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Clinical

Assessing Competency for Medicines Administration: SOP

Document Control Summary

Status: New

Version: v1.0 Date: 08.12.15

Author/Owner/Title: Cathy Riley - Director of Pharmacy

Approved by: Policy and Procedures Committee Date:

Ratified: Date:

Related Trust Strategy and/or Strategic Aims

Medicines Optimisation Strategy 2013-2018: Making the Most of Medicines

Implementation Date: February 2016

Review Date: December 2018

Key Words: Medicines, Administration, Assessing, Competency, Assessment

Associated Policy or Standard Operating Procedures

Administration of Medicines in the Community Setting SOP Administration of Medicines in the In-Patient Setting SOPMedicines Code

Contents

1. Introduction .............................................................................................................. 3

2. Purpose ..................................................................................................................... 3

3. Scope ........................................................................................................................ 3

4. Body Text .................................................................................................................. 3

5. Process For Monitoring Compliance And Effectiveness ....................................... 4

6. References ................................................................................................................ 4

Appendix 1a ..........................................................................................................................5

Appendix 1b………………………………………………………………………………..18

Appendix 2 ........................................................................................................................ 26

18.02.16

18.02.16Policy and Procedures Committee

SOP: Assessing Competency for Medicines Administration, Dec 2015

Change Control – Amendment History

Version Dates Amendments

v1.0 Dec 15 SOP created from existing Medicines Code V6.10


1. Introduction

This SOP is needed to ensure those who are required to administer medicines to

service users are competent to do so.

2. Purpose The Assigned Practitioner in Charge is responsible for ensuring that prescribed medicines are administered within a reasonable time, plus or minus one hour either side of the prescribed time, with regard to the efficacy of the medication, and possible risk regarding overdose.

3. Scope

Medicines must only be prepared, checked or administered to a patient by the

following categories of healthcare staff:

A Designated Practitioner

A Medical Practitioner

Authorised Pharmacy Staff

A practitioner in training, but only under the direct supervision of a Designated Practitioner.

Other Authorised Employees (e.g. Learning Disabilities)

4. Procedure

1. The Trust has developed a Competency Framework for Medicines Administration (Appendix 1). Each qualified nurse involved in administering medicines will be competency assessed:

Annually as part of appraisal process

After a medicines administration error

On local induction to each clinical area

2. Assessment will normally be conducted by the senior nurse in each clinical area, or in the cases of ward managers, by the service manager (if a nurse) or a senior nurse from the Nursing directorate. There are two competency assessments templates: for in-patient and community services respectively. If a nurse works in both settings, then both competency assessments need completing (with duplicate sections omitted as advised on the assessment). All applicable parts of the competency framework require completion for annual appraisal and during local induction.

3. After a medicines administration error, the assessor should use his/her professional judgement to identify the pertinent parts of the competency assessment framework which require completion; it will not always be necessary to complete the whole assessment. Decision to only complete parts of the competency framework should be made by the ward manager, hospital co-ordinator (duty nurse manager), modern matron or a senior nurse from the Nursing directorate; the nurse assessor should ensure that the nurse’s medicines administration competency assessment was already in date, when making this


judgement (if not, the whole framework will require assessment), and take due account of any recent history of medicines administration errors. The assessor should also identify whether the medicines error also requires competency assessment of any unregistered healthcare worker providing the second check (again professional judgement is allowed to identify the relevant parts of the framework to be assessed). In all cases, incident forms should be completed, and a file note placed on each individual staff member’ file to record action taken and the outcome.

4. The second check provided by an unregistered healthcare worker

provides additional governance around medicines administration. A

competency framework is also developed for the second check function

(see Appendix 2).

