Faculty of Education, Health & Sciences
School of Health
Advanced Diploma in Nursing Studies Programme
Administration of Medicines Policy for Student Nurses
Originator(s):
Programme Team
Applicable To:
Students on the BSc (Hons) Nursing
Adult and Mental Health
Approved by:
Programme Management Team
Practice Partnership Group
Ratified by:
Richelle Duffy
Assistant Subject Head
Equality Impact Assessment
N/A
Implementation from:
30th April 2010
Review date:
30th April 2013
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INTRODUCTION
Nurses, during training, need to be prepared to begin to take on their professional
responsibilities at the conclusion of that training period. The Nursing and Midwifery
Council (2008a pg2) in their Standards for medicines management identify that “The
administration of medicines is an important aspect of the professional practice of
persons whose name is on the Nursing and Midwifery Councils register.”
The safe and secure handling of medicines is a complex process underpinned by
legal, professional and employer frameworks and requiring extensive knowledge and
skill in its delivery.
The NMC Code (2008b) identifies that registered nurses are personally accountable
for their actions and omissions in practice and must always be able to justify their
decisions. This over arching statement will necessitate that during the administration
of medicines patients/clients must be treated and cared for in such a way as to
maintain their:
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safety
continuity of treatment and care
respect and dignity
contact with appropriate staff, relatives and carers
confidentiality of information on a need to know basis
POLICY AIM(S)
To set the standards, for safe practice in the management and administration of
medications, for student nurses.
The aims of this policy are to ensure that:
1. patients/clients needs are safeguarded
2. the clinical accountabilities of the mentor and student nurse in respect of the
administration of medicines are transparent
3. learning opportunities for student nurses are explored, utilized and monitored
appropriately
RATIONALE
Medications are now available for administration in many different formulations and
via multiple routes. Independent and supplementary prescribers not only exert their
professional judgement in their choice of medication for their patients/clients but are
guided through a range of laws and policies issued via government agencies eg
Medicines Act (1968) Misuse of Drugs Act (1971), National Institute for Clinical
Excellence (NICE). Whilst the route of administration will depend on availability,
cost, speed and mode of action, the condition being treated and the recipients ability
and/or tolerance of the route chosen. Consequently students have to be aware that
the administration of medicines ‘is not solely a mechanistic task to be performed in
strict compliance with the written prescription of an independent or supplementary
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prescriber. It requires thought and the exercise of professional judgement.’ (NMC
2008a pg2)
The NMC (2008c) in the standards to support learning and assessment in
practice, identify that mentors are responsible and accountable for:
 organizing and co-coordinating student learning activities in practice.
 supervising students in learning situations and providing them with
constructive feedback on their achievements.
 setting and monitoring achievement of realistic learning objectives
The University of Derby Advanced Diploma in Nursing Programme encourages
clinical environments to explore and develop, within acceptable parameters such as
laid out in this policy, suitable learning opportunities for student nurses placed with
them. Students will throughout their training undergo three summative assessments
on numeracy, drug calculations and the administration of medicines
Individual Trusts may also have their own policies on the issues relating to the
administration of medicines and their management, these must also be considered
and adhered to.
Mentors need therefore to be able to ensure that the well being of patient/clients
during any medicines administration together with their employment requirements are
addressed, whilst there responsibilities towards student nurses are also
acknowledged.
Student nurses also need to be aware of the NMC (2009) guide to practice which
whilst carrying similar care requirements to that of the registered nurse specifically
identifies that students recognize and stay within the limits of their competence.
APPLICATION OF POLICY
Students are prepared from the first theory module on the administration of oral
medicines, with instruction in the administration of intramuscular and subcutaneous
injections occurring later in the first year of training. Throughout the three year
programme these skills are revisited periodically and other routes of medicines
administration explored eg topical, eye, ear.
Appreciation of the wider professional and legislative frameworks that support the
administration of medicines are introduced and explored throughout the three year
programme.
Students competence in the numerical and administrative aspects of medicines
administration is also summatively assessed during the first year and subsequent
years of the programme. A specific assessment in third year, focuses on patient
group direction (PGD).
Students, if judged to be competent by the registrant, may actively participate in the
administration of the following medication, providing these are subject to a patient
specific direction (PSD).
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Oral
Topical
Transdermal
Instillation of eye drops/ointment
Instillation of ear drops/ointments
Intramuscular injections
Subcutaneous injections
The NMC (2009 pg2) clearly identify that ‘student nurses CANNOT supply
and/or administer under a patient group direction(PGD), but that they would be
expected to understand the principles and should be involved in the process.’:
Students and registrants are advised that:
 During training students are NOT able, nor should they be expected, to
administer medications out with those specifically identified above, which ALL
MUST be subject to a patient specific direction.
