should be aware of any change to the recommendations for the medicine listed. It is the responsibility of the individual to keep up-to-date with continued professional development. Referral Arrangements and Audit Trail Referral arrangements Records/audit trail: As per local arrangements Patient’s name, address, date of birth and consent given Contact details of GP (if registered) Diagnosis Dose and form administered and batch details Advice given to patient (including side effects) Signature/name of staff who administered or supplied the medication, and also, if relevant, signature/name of staff who removed/discontinued the treatment Details of any adverse drug reaction and actions taken including documentation in the patient’s medical record Referral arrangements (including self-care) References/Resources Notes: Local Protocol and comments: SPC – Summary of Product Characteristics BNF – British National Formulary Date Approved: Review Date: Template Version: Version: Expiry Date: Page 4 of 7 NHS Greater Glasgow & Clyde Patient Group Direction (PGD) for Nurses Chloramphenicol 0.5% Eye Drops This Patient Group Direction must be agreed to and signed by all healthcare professionals involved in its use. The original signed copy will be held at PPSU, Queens Park House, Victoria Infirmary. The PGD must be easily accessible in the clinical setting. Organisation: NHS Greater Glasgow & Clyde Professionals drawing up PGD/Authors Designation and Contact Details *Name: Signature: Designation : Date: Name: Signature: Designation : Date: Name: Signature: Date: E-mail address : Designation: Date: Name: Signature: E-mail address : Designation : Name: Signature: E-mail address : E-mail address: Designation: Date: E-mail address: * Lead Author Date Approved: Review Date: Template Version: Version: Expiry Date: Page 5 of 7 NHS Greater Glasgow & Clyde Patient Group Direction (PGD) for Nurses Chloramphenicol 0.5% Eye Drops AUTHORISATION: NHSGG&C PGD & Non-medical Prescribing Sub-Committee of ADTC Chairman Signature: Date: in BLOCK CAPITALS Lead of the professional group to which this PGD refers: Name: Signature: Date: in BLOCK CAPITALS Pharmacist representative of PGD & Non-Medical Sub-Committee of ADTC Name: Signature: Date: in BLOCK CAPITALS Antimicrobial use If the PGD relates to an antimicrobial agent, the use must be supported by the NHS GG&C Antimicrobial Management Team (AMT). A member of this team must sign the PGD on behalf of the AMT. Designation: Microbiology Name: approval Signature: Date: (on behalf of NHS GG&C AMT) Date Approved: Review Date: Template Version: Version: Expiry Date: Page 6 of 7 NHS Greater Glasgow & Clyde Patient Group Direction (PGD) for Nurses Chloramphenicol 0.5% Eye Drops Local Authorisation: Service Area for which PGD is applicable: I authorise the supply/administer medicines in accordance with this PGD to patients cared for in this service area. Lead Clinician for the service area (Doctor) Name: Signature: Designation: Date: E-Mail contact address: I agree that only fully competent, qualified and trained professionals are authorised to operate under the PGD. Records of nominated individuals will be kept for audit purposes. Name (Lead Professional): Signature: Designation: Date: E-Mail contact address: Description of Audit arrangements: Frequency of checks: (Generally annually) Names of auditor(s): PGDs DO NOT REMOVE INHERENT PROFESSIONAL OBLIGATIONS OR ACCOUNTABILITY. It is the responsibility of each professional to practice only within the bounds of their own competence and in accordance with their own Code of Professional Conduct. Note to Authorising Managers: authorised staff should be provided with an individual copy of the clinical content of the PGD and a photocopy of the document showing their authorisation. I have read and understood the Patient Group Direction. I acknowledge that it is a legal document and agree to supply/administer this medicine only in accordance with this PGD. Name of Professional Date Approved: Review Date: Template Version: Signature Date Version: Expiry Date: Page 7 of 7