Safe Administration of
Medication (SAM) Policy
*****************************
KARE POLICY DOCUMENT
Policy Owner: Chairperson Nurses Group
Rev. No.
Rev. 1
Approved by Heads
of Units / OMT
Sept. 2003
Approved by
KARE Board
Oct. 2003
Rev. 2
Jan. 2007
March 2007
Rev. 3
Feb 2009
March 2009
Rev. 3.1
June 2009
Rev. 3.2
Sept. 2009
Launched
Heads of Units
Operational Period
Nov. ’03 – Mar. ‘07
April ’07 –Mar. ‘09
March 2009
Mar ‘09 – May 09
N/A
June 2009
June 09 - Oct. 09
Oct 2009
Nov. 2009
Nov. 09 -
KARE Policy: Safe Administration of Medication
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Section 1:
1.1
Policy
Background to this Policy
KARE recognises that where medication is prescribed for service users in their care, every
effort should be made to ensure the safe and proper use of such medication. In keeping with
the ethos of ordinary living, the requirements for administration, storage and transport of
medication should not over-ride other rights of freedom of service users. Medication should be
administered in a dignified and confidential manner. This is particularly important where
medications are administered away from a KARE setting and require a level of privacy on
administration.
The previous revision of KARE's Administration of Medication Policy has been updated in line
with best practice to form this policy.
1.2
Aim of this Policy
The aim of this policy is to ensure KARE staff manage and administer medication in a safe
manner and in line with best practice.
1.3
Scope of this Policy
This policy refers to all medication used by service users while in KARE services.
“Medication” is a licensed drug taken to cure or reduce symptoms of an illness or medical
condition. Medications are generally divided into two groups - Over-the-counter drug (OTC)
medications, which are available in pharmacies and supermarkets without special restrictions,
and Prescription only medicines (POM), which must be prescribed by a physician.
All medications have some effect on the body, therefore it is necessary to have all medication,
including ‘over the counter’ preparations e.g. painkillers, calpol, creams etc., prescribed by a
Medical Practitioner apart from those outlined in 1.4.1.5.
1.4
Policy Statements
1.4.1
General
1.4.1.1
Medication will be administered to Service Users in a dignified way that respects their
right to confidentially and privacy.
1.4.1.2
Particular care will be taken to ensure medications that need to be administered away
from KARE settings are done so in a way that respects the privacy of the individual.
1.4.1.3
The Line Manager will take overall responsibility for the management of medication
within their service except when a Registered Nurse is on duty. In doing this they may
delegate the responsibility for the administration of medication to a staff member they
deem competent to carry out this task.
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Rev. 3.2
Nov 2009
Page 1 of 7 pages
KARE Policy: Safe Administration of Medication
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1.4.1.4
When a Registered Nurse is on duty, they will take overall responsibility for the
management of medication within their service. In doing this they may delegate the
responsibility for the administration of medication to a staff member they deem
competent to carry out this task.
1.4.1.5
The first aid box held on a KARE premises may include the following non-prescription
medication:

