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  • MEDICATION ADMINISTRATION POLICY

    FOR NURSES, MIDWIVES AND UNREGULATED HEALTH WORKERS

    The Medicines and Poisons Act 2014 and Medicines and Poisons Regulations 2016 came into effect on 30 January 2017. The transitional provisions of this legislation ensure the continuity of arrangements outlined in this policy.

    https://www.slp.wa.gov.au/pco/prod/FileStore.nsf/Documents/MRDocument:26047P/$FILE/Medicines%20and%20Poisons%20Act%202014%20-%20%5b00-00-00%5d.pdf?OpenElement https://www.slp.wa.gov.au/gazette/gazette.nsf/searchgazette/04B222C38CEE128E482580A9007B6364/$file/Gg014.pdf https://www.slp.wa.gov.au/gazette/gazette.nsf/searchgazette/04B222C38CEE128E482580A9007B6364/$file/Gg014.pdf

  • This information is available in alternative formats upon request This information is available in alternative formats upon request

    Effective: 25 January 2018

    This information is available in alternative formats upon request This information is available in alternative formats upon request

    Page 1 of 50

    TITLE: MEDICATION ADMINISTRATION POLICY FOR NURSES, MIDWIVES AND UNREGULATED HEALTH WORKERS

    TABLE OF CONTENTS 1. BACKGROUND .......................................................................................................... 3 2. LEGISLATIVE REQUIREMENTS ............................................................................... 4 3. DEFINITIONS .............................................................................................................. 4 4. ROLES AND RESPONSIBILITIES ............................................................................. 5

    4.1 Registered Nurse and Midwife ............................................................................ 5 4.2 Direct Entry Midwife (who is not a registered nurse) ........................................... 6 4.3 Enrolled Nurse .................................................................................................... 7 4.4 Enrolled Nursing or Registered Nursing or Midwifery Students .......................... 8 4.5 Unregulated Health Worker ................................................................................. 8

    5. PRINCIPLES OF MEDICATION ADMINISTRATION ................................................. 9 5.1 Administration Standards .................................................................................... 9 5.2 National Inpatient Medication Charts ................................................................ 10 5.3 Medication History and Management Plan ........................................................ 10 5.4 Patient’s Self Medication ................................................................................... 11 5.5 Withholding Medication ..................................................................................... 12 5.6 Correct Documentation ..................................................................................... 12 5.7 Discharge, Transfer, or Non-admitted Patient Medication Planning .................. 13 5.8 Fees and Charges for Medication ..................................................................... 13 5.9 Patient Education ............................................................................................. 13

    6. MEDICATION ERRORS ........................................................................................... 14 7 MEDICATION PRESCRIBERS ................................................................................. 15

    7.2 Labelling of medications other than starter packs ............................................. 15 7.3 Registered Nurse’s Legal Responsibility ........................................................... 16

    8. VERBAL ORDERS ................................................................................................... 16 9. DESIGNATED REMOTE AREA NURSING POST ................................................... 17 10. APPROVED STARTER PACKS ............................................................................... 17

    10.1 Approved Starter Pack Supply .......................................................................... 17 10.2 Before Giving an Approved Starter Pack .......................................................... 18 10.3 Provision of a Psychiatric Starter Pack ............................................................. 18

    11 NURSE INITIATED NON PRESCRIPTION MEDICATIONS ..................................... 18 12. NURSE INITIATED STI TREATMENT CODE .......................................................... 19 13. GUIDELINES FOR USE OF OXYGEN ..................................................................... 19 14. VACCINATIONS/IMMUNISATIONS ......................................................................... 19 15. COMPLEMENTARY MEDICINES............................................................................. 20 16. PRESCRIBING NUTRITIONAL SUPPLEMENTS..................................................... 20 17. HIGH RISK MEDICATIONS ...................................................................................... 20

    17.1 Anti infective agents. ......................................................................................... 20 17.2 Guidelines for Midazolam for Adult or Paediatric Sedation .............................. 19 17.3 Potassium Chloride ........................................................................................... 22

  • This information is available in alternative formats upon request This information is available in alternative formats upon request

    Page 2 of 50

    17.4 Insulin ................................................................................................................ 22 17.5 Narcotics (opioids) ............................................................................................ 22 17.6 Chemotherapy................................................................................................... 22 17.7 Heparin and other anticoagulants ..................................................................... 22 17.8 Systems ............................................................................................................ 23

    17.8.1 Intrathecal Medication .......................................................................... 23 17.8.2 Epidural Therapy .................................................................................. 23 17.8.3 Medication Restrictions to Nurse Administered IV Bolus Treatment .... 23 17.8.4 Infusion Pumps..................................................................................... 23

    18. RECORDABLE DRUGS INCLUDING CONTROLLED DRUGS/ DRUGS OF ADDICTION .............................................................................................................. 24 18.1 Schedule 4 Restricted Medications ................................................................... 24 18.2 Schedule 8 Medications .................................................................................... 24 18.3 Administering Schedule 4 Restricted or Schedule 8 medications from dose

    administration aids in hostel and aged care facilities. ....................................... 25 18.4 Patient Discharge and Schedule 8 Medication .................................................. 26 18.5 Storage, transfer or disposal of medication refer to section 20 .......................... 26

    19. INTRAVENOUS (IV) ADMINISTRATION .................................................................. 26 19.1 Intravenous therapy and infusion and bolus medication administration ............ 26 19.2 I V Flushes ........................................................................................................ 28 19.3 Intravenous Additives and Bolus Dose .............................................................. 28 19.4 Infusion Pump Safety Information ..................................................................... 29 19.5 Labeling, Changing Infusions and Intravenous Lines ........................................ 30

    20. STORAGE OF MEDICATIONS ................................................................................. 30 20.1 Bedside Storage ................................................................................................ 30 20.2 Storage of Patient’s Own Medication ................................................................ 31 20.3 Storage of controlled drugs ............................................................................... 31 20.4 Keys and Access to Controlled Drug Keys ........................................................ 32 20.5 Transfer of controlled drug keys ........................................................................ 32 20.6 Transfer of recordable medication including Controlled Drugs. ......................... 33 20.7 Disposal of Drugs of Addiction and Poisons Included in

    Schedule 4 Restricted and Schedule 8 ............................................................. 33 20.8 Reporting Of Schedule 4 Restricted and 8 Medication Stock Discrepancies 34 20.9 Medication Fridge .............................................................................................. 34

    21. EVALUATION ........................................................................................................... 35 21.1 Compliance ....................................................................................................... 35 21.2 Mitigation strategies .......................................................................................... 35

    REFERENCES .....................................................................................

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