5. Process For Monitoring Compliance And Effectiveness

Annual Audit

Administration error monitoring

6. References

Medicines Code


Appendix 1a - Medicines Administration Competency Framework In-patient

Name:

Date:

Designation:

Name of assessor:

Date:

Designation:

Comments:

Purpose of assessment: To assure the quality and safety of medication administration by a qualified practitioner in conjunction with standards for better health; core standards C1A, C4d, D2d, Governance D4, C11 and NPSA competence assessments. The practitioner undergoing assessment will demonstrate by practical methods a comprehensive understanding of the administration of medicines. The assessment will be completed using the following criteria:

− Completion of ward medicine round

− Administration of an intra- muscular injection − For preceptorship staff nurses over three occasions within eight

weeks of registration − For qualified nursing staff annually as part of the individual appraisal

process

− Following a medication error if deemed appropriate by the manage


Prior to assessment it is the individual’s responsibility to familiarise themselves with the documents listed below prior to the assessment commencing.

Please date and sign to Assessor – Please date indicate you are familiar and sign to indicate the with the following trust individual undergoing and professional assessment is able to documents locate the documents

NMC Guidelines for the

Management of

Medicines 2007

Mental Capacity Act

British National

Formulary

Rapid Tranquillisation

Policy

IM administration

Guidelines

Oral administration

guidelines

Standard precautions

and equipment policy for

the control and

prevention of infection

The practitioner undergoing assessment will demonstrate by practical methods comprehension of the administration of medicines via oral and intra-muscular routes.

The Following criteria will be used; A Yes No COMMENTS

Confirm the Validity of the 1. Prescription;

Assure the Identity of the patient is following Trust policy, checking that the patient understands the treatment being given and consents where appropriate.

Assure all detention papers are in


A Yes No COMMENTS

date and accurate

Recorded drug allergies and confirmation of such with the

patient

Assure the prescription is legible

Confirm Start date

Confirm stop date

Confirm drug dosage and strength

Confirm administration route prescribed

Prescribers signature

Specific/other instructions

Assure knowledge of safe storage

and handling of medication , I.E

security of medication, stock

ordering, rotation

2. Assure the Preparation of the dose for

oral administration, in accordance with

the guidelines for oral administration of

medication and calculate doses

accordingly

3. Assure Preparation of the dose for intra-

muscular administration in accordance

with the guidelines for IM administration

of medication

4. Assure Cross checking / double checking

of medication against prescription as per

medicines code 5. Identify Actions to be taken if the

prescription is illegible or invalid 6. Assure evidence of cross checking as

required medication, with the regular prescription, not exceeding daily dose

7. Assure the correct amount of prescribed medication has been placed in the container/ syringe

8. Demonstrate knowledge of SOP for own area for controlled drugs, Trust procedure for administration, storage, loans, wastage, and checks as per medicines code.


B. Following Yes No COMMENTS administration of the

medication, the

practitioner will: 1. Ensure that the patient

has taken the drug 2. For Intra- Muscular

administration evidence that the administration site is observed for immediate adverse effects

3. Sign the medication chart in the appropriate section

4. Note the time and dose given on administration on the prescription chart if a variable dose or I/M has been prescribed

5. Demonstrate accurate / appropriate recording of medication administration on the card and within health records

6. Demonstrate accurate recording following administration of a drug under a PGD

7. Monitor the patient for any side effects and document in health records

The individual undergoing assessment will demonstrate by verbal method knowledge of medication from a current treatment card, containing at least 5 medications one of which will be administered via the intra- muscular route if applicable;

The following criteria will be used:

C. Yes NO COMMENTS 1. Brand name 2. Approved name


3. Drug group 4. Drug usage

- What condition(s) is the drug prescribed for?

5. Indications - What is the drug being used for?

6. Side effects

7. Contra-indications 8. Dosage range

- oral/intramuscular

Signs of, and treatment of: Yes NO COMMENTS 9. Extrapyramidal side effects

10. Neuroleptic Malignant Syndrome 11. Overdose/self-poisoning 12. Dependency/withdrawal

Drug specific: Yes No COMMENTS

13. Dietary needs for MAOI’s

14. Blood monitoring:

Clozaril

Lithium

Anticonvulsants

15. Insulin

16. Controlled drugs

Other Yes No COMMENTS


D) The practitioner undergoing the assessment (if applicable to the clinical area) will demonstrate by verbal method knowledge and understanding of rapid tranquillisation, its implementation, risks and associated benefits D1 What are the aims of rapid

tranquillisation?

