MANAGEMENT OF PATIENTS OWN CONTROLLED DRUGS IN THE WARD
SETTING
Rie Hitchmough Oncology Pharmacy CCO NHS F Trust Wirral
Patients have always been encouraged to bring in their own medication from home
and/or any products they may have purchased over the counter, at CCO this also
included patient’s own controlled drugs.
Patient’s CD’s were often mixed amongst their normal medication and so suffered the
fate of either being sent for disposal or kept in or around the drugs trolley or left at the
bottom of stock cupboards to be disposed of occasionally when ward staff had a clear
out as they were very rarely returned to the patients on discharge due to the patient
being reviewed by the pain management team and some aspects of the CD regime
changed or deleted.
The nursing staff on the wards were increasing concerned about the quantities of
patients own CD’s being brought onto the wards on admission and no procedure to
follow regarding the correct way to handle/store or secure this type of medication.
They were also beginning to question the advisability of accepting these drugs in this
informal manner, not only from the ward perspective, but also on a personal and
professional level.
A review was undertaken by the Chief Technician for Ward Pharmacy Services to
identify areas of concern from a risk management point of view, using Fishbone
Analysis Tool, and looking at potential abuse and/or allegations of misuse by
patients/carers and/or Regulatory Bodies.
Reading was also undertaken to clarify areas around controlled drug usage on the
wards and associated regulations for storage and management (4) and also CCO Trust
policies (1/3) covering medicines management and risk analysis tools.
Once identified plans were formulated to rectify these issues as soon as possible with
the support and approval of the ward managers at CCO.
Review and Feedback included ensuring correct daily usage of the newly acquired
POM-CD ledger and newly sited POM-CD cupboard on each ward and
accompanying SOP’s.
Endiver
Reference/Reading:
1
Risk Management Policies/Procedures CCO NHS Foundation Trust – 2007/8
2
Standard Operating Procedure (CS:14.1(o) Oncology Pharmacy) – 2008/9
3
Medicines Management Policy CCO NHS Foundation Trust – 2007/8
4
Medicines, Ethics & Practice (Ed. 31-July 2007) pg 24-33