Top Tips Medicines Management
CQC are specifically looking at:
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Daily checking routines:
records of temperature checking of drug
fridges
records of resus trolley checking
daily reconciliation checks in CD registers
What control measures we must demonstrate:
All of these are required in our policy to be checked on a
daily basis
If there are discrepancies, CQC will expect you to know
how to escalate
CQC inspectors WILL check these records
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CQC have also started to report on
checking of room temperature in drug
storage areas
please ensure a room temperature check is done on ward
areas and there is a written record
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Expiry date checking:
CQC are physically inspecting contents of
cupboards.
They are specifically looking for evidence of stock rotation,
correct stock levels, and evidence of expiry date checking
(please ensure you have a written record)
Storage of medicines:
CQC are reporting if keys to medicines
cupboards are not controlled properly by
staff
Our requirement is that the keys (including the CD
cupboard key) MUST be under the control of the nurse in
charge in every service. Please ensure they are not left in a
drawer or on a hook.
On ward areas there must be a written sign over record of
medicines keys at shift change
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CQC are specifically looking for medicines
that are not secured in the proper storage
facility. This includes iv fluids, creams,
suppositories, inhalers
Do not leave drugs, creams, inhalers etc on the patient
bedside locker. When not in use, they must be LOCKED in
the patient's bedside medication locker.
Do not leave drugs at the nurse's station unattended
Do not leave drugs on worktops in the treatment rooms put in the appropriate iBin if for disposal
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Ensure doors to drug storage areas are
always locked
NEVER prop open doors to treatment rooms or leave them
"on the latch"
Self-administration of medicines
CQC are checking if we promote self
administration.
Where patients are self administering, ensure the correct
assessments and documentation are completed and the
drugs are monitored accordingly (see policy and procedure
on website)
Correct administration of medicines
CQC are checking that drugs are
administered as prescribed, and if not then
an appropriate clinical justification is given
Ensure there are no blank squares on inpatient drug charts
A blank means there is no evidence that a drug has been
given or not
A clinical decision may be needed based on the response
to drug therapy
CQC are observing administration of
drugs on drug rounds
Please ensure there are strategies in place to avoid
interruptions so that concentration can be maintained
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Medical gas cylinders
Main storage may be outside, therefore check they are
CQC checking that cylinders on the wards clean when brought into the clinical area
Be clear who is responsible for this
are free from dust and dirt
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Patient Group Directions
Checking practitioners have received
training and competency assessments
Please ensure your registers of who has received
medicines via PGD are maintained accurately, that all staff
are properly signed off on the master copy of the PGD and
that previous versions have been archived
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Availability of medicines
Ensuring prompt drug treatment available
to the patient e.g. pain relief
Ensure the stock list is available to prescribers e.g.
Shropdoc so that something already in stock can be
prescribed to avoid delays in getting non-stock items.
Check and challenge prescribers
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Guidance / information sources
Ensure up to date information is being
used. CQC are highlighting where they
see old versions of BNFs in use
Ensure staff have a current BNF or know how to access
online versions.
Ensure current versions of guidance are available e.g.
antibiotics prescribing guidance
FP10 prescription pads
Ensure secure storage and traceability of
use
FP10s are controlled stationery.
CQC are looking for evidence of correct controls to
minimise the risk of inappropriate use
Correct procedures for disposal of
unwanted medicines
Checking right procedures are followed
Please ensure that you have the correct waste bins in use
(see Medicines Policy Part 1 for list of drugs that require
special handling because they are classified as cytotoxic or
cytostatic. You may need purple top bins).
Any concerns or questions please talk to Rita O’Brien out Chief Pharmacist
Rita.obrien@shropcom.nhs.uk
William Farr house 01743 277500 ext 2241