Sun Cream

Anti-Septic solution

Anti-septic ointment

Vaseline
1.4.1.6
The Line Manager will ensure all staff are aware of the actions and side effects of
medication administered in their unit/area of work.
1.4.1.7
The Line Manager will ensure service users are given information on the actions and
side effects of the medication prescribed to them.
1.4.1.8
The Line Manager will ensure that there is an up to date copy of the British National
Formulary (BNF) reference or Monthly Index of Medical Specialities (MIMS) available
to staff in their unit.
1.4.1.9
The Line Manager will ensure parents/guardians of users of their service are aware
of the Safe Administration of Medication Policy and how non-adherence to it may
result in their son/daughter having to return home.
1.4.2 Transcribing of Prescriptions
1.4.2.1
Each service user who requires medication will have an up to date Kardex.
1.4.2.2
The Kardex will be written and signed by the service user’s GP and is valid for a
period of six months.
1.4.2.3
KARE will nominate designated Transcribers who may transcribe Kardex where
necessary. A Transcriber will be a registered nurse who has undertaken specific
training in transcription of Kardex.
1.4.2.4
A doctor’s prescription may be transcribed / typed onto a KARE Kardex by a
designated Transcriber.
1.4.2.5
A transcribed Kardex will be witnessed by a second staff member and signed by the
GP
1.4.2.6
In an emergency, a faxed copy of a prescription signed by the prescribing doctor may
be obtained to facilitate the administration of medication. This copy should be
attached to the service user’s Kardex. The Kardex should be updated and signed by
the GP on the next working day.
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Rev. 3.2
Nov. 2009
Page 2 of 7 pages
KARE Policy: Safe Administration of Medication
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1.4.2.7
1.4.3
Where non-regular medication (PRN) is prescribed it should have clear written
guidelines on when it is to be administered.
Managing the KARDEX
1.4.3.1
KARE staff will work with families to ensure an individual’s Kardex is kept up to date.
In the case of individual’s living with KARE, residential staff will ensure that the
Kardex is kept up to date for individuals supported by them. The original Kardex must
travel to and from residential to day services each day with the service user if they
receive medication during the day. In all other cases, day service staff will ensure
the Kardex is kept to up to date for the individuals
1.4.3.2
When service users are availing of respite services and have an original Kardex in
their day services it is the responsibility of the day service staff to ensure that an up to
date Kardex travels with the service user to and from respite every day.
1.4.3.3
When service users are availing of respite services and do not have a Kardex in Day
Services it is the responsibility of the parent/care giver to ensure that an up to date
Kardex is made available to the respite house prior to availing of a respite service.
1.4.3.4
The Kardex should accompany the service user when attending G.P / doctor and
appropriate changes made at this time.
1.4.3.5
Staff will only administer medication if the individual has an up to date
Kardex/Prescription as per Medication Policy
1.4.4
Administration of Medication
1.4.4.1
KARE staff may only administer medication that is recorded on the service users
Kardex, or in the case of an emergency a faxed copy of a prescription signed by the
prescribing doctor.
1.4.4.2
Medication will only be administered when it is in its original container/blister pack
with the original dispensing label.
1.4.4.3
A staff member will ensure they have the correct medicine and dosage prior to
administrating medication to a service user. Non-prescription applications as listed in
1.4.1.4 will be administered in strict accordance with the instructions on the packet.
1.4.4.4
When in doubt with regard to administration advice should be sought from Line
Manager/nurse/pharmacist/doctor prior to administering.
1.4.4.5
A staff member who administers medication will record it on the Drugs Administration
Record (see Forms and Templates Section on intranet) and sign the record to signify
the medication was administrated. In the case of PRN medication the reason for
administration and the outcome of treatment recorded in the service user’s contact
sheet.
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Rev. 3.2
Nov. 2009
Page 3 of 7 pages
KARE Policy: Safe Administration of Medication
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1.4.4.6
Any symptoms requiring persistent use of non-prescription medication should be
reported to the service user’s parent/guardian or their GP as soon as possible.
1.4.4.7
The staff member will report any adverse reaction to medication to the individual’s
family immediately and seek advice from the GP as to any actions required.
1.4.4.8
A staff member will respect the right of a service user to refuse to take their
medication; in such situations the staff member will inform all relevant people
including the individual’s family and seek advice from the GP as to any actions
required.
1.4.4.9
KARE will support service users to administer their own medication where
appropriate. Where relevant a plan will be put in place to support this.
1.4.4.10 A staff member will report any error in the administration of medication including
incorrect dosage and omission to administer medication using the Health and Safety
Incident / Near Miss reporting procedure as outlined in Section 3 of this policy.
Medication that is administered within one hour of its prescribed time is not
considered a drug error.
1.4.4
Transportation and Storage of Medication
1.4.5.1
Discontinued medication and medication passed its expiry date will be returned to the
pharmacy for disposal and receipt obtained for same.
1.4.5.2
Medication will be transported from a service user’s home to a KARE premises in its
original container/blister pack with the service user’s name, the name of medication,
dosage and time of administration clearly marked.
1.4.5.3
On receipt of medication a staff member will check the medication and store it in its
original container/blister pack in a locked cupboard and record it on the Medication
Stock Received Record.
1.4.5.4
Where appropriate medication may be transported between KARE’s units or on
social outings by placing it in a clearly labelled container with the services user’s
name, name of medication, dosage, time of administration and expiry date clearly
recorded on the container. The staff member will note the transfer of medication from
its original container on the Drug Administration Record. On return from outing, the
staff who administered the medication must sign the Drug Administration Record.
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Rev. 3.2
Nov. 2009
Page 4 of 7 pages
KARE Policy: Safe Administration of Medication
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Section 2:
Process
Administration of Medication
Line Manager/
Registered
Nurse
General
Practioner
Owner: Chairperson Nurses Group
Complete
Kardex
Approve
and Sign
Kardex
Kardex
clear?
Yes
File Kardex
ready for
use
Staff Member
Designated
Prescriber
No
Transcribe
Kardex and
get witnessed
Receive and
store medication
as appropriate
Administer
medication as
per Kardex
Error
Report Error using Initial
Incident Report Form and
complete Drug Error Form
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Rev. 3.2
Nov. 2009
Page 5 of 7 pages
Complete Drug
Administration
Record
Section 3:
3.1
Procedures
Drug Error Procedure
3.1.1 In the event of a drug error, the staff member will seek advice from a nurse within
KARE in the first instance, if no nurse available they will telephone the service user’s
Doctor or the Doctor on call immediately to get advice on the action required to
ensure the service user’s safety and how to give medication in the aftermath of the
error.
Where there is extreme concern for the service user an ambulance should be called.
3.1.2 The staff member will give the doctor/emergency service relevant information
including:
a) Service Users name
b) Name of wrong drug given or drug
c)
d)
e)
f)
omission
Time and circumstances of error /
omission
Name any other medication the
service user is taking
Relevant information regarding
service user’s medical history
Observations of any symptoms
since administration of incorrect
medication or omission.
Staff Member
Line Manager
Chairperson of
Nurses Group
Phone doctor/
emergency
services for advise
Carry out advise
Inform Line
Manager
Inform parents /
guardian
Complete and
forward Incident
Report Form
Complete Drug
Error Record
Review Drug Error
Record
3.1.3 The staff member will inform the Line
manager immediately of the drug error.
3.1.4 The staff member in conjunction with relevant
others will carry out the advise of the
doctor/emergency services.
3.1.5 Line Manager/designate will inform the service
user’s parent/guardian/other staff of the drug
error / omission and the action taken.
3.1.6 The Staff member will complete an Initial Incident Report Form and forward it to the
Health and Safety Officer within 24 hours of the error / omission
3.1.7 The Staff member will complete a Drug Error Report (see Forms and Templates
Section on the Intranet) and submit to the Chairperson of the Nurses Group.
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Rev. 3.2
Nov. 2009
Page 6 of 7 pages