MEDICATION
ADMINISTRATION
Topic 1A
Drug Schedules
Identify the schedules of drugs
relevant to nursing practice
It is the Poisons and Therapeutic Goods Act
1966 ( NSW ) who impose some limitation
on the use of many potent drugs by
restricting their distribution to certain
groups or persons trained in handling
them and permitting their administration
only on medical authority.
It is the Poisons and Therapeutic
Goods Act provides for the
establishment of a Poisons List, which
consists of eight schedules.
1.( DANGEROUS POISONS )
Extreme danger to life. Only
available from Medical Practioners
e.g. Atropine, Arsenic
2. Medicinal Poisons
Poisons for therapeutic use which are
available to the public only from
pharmacies. Dangerous to life if
misused or carelessly handled.
e.g. Panadol, Aspirin, Codeine
3. Potent Substances
Poisons for therapeutic use, which are
dangerous or liable to abuse. Their
availability to the public is restricted to
supply by pharmacists and medical
practioners/ dentists/ vets.
e.g. Insulin
4. Restricted Drugs
Substances which in the public interest
should be supplied only on the written
prescription of a medical practitioner,
dentist or veterinary surgeon.
e.g. Oral hypoglycaemic agents, Cortisone
Barbiturates.
4D. Prescribed Restricted
Substances
Substances which are also only available to
the public on the prescription of an
authorised person. These substances are
treated differently because of their
potential for misuse and abuse.
e.g. Diazepam, Midazolam
5. Domestic Poisons
Poisons of a hazardous nature, which are
readily available to the public but require
caution in handling storage and use.
e.g. Bleach, Hydrogen peroxide
6. Industrial and Agriculture
Substances which should be readily
available to the public for agricultural,
pastoral, horticultural, veterinary,
photographic or industrial purposes or for
the destruction of pests.
e.g.Phenol
7. Special Poisons
Poisons which require special precautions in
manufacture, handling, storage or use or
special individual regulations regarding
labelling or availability.
e.g. Insecticides
8. Drugs of Addiction
Substances which produce addiction or
have such potential. A drug register must
be kept.
e.g. Morphine, Pethidine
STORAGE
• Nurse in charge of the ward is responsible
for the storage of all drugs. Must met legal
requirements that is security, temperature
and stock rotation.
• Storage should be such a way that it
minimises errors
GENERAL SCHEDULE 4
MEDICATIONS
 Must be stored out of patient and public
access. ( locked cupboard, locked room or
locked medication trolley ).
 Keys kept by the nurse in charge of the
ward or their delegate who must be a
registered /authorised enrolled nurse.
 Emergency or anaesthesia trolleys are
exempt for locked storage
Please note that Drug keys must
be kept from ward keys.
SCHEDULE 4 APPENDIX D
 Liable to abuse
 Stored separate from all other drugs
except S8
 No other goods should be stored in the
same place ( e.g. cash, keys )
 S4D Drug key and S8 keys can be kept
together but with no other ward keys and
carried by an RN.
Stored in a secure bedside storage
that is inaccessible to other patients
or visitors e.g. locked bedside
drawer to which the patient may
hold the key.
STORAGE IN ORIGINAL PACKS
All drugs should be stored in their original
packs or containers as received from
Pharmacy
MEDICATION INCIDENT
REPORTING
 Part of quality improvement programs,
should have a system in place.
 All disciplines should be encouraged to
report incidents even near miss incidents
 Drug committee for review.
 Circular – Incidents Reportable to the
Department 97/58.
What do you think
should be included on
the medication order ?
Medication Order
 Must use a patient medication chart (
area health logo )
Allergies/ adverse drug reactions
 Clear, legible and unambiguous
Patient full name, DOB,MRN and or
address.
 age, weight of a paediatric patient
Medication Order
 Name of medication ( what name trade
chemical or generic ?? )
 Strength of medication
Form of medication
Dose, route, and frequency
 Date of cessation, total number of doses
or finite time period of administration.
Medication Orders
 Signature and date. Each individual
medication order must be written in a
separate box and each medication order
must be signed.
 To cease a medication order the MO
must draw a line across the area of the
chart where administration is recorded (
after the last entry ) and sign and date
adjacent to this line.
Medication Orders
 If a drug is not to be given on certain
days, the prescriber must cross out those
days on the medication chart, to prevent
errors.
 Medication orders must not be duplicated
so the drug is not administered twice in
error/
Medication Orders
 A MO should confirm their intention to
order any dose that could be considered to
be unusually high by underlining and
initialling the dose.