Download midwife formulary pilot workshop - Healthcare Improvement Scotland

Workshop to introduce local
selection of monographs from
national midwifery formulary
Welcome and Housekeeping
Introductions
 Breaks and refreshments
 Fire alarms
 Facilities
 Mobile phones and pagers
 Programme of the day
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Programme
0830 – 09345
Introduction, Pre course work discussion,
presentation – use of Midwife Formulary,
Clinical Governance, Patient Safety Agency
0945 – 1015
BREAK
1015 – 1200
group workshop and feedback
1200 – 1230
1230 – 1300
Completion of Multiple Choice Questionnaire
(MCQ) – 20 questions, with access to reference
materials
Next steps - Portfolio, Evaluation
MCQ feedback, certificates of attendance
Aim
By the end of the workshop the
participants will be able to clarify and
define roles and responsibilities in
relation to medicines and use
monographs the local NHS board has
selected from the national midwifery
formulary within their sphere practice.
Objectives
Demonstrate safe practice in the administration of medicines by
working within the legal and ethical framework that underpins the use of
Midwife Exemptions arrangements and atient Group Directions.
Apply knowledge of safe and effective medicines management in
relation to PGD’s, and local policies.
Apply knowledge of the legal status of medicines and of how the status
for the same medicine can vary with pack size, formulation, indication
and dosage.
Describe the indication, dosage, contra-indications, caution, side
effects and the categorisation of the medicines in the monographs
selected by your NHS board from the national midwifery formulary.
Document accurately the administration and supply of medicines in the
monographs selected locally from the national midwifery formulary.
Critically evaluate the information on the medicines used within the
midwifery formulary in order to give accurate information to women.
Pre course Worksheet
Click to add local information
The administration of medicines is an important
aspect of professional practice of persons
whose names are on the council’s register. It is
not solely a mechanistic task to be performed in
strict compliance with the written prescription of
a medical practitioner (now
independent/supplementary prescriber). It
requires thought and the exercise of
professional judgement.”
NMC 2007
Governance
Medication has become increasingly
complex in recent times
 Medication error is a major cause of
preventable patient harm
 You have an important role in making
medication use safe

Insert local board information
Heat target of 15% reduction in
medicine errors
 Current situation…

Knowledge Requirements
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Understand the scale in medication error
Understand the steps involved in a patient
using medication
Identify factors that contribute to medication
error
Learn how to make medication use safer
Understand your responsibility when using
medication
Steps in using medication
Prescribing
 Administering
 Monitoring

Note – self administering over the counter
medicines ( GSL) or at home
Choosing an appropriate medication for a given clinical
situation taking individual factors into account eg
allergies
Selecting the administration route, dose, time and
regimen
Communicating details of the plan with :
- woman
- whoever will administer the medication
( record /transcribing)
Documentation
How do medicine errors
occur?
Inadequate information about medicine indications and
contraindications
Not considering individual factors such as allergies,
pregnancy, co-morbidities or other medications
Wrong patient, wrong dose ,wrong time, wrong
medicine, wrong route
Inadequate communication ( written, verbal, electronic)
Documentation – illegible, incomplete, ambiguous
Mathematical error when calculating dosage
Ambiguity

Tegretol 100 mg
 S/C
 1.0 mg
 .1 mg

Tegreto 1100 mg
 S/L
 10 mg
 1 mg
Avoiding
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Avoid trailing zeros e.g write 1 not 1.0
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Use leading zeros e.g. write 0.1 not .1
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Know accepted terminology
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Write neatly print if necessary
How can administration go
wrong?
Many wrongs….
Wrong patient
 Wrong route
 Wrong dose
 Wrong time
 Wrong drug/medicine
 Omission, failure to administer
 Inadequate documentation

The 8 Rs
Right drug
Right route
Right time
Right dose
Right patient
Right effect
Right education
Right documentation
What women are most at risk
of medicine error?
Some suggestions…

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
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Women on multiple medication
Women with another medical condition e.g
essential hypertension, renal impairment,
substance misuse
Women who cannot communicate well
Women who do not take an active role in their
own medication use
Children and babies (dose calculation
required)
How do we contribute to
medicine error?
Inexperience
Rushing/ Doing two things at once
Interruptions
Fatigue, boredom, being on “automatic pilot” leading
to failure to check and double check
Lack of checking and double checking habits
Poor team work and/or communication between
colleagues
Reluctance to use memory aids
Know your medicines well

Do your homework on medicines you
administer – BNF
 Pharmacology
 Indications
 Contraindications
 Side effects
 Special precautions
 Dose and administration
 Regimen
Why have we selected monograph from
the national midwifery formulary for our
local use?
 Developed to support midwifery practice
in administration of medicines
 Evidence based practice tool with clear
guidance for midwives role in
administering medicines relevant to
practice
 NMC extension to exemption medicines
list
Student Midwives
Exemption medicines
 Patient group directions
 Controlled drugs
 Prescribed medication
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Skill station
Multiple Choice Questionnaire
Next Steps
Portfolio and competency assessment
Evaluation
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Pre course reading
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Pre course MCQ

Workshop

Portfolio
Thank you