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 studiesto provide a learning opportunity toaid 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

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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 NorthumbriaUniversity 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).

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: / Date:

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 / 2 / 3 / 4 / 5 / 6 / Comments
The nurse/student demonstrates care of the medicine trolley/individual patient locker/homei.e. kept locked when not near it, keptclean and tidy
The nurse/studentchecks 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

Competency criteria / 1 / 2 / 3 / 4 / 5 / 6 / Comments
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.
Competency criteria / 1 / 2 / 3 / 4 / 5 / 6 / Comments
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
Competency criteria / 1 / 2 / 3 / 4 / 5 / 6 / Comments
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
Competency criteria / 1 / 2 / 3 / 4 / 5 / 6 / Comments
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
Nurse/student demonstrates an awareness of the protocols when administering Patient Groups Directives

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

c

3 common anti emetics

a

b

c

3 common cardiac drugs

a

b

c

2 anticoagulants

a

b

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.

3 common non oral medicines (includehow 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

Medicine Administration - Storage and Ordering

Competency criteria / 1 / 2 / 3 / 4 / 5 / 6 / Comments
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 TrustPolicy regarding the storage of medications
The nurse demonstrates the ability to order medication out of hours
Competency criteria / 1 / 2 / 3 / 4 / 5 / 6 / Comments
The nurse demonstrates knowledge of the contents of the emergency cupboardor 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
The nursedemonstrates knowledge on key policy and the custody of keys on the ward/department as appropriate

Comments:

Name, signature and position of assessor and date

1. / 4.
2. / 5.
3. / 6.

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NOTES

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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:-
  • “Other courses available”
  • “Moodle E-Learning”
  • Go to right hand side of the screen and click on “log in”
  • As you are a new user click on the button to create a new account
  • 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.

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