D2 When should the use of

I/M administration be considered?

D3 What are the 3 main

agents associated for use within rapid tranquilisation?

D4 What is the suggested

scheme of monitoring for a patient following parenteral administration of medication following Rapid tranquilisation?


E) Drug Calculations- answer all of the questions

Formulation- What you need X What you’ve got

What it’s in

Show your calculations Write your answer in the box

Calculations are provided at the competency assessment, and will change at

each session


Additional Comments

______________________ _______________ _______________________________ Name Date Signature

______________________ _______________ _______________________________ Name of assessor Date Signature A copy of this document must be retained in the Individual’s personnel file


Medicines Competency Framework

Procedural Note

Purpose of the Assessment:

This assessment framework aims to ensure both the quality and safety of

medicines administration by all first level registered nurses working within South

Staffordshire and Shropshire NHS Foundation Trust continues. The framework

has been developed in conjunction with Standards for Better Health Document

and links directly to the following core standards: C1A, C4D, D2D, Governance

D4, C11 and the National Patient Safety Agency (NPSA) Competency

Assessments.

By undertaking the assessment the practitioner will demonstrate, by practical application, a comprehensive understanding of the administration of medicines.

Frequency of the Assessment: This assessment must be conducted annually for all registered nurses and must

form part of each registered nurses annual appraisal. Where a medicine error

has occurred within the clinical practice setting a re assessment must be carried

out within a timely manner. The assessment must also be conducted when a

registered nurse is inducted in to a new clinical environment. Where an

assessment has been conducted following a medicine error or induction, it does

not need to be completed for a further year unless the manager considers this to

be necessary.

Prior to Conducting the Assessment: Prior to the assessment being conducted the assessor will discuss the assessment purpose with the individual undergoing assessment. This will be documented within the individuals Clinical Supervision records and should form part of the individuals Annual Appraisal. This will ensure that the individual is clear about the rationale for the assessment being undertaken. It is the responsibility of the assessor to provide the individual with a copy of the

Medicines Competency Assessment Document prior to the assessment being


conducted. This must exclude any Drug Calculation questions. Drug calculation

questions are an unseen component of the assessment and therefore must only

be issued during the assessment and marked by the assessor at the end of the

assessment process.

It is the individuals’ responsibility to ensure that they are familiar with all of the

documents outlined within the Competency Framework prior to the assessment.

Whilst some clinical areas hold paper copies of Trust policies and procedures,

the most up to date copies are always accessible on the Trusts intranet. It is

reasonable therefore to expect the individual to demonstrate competency in

accessing these documents electronically.

Assessment Process: The assessment should form part of the individuals’ daily clinical practices, and

should take place in their own clinical area. There may be occasion’s where

particular components of the assessment cannot be carried out in the individuals

area of practice e.g. administration of a depot injection. Where it is deemed

necessary and appropriate for the individual to be assessed as competent in this


area, there will need to be a process of negotiation for this part of the

assessment to be assessed in another clinical area within the Trust.

Through negotiation the assessor and the individual undergoing assessment will

select which medicines round they will be assessed on.

Whilst conducting the assessment the assessor must be confident that the

individual is practicing in a safe and competent manner, in line with Trust

Medicines Code (C/YEL/MM/03) and with due regard for Nursing and Midwifery

Council Standards for Medicines Administration (NMC, 2007).

Where and individual is deemed as demonstrating unsafe practice at any time

during the practical assessment the assessor must stop the assessment

immediately to ensure that the highest level of client and staff safety is

maintained. Where an assessment is stopped the assessor must inform the

individual of the reasons for this. This will result in the individual being awarded a

fail for their assessment and they will not be allowed to administer or witness any

further medicines administration within any clinical area.

