Microsoft word - administration of medicines.doc

"Striving for excellence within our profession." Guidelines for Administration of Medicines

Introduction:
It has been well established over recent years that Medical Radiation Technologists (MRTs)
inclusive of Radiation Therapists and Nuclear Medicine Technicians, are undertaking
venepuncture and administering medicines. The movement of MRTs into this role has benefit to
patients/clients and the profession.
The following document is provided as a guideline to members undertaking venepunture for the
administering of medicines and/or checking medicines.
The preparation and administration of drugs for injection requires additional skills and knowledge.
Current undergraduate and postgraduate education programmes do not provide practitioners with
these additional skills and knowledge. It is recommended that further education and training by an
employer is required before any health professional embarks in performing the preparation and
administration of medicines.
The NZIMRT does not provide IV certification or training nor does the NZIMRT maintain a record
of members certified. Certification is an agreement between an individual MRT and his/her
employer.

Recommended Guidelines:
 Ensure that their MRTB registration and Annual Practicing Certificate (APC) is current and in the appropriate scope of practice.  Be familiar with their institution's / employer's management of medicines policy and related documents. If there is no policy, ensure there is written and well documented authority to perform the administrating task.  Ensure that all required certifications as expected by the employer are gained and maintained. It is advised that the level of certification includes written documentation of which intravenous medicines (IV) medicines an individual is authorised to administer.  If an employer does not have established certifications then you are advised not to perform venepuncture or administer medicines.  Ensure practice is to the level of certification. When administering IV contrast media an individual must be fully aware of the contraindications for, actions of, reactions to, and the methods of dealing with any adverse consequences of its administration.  It is recommended that appropriate resuscitation methods are learnt and certified. It is advisable to administer IV contrast agents only when a registered medical practitioner is on site and available to assist in the event of a medical emergency.  Ensure all prescriptions are clearly written, signed, and dated by an authorised prescriber. Do not administer medicines if the prescription is unclear, confusing or illegible. Administer only medicines that have been authorized by certification.  Be aware that both the individual administering the medicine and the individual checking the medicine against the prescription are responsible for the correct administration of the medication.  Ensure that any IV contrast agent is prescribed in a dosage known to be safe and is administered as prescribed and / or in accordance with the drug administration instructions.
Education and Training:
An employer's certification programme should be a well-defined clinical training programme
including both theoretical and practical components.

Health and Safety:
It would be expected that any certification gained would have an ongoing monitoring process
within it as there is a need to maintain and prove ongoing competency in this field.

Related Documentation:
NZIMRT / MRTB Code of Ethics (updated 2004) Australian Institute of Radiography - Guidelines for Radiographers involved in venepuncture. (2009)
Associated Acts and Regulations:

o Health Practitioners Competence Assurance Act 2003 o Medicines Act 1981 and Medicines Regulations 1984 o Misuse of Drugs Act 1975. o Health o Health and Disability Services (Safety) Act 2001
References:

New Zealand Nurses Organisation (2007).
Guidelines for nurses on the administration of medicines. (Appendix One)
New Zealand Nurses Organisation, Wellington, New Zealand.
Nursing Midwifery Council United Kingdom (2008). (Appendix Two)
Standards for medicines management. Section 4.
Retrieved 11 August 2009 from www.nmc-uk.org/.
New Zealand Nurses Organisation (2007). Standards for the administration of medicines.
APPENDIX ONE

New Zealand Nurses Organisation (2007). Guidelines for nurses on the administration of
medicines. Standards for the administration of medicines.

Training and Education requirements
The person who is administering the medicine will be satisfied that she or he:
a. Understands his/her scope of practice as determined by the appropriate regulatory b. Has had adequate training/orientation for types of medicines being administered. c. Is familiar with the local area policy and guidelines related to medicine d. Understands professional and legal issues regarding medicine administration.
Prior to administration of medication, the regulated nurse administering the
medicine:

a. Within the limits of the available information, confirms the correctness of the prescription/medication chart, and the information provided on the relevant containers. b. Ensures that she or he is aware of the client's current assessment and planned program of care; and makes a clinical assessment of the suitability of administration at the scheduled time of administration. c. Checks the five rights: the right medicine in the right dose must be administred to the right person at the right time by the right route. d. Checks the expiry date of the medicine. e. Checks that the client is not allergic to the medicine. f. Contacts the prescriber.pharmacist, designated senior health professional as  The prescription/medication chart or container is illegible, unclear,  Where it is believed that the dosage or route of administration falls outside the product license for the particular substance.  There are potential adverse interactions with other medicines.  Where contra-indications to the administration of any prescribed medicine g. When believed necessary, refuses to administer the prescribed substance. If this situation arises, document clearly the reason and inform h. prepares the medicine as specified by manufacturer/ area policy and i. pays due regard to the environment in which that care is being given eg. appropriate cardiac monitoring available. j. is certain of the identity of the client to whom the medicine is given. k. Informs the client of the purpose of the medicine as appropriate, and provides access to relevant client information leaflets.
During the administration of medication, the regulated nurse administering the
medicine:

a. monitors the patient for adverse effects of the medicine and takes appropriate action as determined by local guidelines eg. Anaphylaxis management. b. Uses the opportunity, when appropriate, for emphasizing to clients and significant  The importance and implications of the prescribed treatment and  Enhancing their understanding of its effects and side-effects.
Post administration

a. Makes clear and accurate recordings of the administration of each individual medicine administered or deliberately withheld, ensuring that any written entries and the signature are clear and legible. Documentqation must be timely. b. Records the positive and negative effects of the medicine and make them known APPENDIX TWO

Nursing Midwifery Council United Kingdom (2008). Standards for medicines
management. Section 4, standard 8. Retrieved August 2009 from www.nmc-uk.org/.
Standard 8
As a registrant, in exercising your professional accountability in the best interests of your
patients:
 You must be certain of the identity of the patients to whom the medicine is to be  You must check that the patient is not allergic to the medicine before administering  You must know the therapeutic uses of the medicine to be administered, its normal dosage, side effects, precautions and contra-indications.  You must be aware of the patient's plan of care (care plan/pathway).  You must check that the prescription or the label on medicine dispensed is clearly  You must check the expiry date (where it exists) of the medicine to be  You must have considered the dosage, weight where appropriate, method of  You must administer or withhold in the context of the patient's condition (e.g. digoxin not usually to be given if pulse below 60) and co-existing therapies e.g. physiotherapy.  You must contact the prescriber or another authorised prescriber without delay where contra-indications to the prescribed medicines are discovered, where the patient develops a reaction to the medicine, or where assessment of the patient indicates that the medicine is no longer suitable (see Standard 25).  You must make a clear, accurate and immediate record of all medicine administered, intentionally withheld or refused by the patient, ensuring the signature is clear and legible; it is also your responsibility to ensure that a record is made when delegating the task of administering medicine.

Source: http://www.nzimrt.co.nz/userFiles/file/NZIMRT/administration_of_medicines.pdf