Top Tips Medicines Management

CQC are specifically looking at: / What control measures we must demonstrate:
Daily checking routines:
  • records of temperature checking of drug fridges
  • records of resus trolley checking
  • daily reconciliation checks in CD registers
/ All of these are required in our policy to be checked on a daily basis
If there are discrepancies, CQC will expect you to know how to escalate
CQC inspectors WILL check these records
CQC have also started to report on
  • checking of room temperature in drug storage areas
/ please ensure a room temperature check is done on ward areas and there is a written record
Expiry date checking:
  • CQC are physically inspecting contents of cupboards.
/ They are specifically looking for evidence of stock rotation, correct stock levels, and evidence of expiry date checking (please ensure you have a written record)
Storage of medicines:
  • CQC are reporting if keys to medicines cupboards are not controlled properly by staff
  • CQC are specifically looking for medicines that are not secured in the proper storage facility. This includes iv fluids, creams, suppositories, inhalers
  • Ensure doors to drug storage areas are always locked
/ Our requirement is that the keys (including the CD cupboard key) MUST be under the control of the nurse in charge in every service. Please ensure they are not left in a drawer or on a hook.
On ward areas there must be a written sign over record of medicines keys at shift change
Do not leave drugs, creams, inhalers etc on the patient bedside locker. When not in use, they must be LOCKED in the patient's bedside medication locker.
Do not leave drugs at the nurse's station unattended
Do not leave drugs on worktops in the treatment rooms - put in the appropriate iBin if for disposal
NEVER prop open doors to treatment rooms or leave them "on the latch"
Self-administration of medicines
  • CQC are checking if we promote self administration.
/ Where patients are self administering, ensure the correct assessments and documentation are completed and the drugs are monitored accordingly (see policy and procedure on website)
Correct administration of medicines
  • CQC are checking that drugs are administered as prescribed, and if not then an appropriate clinical justification is given
  • CQC are observing administration of drugs on drug rounds
/ Ensure there are no blank squares on inpatient drug charts
A blank means there is no evidence that a drug has been given or not
A clinical decision may be needed based on the response to drug therapy
Please ensure there are strategies in place to avoid interruptions so that concentration can be maintained
Medical gas cylinders
  • CQC checking that cylinders on the wards are free from dust and dirt
/ Main storage may be outside, therefore check they are clean when brought into the clinical area
Be clear who is responsible for this
Patient Group Directions
  • Checking practitioners have received training and competency assessments
/ Please ensure your registers of who has received medicines via PGD are maintained accurately, that all staff are properly signed off on the master copy of the PGD and that previous versions have been archived
Availability of medicines
  • Ensuring prompt drug treatment available to the patient e.g. pain relief
/ Ensure the stock list is available to prescribers e.g. Shropdoc so that something already in stock can be prescribed to avoid delays in getting non-stock items. Check and challenge prescribers
Guidance / information sources
  • Ensure up to date information is being used. CQC are highlighting where they see old versions of BNFs in use
/ Ensure staff have a current BNF or know how to access online versions.
Ensure current versions of guidance are available e.g. antibiotics prescribing guidance
FP10 prescription pads
  • Ensure secure storage and traceability of use
/ FP10s are controlled stationery.
CQC are looking for evidence of correct controls to minimise the risk of inappropriate use
Correct procedures for disposal of unwanted medicines
  • Checking right procedures are followed
/ Please ensure that you have the correct waste bins in use (see Medicines Policy Part 1 for list of drugs that require special handling because they are classified as cytotoxic or cytostatic. You may need purple top bins).

Any concerns or questions please talk to Rita O’Brien out Chief Pharmacist

William Farr house 01743 277500 ext 2241