Where an incident of this type occurs further advice should be sought from Cathy

Riley (Chief Pharmacist) or Michelle Lycett-Smith (Non-Medical Prescribing Lead).

This action will need to be documented in the individuals Supervision Record. This

will allow further CPD needs to be explored.

Drug Calculations: This component of the assessment is unseen prior to the assessment being

conducted. The assessor must provide Drug Calculation questions only at the

time of the assessment. It is acceptable for the individual to use a calculator and


they must show their mathematical workings out on the assessment document.

The most recent BNF should also be made available for the individual to use as a

resource should they require it.

It is expected that a score of 100% should be achieved with the Drug

Calculations. Where a score below 100% is achieved this will be deemed as a

fail and the individual will not be allowed to administer or witness any further

medicines administration within any clinical setting.

Where an incident of this type occurs further advice should be sought from Cathy

Riley (Chief Pharmacist) or Michelle Lycett-Smith (Non-Medical Prescribing Lead).

This action will need to be documented in the individuals Supervision Record. This

will allow the further CPD needs to be explored.

Successful Completion: Following successful completion of Medicines Administration Competency, the

assessor will inform the individual of the outcome. Where this has formed part of

an annual assessment a record of successful completion will be made in the

individual’s annual appraisal document.

Where successful completion has occurred following a medicine error the

individual will be allowed to administer and/or witness medicines administration in

line with Trust Policy and Procedure. An entry of successful completion of the

assessment must be made in the individuals Clinical Supervision record.

Nurses Employed to Work Across In-patient and Community Settings:

The in-patient competency framework will be the key assessment undertaken, but in addition the community competency assessment framework will also be


undertaken (using the community card and authorised documents relating to medicines), with omission of any duplicated sections on the community assessment:

if depot administration has already been assessed as part of the in-patient

assessment, criteria A12, A14, A15, A16, A17, A18 A19 may be omitted

from the community assessment with “refer to in-patient assessment”

recorded

criteria C1-C4 and criteria D17 & D18 may be omitted from the community

assessment with “refer to in-patient assessment” recorded

Criteria E (drug calculations) may be omitted from the community

assessment with “refer to in-patient assessment” recorded

Reference:

Medicines Code: Policies and Procedures to Manage the Clinical Risks Associated with the use of Medicines. (C/YEL/mm/03).November 2007.

Nursing and Midwifery Council (2007). Standards for Medicines Management. London, NMC.


Appendix 1b- Medicines Administration Competency Framework Community Practitioners

Name: Date: Designation: Name of assessor: Date: Designation:

Comments:

Purpose of assessment:

To assure the quality and safety of medication administration by a qualified practitioner in conjunction with standards for better health; core standards C1A, C4d.

D2d, Governance D4, C11 and NPSA competence assessments. The practitioner undergoing assessment will demonstrate by practical methods a comprehensive understanding of the administration of medicines. The assessment will be completed using the following criteria:

Administration of an intra-muscular injection where possible For preceptorship staff nurses over three occasions within eight weeks of registration For qualified nursing staff annually as part of the individual appraisal process

Following a medication error The supply and/or administration of a patient group direction.


Prior to assessment it is the individual's responsibility to familiarise themselves with the documents listed below prior to the assessment commencing.

Please date and sign to Assessor - Please date and indicate you are familiar sign to indicate the with the following trust individual undergoing and professional assessment is able to documents locate the documents

Medicines Code

NMC Guidelines for the

Management of Medicines

(2010)

Mental Capacity Act

British National Formulary

IM administration

Guidelines

PGD administration

guidelines

Standard precautions and

equipment policy for the

control and prevention of

infection

The practitioner undergoing assessment will demonstrate by practical methods a comprehensive understanding of the administration of medicines via intra-muscular routes and/or the supply and/or administration of oral medicines via a patient Group Direction (PGD)


The following criteria will be used to assess competence for the administration of a depot injection:

A. Confirm the validity of the prescription:

Yes No COMMENTS

1. Assure the identity of the patient is established

following Trust policy, checking that the patient

understands the treatment being given and consents

where appropriate.

