Download Chloramphenicol 0.5% Eye Drops

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:
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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:
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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:
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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:
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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:
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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:
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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:
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