Guidelines for student nurses, midwives and
allied health professionals on the
management of medicines
These guidelines do not replace local trust policies, which take precedence. Local policy must be adhered to
at all times.
Introduction
This Guideline summarises the University of Southampton’s advice regarding medicines management.
All student nurses, student midwives and Allied Healthcare Professionals (AHP) students (except
Occupational Therapy students) must observe and/or participate in the administration of medicines
during their programme of education.
These guidelines and local medicine administration policies should be discussed at the beginning of each
practice placement experience.
Registered practitioners and students must be aware that whenever a student is involved in the
administration of medicines, the registered practitioner maintains the responsibility and accountability for all
related activity including: the ordering, receipt, storage, preparation, administration and disposal of
medicines and the maintenance of all associated documentation
.
Professional regulatory body guidance must be adhered to at all times.
Statement of Intent
The University of Southampton confirms its commitment to partnership working with placement providers.
The aim of the Guideline is to ensure that Professional regulations are upheld and that adverse events are
avoided during learning experiences; the guideline does not supersede or replace Local Trust Policies.
Responsibility of the student
With the direct supervision of the registered practitioner, the student should follow the 6 rights of
administration (right person, right drug, right dose, right route, right time, and right documentation) by:
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. identifying the correct service user
. selecting the prescribed medicine
. calculating the required dosage
. identifying the correct timing of the prescribed medicine
. preparing and administering medicine
. recording the administration appropriately
. challenging incorrect documentation
The student must demonstrate an understanding of the 5 rights of their own knowledge base (action, side
effects, and contraindications, patient education and right to refuse) by:
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. identifying the reason for prescribing, supplying and administering the medicine
. understanding the action of the medicine
. having an awareness of possible adverse effects & contraindications
. the ability to recognise adverse effects & contraindications
. discussing medication appropriately with patient and families
Responsibility of the Mentor
During each practice placement the mentor should assess the student’s proficiency in administering
medicines. The student’s level of proficiency must be recorded in their assessment document.
The student should increase their level of proficiency in all aspects of medicine administration, including the
signing of the prescription sheets where applicable, but always under the direct supervision of the qualified
practitioner. The prescription sheet must be countersigned by the registered practitioner.
Profession Specific Guidance
Students cannot be
involved in administering
medicines via the
following routes:
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Intra-dermal
peripheral cannula
central venous
cannula
flushing lines with
transducers
epidural
intra-thecal
intra-osseous
intra vesicle
arterial lines
With the direct
supervision of a midwife
or first level nurse the
student should be
involved in administering
medicines via the
following routes:
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. oral
sublingual
buccal
nebulised
inhaled
intranasal
topical
trans-dermal
intramuscular
subcutaneous
vaginal
rectal
Related activities in
which students cannot
participate but may
observe:
Under the direct
supervision of a
registered podiatrist the
student should be
involved in the
administration of
medicines via the
following routes
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Verbal orders to
administer medicine
without a written
prescription
Patient group
directives
Cytotoxic medicine
administration.
Ultraviolet therapy
arterial cannulation
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Parenteral
administration of
relevant medicines
for subcutaneous
digital nerve block
Direct application to
the skin, nail, or nail
bed/matrix
Direct application of
dressings to skin
and/or wounds
Oxygen must be
prescribed and students
may be involved in the
administration of oxygen
in accordance with local
trust policy.
NB Student Midwives with
the direct supervision of
a registered practitioner
should be involved in
 Patient group
directives
 Ultraviolet therapy
NB Student Podiatrists,
under the direct
supervision of a
registered podiatrist,
may be involved in the
supply or sale of
medicines under
statutory exemptions
Guidelines for specific situations
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Keys: Under no circumstances are students permitted to be responsible for the practice placement’s
medicine keys.
Patient group directions (PGD): All students, except midwifery students, may observe but cannot
participate in the following:
 Supply or administration of medicines under patient group directions (PGD) including
supplementary prescribing via clinical management plan.
Controlled Medicines:
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Administration of controlled drugs should involve 2 practitioners, one of whom should be a
registered nurse or midwife. All students may act as a second checker if local policy allows. In
practice with direct supervision of the person administering the drug, the student may:
 “Sign out” controlled medicines in the controlled medicine register as the second person
 Participate in the administration of controlled medicines
 Students must not order, receive or dispose of controlled medicines
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Administration of Fluids (nursing and midwifery only): Students may administer prescribed, preprepared 0.9% sodium chloride or dextrose saline via an existing intravenous or subcutaneous line.
This activity must be checked and the connection supervised by a midwife or first level nurse who has
deemed the student competent to perform this skill.
 This is the only situation where the student can participate in the administration of
intravenous or subcutaneous fluid.
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Oral Suspensions (nursing and midwifery only): Students may participate in the preparation /
reconstitution of oral medicines such as suspensions with the direct supervision of the midwife or
first level nurse.
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Return to practice nursing students (RTPS): RTPSs attend a study day on medicine administration
early in their course. Following attendance at the study day, RTPS’s should be involved in the
administration of medicines in accordance with the guidance in the RTPS assessment of practice
document.
Other policies to be read in conjunction with these guidelines
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Medical devices (related to infusion devices)
Vena-section
Central venous line monitoring
Blood transfusions
Complementary medicines/therapies
Statutory exemptions for podiatrists
Health Professions Council Standards of Proficiency
References
Health Professions Council (2009), Standards of Proficiency Chiropodists/Podiatrists, London: Health
professions Council.
National Prescribing Centre (2007) 2ndEd. A guide to good practice in the management of controlled
medicines in primary care (England). National Prescribing. Centre. Liverpool
Nursing and Midwifery Council (2008) Standards for medicine management. NMC. London
Royal College of Nursing. (2005) Standards for Infusion Therapy, RCN. London
Royal Pharmaceutical Society of Great Britain (2005) The Safe and Secure Handling of Medicines, A Team
Approach; A Revision of the ‘Duthie Report 1988’. Royal Pharmaceutical Society of Great Britain.
Status:
Approved
Originated by:
Cathy Sullivan, Practice Learning Committee
Date of Approval
2011/12 academic year
Updated
May 2012 – Updated Branding
Effective from (date)
Immediate Effect
Date for review
2012/13 academic year