2. Where relevant assure all detention papers are in date

and accurate.

3. Confirms recorded drug allergies, sensitivities with the

client.

4. Assure the prescription is legible.

5. Confirm start date.

6. Confirm stop date.

7. Confirm drug dosage and strength.

8. Confirm administration route prescribed.

9. Prescriber’s signature.

10. Specific/other instructions.

11. Assure knowledge of safe storage, handling and

transporting of medication, stock ordering, stock

rotation and destruction of medicines.

12. Assure preparation of the dose for intra-muscular

administration in accordance with the guidelines for IM

administration of medication.

13. Assure cross checking/double checking of medication

against prescription as per medicines code prior to

leaving base.

14. Identify actions to be taken if the prescription is illegible

or invalid.

15. Assure the correct amount of prescribed medication

has been placed in the syringe.


Following administration of depot

medication, the practitioner will: Yes No COMMENTS

16. For intra-muscular administration evidence

that the administration site is observed for

immediate adverse effects.

17. Sign the medication chart in the appropriate

section.

18. Demonstrate accurate/appropriate recording

of time and date of medication

administration on the card and within health

records.

19. Monitor the patient for any side effects and

document in health records.

B. The following criteria will be used to assess

competence for the supply and/or Yes No COMMENTS administration of a PGD: 1. Assures the identity of the patient following

Trust policy, checking that the patient understands the treatment being given and consents where appropriate.

2. Has considered the use of non-pharmacological approaches before using a PGD.

3. Assures that the PGD chosen is in date and operational.

4. Makes an accurate assessment of the patient checks and adheres to all information included in the PGD, with particular attention to all inclusive and exclusive criteria.

5. Assures double checking of medication as per medicine code.

6. Assures the correct amount of prescribed medicine is supplied and/or administered.

7. Demonstrates knowledge of the Trust procedure for administration, storage, waste and checks as per medicine code. Following administration of the

medication: Yes No COMMENTS 8. Ensure the patient has taken the drug.

9. Sign the medication chart in the appropriate

section. 10. Note the time and dose and PGD No. on

the medicine card.


11. Demonstrate accurate/appropriate

recording of medication administration in the client’s health records.

12. Monitor the client for any side effects and

document in their health records.

C.

Signs of, and treatment of: Yes No COMMENTS

1. Extrapyramidal side effects.

2. Neuroleptic malignant syndrome.

3. Overdose/self-poisoning.

4. Dependency/withdrawal.


D) The individual undergoing assessment will demonstrate by verbal method knowledge of one medication from a current treatment card, being administered via the intra-muscular route if applicable; and one medication available for administration and/or supply via a PGD.

D. Yes

No

COMMENTS

The following criteria will be used:

1. Brand name

2. Approved name

3. Drug group

4. Drug usage:

What condition(s) is the drug

licensed?

5. Indications:

What is the drug being used for?

6. Side effects.

7. Contra-indications

8. Dosage range:

Oral/intramuscular

The following criteria will be used: Yes No COMMENTS

9. Brand name

10. Approved name

11. Drug group

12. Drug usage:

What condition(s) is the drug

licensed?

13. Indications:

What is the drug being used for?

14. Side effects

15. Contra-indications

16. Dosage range:

Oral/intramuscular

Drug specific: Yes No COMMENTS

SOP: Assessing Competency for

Medicines Administration, Dec 2015

17. Dietary needs for MAOI’s

18. Blood monitoring: Clozaril Lithium


E) Drug Calculations – answer all of the questions

A pass rate of 100% is required. You are encouraged to use the most up-to-date BNF and can use a calculator. You must

show your workings out. Formulation – what you need x what you’ve got

what it’s in

Show your calculations

Write your answer in the box

Calculations are provided at the competency assessment, and will change at each session

Name: ……………………………………. Date:……/..…/…. Signature: …………………………………………….. Name of assessor ……………………… Date:…../…../… Signature ……………….…………………….. A copy of this document must be retained in the Individual’s personnel file


Appendix 2 he role of the unregistered support worker (including Assistant Practitioners)

in the witnessing and second checking of medicines by a 1st

level registered nurse:

Rationale

All medicines that are administered by 1st

level Registered Nurses (RN) directly employed by South Staffordshire and Shropshire NHS Foundation Trust (SSSFT) or who are supplied via National Health Service Professionals (NHSP) or a nursing agency are required to have a second checker to witness all aspects of the administration of medicines. This is explicit within the current Medicine Code.