 A registered nurse / midwife should supervise the student with the
administration of medications at all times
 If the student administers any medication it must be signed for by both the
student and the Registered nurse. As the registered nurse / midwife remains
accountable for all administrations.
 In learning environments where staff other than registered nurses / midwives
administer medication the student may observe but not administer
medications.
 If the registered nurse / midwife does not feel able to take responsibility for a
student to administer medications then the student should not partake. The
student and mentor should explore alternative learning opportunities.
 All students should be aware of the NMC Code - Standards of conduct,
performance and ethics for nurses and midwives (2008b); NMC Standards for
medicine management (2008a) and the NMC Guidance on professional
conduct for nursing and midwifery students (2009). Therefore if at any time a
student does not feel prepared to participate in medication administration the
onus is with the student to decline.
 If a clinical learning environment’s local policy prohibits student’s involvement
in medication administration the students should not be involved. The student
and mentor should explore alternative learning opportunities.
Students and registrants are reminded that the scope of situations encompassed
within the administration of medicines is potentially wide. Consequently they are
referred to the definition of what a medicinal product is taken from the NMC (2008a
pg3) Standards for medicine management.
“Any substance or combination of substances presented for treating or preventing
disease in human beings or in animals. Any substance or combination of substances
which may be administered to human beings or animals with a view to making a
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medical diagnosis or to restoring, correcting or modifying physiological functions in
human beings or animals.”
Controlled Drugs
Students may participate, in most instances*, with the checking and administration of
controlled drugs under the supervision of a registered nurse. The student nurse’s
signature must always be countersigned by the registrant. However, please check
with individual Trust policy.
* see NMC (2008a) Standards for medicines management (standard 8)
Subcutaneous and Intravenous infusions
Student nurses may observe and assist practitioners i.e. as assistant in delivery of
aseptic care, with the insertion of cannulae for the administration of any infusions. At
NO point in their training may students insert such cannulae themselves.
Standard 20 of the medicines management (NMC 2008a pg9) identifies that
‘whenever possible two registrants should check medication to be administered
intravenously, one of whom should also be the registrant who then administers the IV
medication.’
Student nurses can, if deemed competent and in line with local policies, and under
the supervision of a registrant ‘run through’ infusion giving sets for registrants to
connect.
Student nurses can, if deemed competent and in line with local policies , and having
carried out the relevant checks under the supervision of a registrant, and with the
registrant in attendance at all times, change infusion bags.
NB: during the branch programme students on the adult branch will undergo a
summative assessment in a practice environment on the monitoring and assessment
of patients/clients receiving intravenous fluids
Blood transfusions
Whilst blood is not classified as a medicinal product some blood components are eg
clotting factors, albumin and antibodies. However guidance by the National Patient
Safety Agency (2006) identifies that all staff involved in blood transfusion should
undergo formal competency assessment on a three yearly basis. Consequently
student nurses MUST NOT be actively involved in any aspect of either the collection
or establishment of blood transfusions.
MONITORING POLICY
Students are reminded that their conduct, skills and professionalism, which include
an ability to adhere to policy requirements and recognize ones own limitations, are
part of the formative and summative assessment processes for each clinical
placement.
University staff will monitor adherence to policy requirements. This will occur when
visiting students in placement areas and through interactions with mentors. It is also
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maintained through formal and informal interactions with students eg during tutorials,
discussion groups and via written work.
Compliance with this policy will be monitored by both, the University and Trusts,
through reports of any incidents.
POTENTIAL REPERCUSSIONS
Failure to comply with this policy will be regarded seriously and steps may be taken
to invoke disciplinary measures.
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REFERENCES
National Patient Safety Agency (NPSA) (2006)Right Patient Right Blood (Safer
practice notice 14) [online] available at
http://www.nrls.npsa.nhs.uk/resources/?entryid45=59805
NMC (2008a) Standards for medicines management. London. NMC
NMC (2008b)The Code: Standards of conduct performance and ethics for nurses
and midwives. London. NMC
NMC (2008c) Standards to support learning and assessment in Practice. London.
NMC
NMC (2009) Guidance on professional conduct for nursing and midwifery students.
London. NMC
NMC (2009) Supply &/or administration of medicine by student nurses and student
midwives in relation to Patient Group Directions (PGDs) NMC circular 05/2009
Accessed online at: http://www.nmc-uk.org/aArticle.aspx?ArticleID=3552
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