It is acknowledged within SSSFT that unregistered support workers (this includes all Assistant Practitioners) have a significant role to play in

supporting 1st

level RNs in this process.

At the current time there are some services that support unregistered support workers to be involved in the witnessing and second checking of medicines administration and others that do not. The purpose of this approach is to ensure that all unregistered support workers are trained and deemed

competent by a 1st

level RN in the witnessing and second checking of

medicines by a 1st

level RN. This will ensure compliance with the Medicine Code and increase patient safety.

Scope

The purpose of this process is to ensure that any unregistered support worker who is involved in the witnessing and second checking process for the administration of medicines has been assessed and deemed as competent to

do so by a 1st

level RN.

This applies to all clients within any in patient setting across SSSFT, including community based bedded units e.g. Castle Lodge, Park House.

Each unregistered support worker will have undertaken appropriate theoretical and practical training on medicines management for unregistered support workers provided and delivered by SSSFT. This must be undertaken on:

• Induction to SSSFT • Three yearly as part of mandatory training • Following the unregistered support worker being involved in a

medicine error

The unregistered support worker must be further assessed as competent by a

1st

level registered nurse before undertaking any involvement in the witnessing of medication administration and this will be achieved through a competency framework document.


The unregistered support worker must agree to adhere strictly to the contents of this document and to the Medicines Code and must report any further training and development needs that they may have to their clinical supervisor or direct line manager as soon as these are highlighted.

Each unregistered support worker must have Medicines Management included in their annual appraisal, and this must be linked directly to a KSF indicator.

1st

Level RNs are responsible for the assessment of the unregistered support workers competence. Where an unregistered support worker has been unable to achieve successful completion of the assessment and competency framework this must be discussed with them individually and clearly documented on a supervision form, a copy of which must be included in the individuals personnel file. In addition it is considered as Best Practice to offer the individual with a copy for their own records. Where this has occurred, the 1

st Level RN must contact the Senior Nurse for Medicines Management

to discuss this in more detail.

An action plan to support their ongoing professional development must be

drawn up between the 1st

Level registered nurse and the unregistered support worker.

Principles

It is intended that these changes to the current Medicines Code will allow unregistered support workers to further develop their clinical skills and knowledge. In addition it will support ongoing clinical governance and risk management in the safe administration and management of medicines for clients receiving in patient care.

2. Impact

Currently unregistered support workers are not registered or regulated by a professional regulatory body as are registered nurses or other health care professionals e.g. physiotherapists, occupational therapists. It is therefore imperative that a structured and robust competency framework exists to ensure that any unregistered support worker involved in the witnessing and second checking of medicines is assessed and deemed competent to do so by a

1st

level RN.

In order to ensure that competence is maintained, each individual will need to undergo further theoretical training on a three yearly basis as part of their mandatory training.

3. Risk Management Issues

In order ensure that risks are reduced and effectively managed:

• All unregistered support workers will receive both theoretical and

practical training in medicines management.

• Unregistered support workers will have an understanding of their roles and responsibilities in respect of medicines management.


• All unregistered staff will have an increased awareness of the importance of medicines management and how SSSFT are committed to minimise the risks associated with medicines use.

• Where an unregistered support worker identifies unsafe standards of

practice from a 1st

level RN they must report this to a senior manager as soon as possible.


Medicines Administration Competency

Framework For Unregistered support workers and Assistant

Practitioners Name of unregistered

practitioner: Date:

Designation:

Name of

assessor: Date:

Designation:

Comments:

Purpose of assessment: To ensure that all unregistered support workers are educated and trained to assist 1

st Level

Registered Nurses in the safe witnessing and dispensing of prescribed medicines to clients.

The unregistered support worker undergoing assessment will demonstrate by practical methods a comprehensive understanding of the checking and witnessing of medicines within the clinical practice setting, with an understanding that they will not be used as “runners” in the administration of any medicines. The assessment will be completed using the following criteria:

• Upon induction • Annually as part of annual appraisal processes • Observation, witnessing and checking of a 1

st Level RN completing

a ward medicine round and where appropriate the administration of an intra-muscular injection.

• Following a medication error if an unregistered practitioner was involved in the checking and administration of a medicine.


Prior to assessment it is the individual's responsibility to familiarise themselves with the documents listed below prior to the assessment commencing.

Please date and sign to Assessor - Please date and sign indicate that you are familiar to indicate the individual with the following Trust and undergoing assessment is able national documents. to locate the documents

Medicines Code

British National Formulary

Standard precautions and equipment policy for the control and prevention of infection

The unregistered practitioner undergoing assessment will demonstrate by practical methods comprehension of the witnessing and second checking of administration of medicines via oral and where appropriate intra- muscular routes. The Following criteria will be used;

Yes No Comments

Confirm the Validity of the Prescription;

• Checks with the 1st

Level RN to assure that the Identity of the patient has been achieved following Trust policy and

observes the 1st

level RN establish that the patient understands the treatment being given and consents where appropriate.


Yes No Comments

• Witnesses and checks with the

1st

Level Registered nurse (RN) to ensure that any Mental Health Act detention papers are in date and accurate.

• Witnesses and checks with the

1st

Level RN for any recorded drug allergies and confirms this with the patient

• Checks the prescription sheet

with the 1st

Level RN to ensure the prescription is legible

• The 1st

Level RN confirms the following with the unregistered care worker who will then check and confirm accuracy:

• Start date • Stop date • Drug dosage and strength • Administration route prescribed • Prescribers signature • Specific/other instructions • Any information relevant to

the safe storage and handling of medication , I.E security of medication, stock ordering, rotation and storage.

The 1st

Level RN will outline the process

for the preparation of the dose for oral administration, in accordance with the guidelines for oral administration of medication and calculate doses accordingly; the unregistered support worker checks and confirms accuracy. The 1

st Level RN will outline the process

for the preparation of the dose for intra-muscular administration in accordance with the guidelines for IM administration of medication; the unregistered support worker checks and confirms accuracy. The 1

st level RN will assure cross

checking / double checking of medication against prescription as per medicines code with the unregistered support worker who will confirm accuracy.


The 1st

level RN will identify and explain actions to be taken if the prescription is illegible or invalid The 1

st level RN will assure evidence

of cross checking as required medication, with the regular prescription, not exceeding daily dose. The unregistered support worker checks and confirms accuracy. The 1

st level RN will assure the correct

amount of prescribed medication has been placed in the container/ syringe. The unregistered support worker checks and confirms accuracy.

Following administration of the Yes No Comments medication, the unregistered

practitioner will:

Where appropriate support the 1st

level RN observe that the patient has taken

the drug.

Observe the 1st

level RN sign the medication chart in the appropriate

section, noting for any omissions and

identify this.

Observe the1st level RN record the

time and dose given on administration

on the prescription chart if a variable

dose or I/M has been prescribed

Where appropriate and under

supervision support the 1st

Level RN in monitoring the patient for any side

effects and document in health records

The practitioner undergoing the assessment will demonstrate by verbal method knowledge and understanding of their role as a witness and second checker in a medication round and can identify: The risks associated with using runners being used within a medication round?

Three risks associated with omissions of regular medicines

The principles of safe administration of medicines to patients e.g. the right patient; the correct dose; correct time; correct route; correct form i.e. tablet/liquid

Additional Comments Name Date Signature Name of assessor Date Signature

Please file one completed copy in Personnel File

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