Factors in administering medications.pdf

Factors in
administering
medications
6/5/2024 Compiled by C Settley 1

Objectives
• 5.1 Identify that the legal requirements of drug prescriptions are
met.
• 5.2 Describe the appropriate conditions for the storage and care of
drugs in the unit in accordance with legislation, regulations and unit
procedures.

Laws and regulations
• In South Africa, drug prescriptions are governed by various laws and
regulations to ensure safe and effective use of medications.
• 1. Legislation
• The primary legislation governing drug prescriptions in South Africa includes:
• Medicines and Related Substances Act (Act No. 101 of 1965)
• Pharmacy Act (Act No. 53 of 1974)
• Health Professions Act (Act No. 56 of 1974)
• SANC

• 2. Prescribers
• Only authorized healthcare professionals are allowed to prescribe
medications. These typically include:
• Medical practitioners (doctors)
• Dentists
• Veterinarians (for veterinary medicines)
• Certain categories of nurses and pharmacists with specific training
and authority under certain circumstances.

• 3. Prescription Requirements
• A valid prescription must include the following information:
• Patient Information: Full name, age, and gender.
• Prescriber Information: Full name, qualification, registration number, contact details,
and physical address.
• Date of Prescription: The date when the prescription is issued.
• Medication Details:
• Name of the medication (generic name is preferred)
• Dosage form (e.g., tablet, liquid)
• Strength of the medication
• Quantity to be dispensed
• Dosage instructions (how, when, and how long the medication should be taken)
• Signature of the Prescriber: The prescription must be signed by the prescriber to be
valid.

• 4. Regulation of Controlled Substances
• Certain medications, particularly those classified as Schedule 5, 6, or 7, are
subject to stricter regulations due to their potential for abuse or dependency.
Prescriptions for these substances must comply with additional requirements:
• Special Prescription Form: Often required for Schedule 6 and 7 drugs.
• Patient Identification: Proof of identity may be required when
dispensing.
• Record-Keeping: Detailed records must be kept by pharmacies for
these prescriptions.

• 5. Validity Period
• Prescriptions have a limited validity period:
• Typically, a prescription is valid for six months from the date it is written.
• For Schedule 5 and 6 substances, the validity may be limited to 30 days.

• 6. Electronic Prescriptions
• Electronic prescriptions (e-prescriptions) are becoming more common and
must comply with the same legal requirements as paper prescriptions. They
must be secure, authentic, and contain all the required information.
• 7. Repeat Prescriptions
• Repeat prescriptions must clearly state the number of times the medication
can be dispensed. If no repeat instructions are provided, the prescription is
considered a single-use prescription.

• 8. Pharmacy Role
• Pharmacies have the responsibility
to:
• Verify the validity of the prescription.
• Ensure the prescription is legible and
complete.
• Dispense the correct medication and
provide appropriate patient
counseling.
• Maintain records of dispensed
prescriptions, especially for
controlled substances.

• 9. Patient Counseling and
Informed Consent
• Patients should be informed
about:
• The name and purpose of the
medication.
• How to take the medication
correctly.
• Potential side effects and what to
do if they occur.
• The importance of adherence to
the prescribed treatment.

• 10. Legal and Ethical Compliance
• Healthcare professionals must adhere to ethical guidelines and professional
standards to ensure the safe prescribing and dispensing of medications.
• They should stay updated with changes in legislation and best practices.
The storage and care of drugs in a healthcare unit must comply with
legislation, regulations, and unit-specific procedures to ensure the safety,
efficacy, and integrity of the medications.

General Storage Conditions
• a. Temperature Control
• Room Temperature: Most medications should be stored at a controlled room
temperature, typically between 15°C and 25°C.
• Refrigeration: Medications requiring refrigeration should be stored at 2°C to
8°C. This includes certain vaccines, insulin, and some antibiotics.
• Freezing: Some medications may need to be stored in a freezer at
temperatures below -15°C, but this is less common and typically applies to
specific biologics.

General Storage Conditions
• b. Humidity Control
• Medications should be stored in a dry environment with humidity levels
controlled to prevent degradation. High humidity can cause tablets to
disintegrate or capsules to become sticky.
• c. Light Exposure
• Medications should be protected from direct sunlight and strong artificial
light. Some drugs are photosensitive and can degrade when exposed to light,
requiring storage in opaque or amber-colored containers.

3. Security Measures
• a. Access Control
• Restricted Access: Drug storage areas should be secured and accessible only
to authorized personnel such as pharmacists, nurses, and physicians.
• Controlled Substances: Medications classified as controlled substances
(Schedules 5, 6, and 7) must be stored in a locked, secure cabinet or safe to
prevent theft and misuse.
• b. Inventory Management
• Regular Audits: Conduct regular inventory checks to monitor stock levels and
identify discrepancies.
• Expiration Monitoring: Implement a system to track expiration dates and
ensure that expired medications are promptly removed and disposed of
according to regulations.

4. Storage Procedures
• a. Labeling and Segregation
• Clear Labeling: All medications should be clearly labeled with the drug name,
strength, expiration date, and storage conditions.
• Segregation: Store different categories of medications (e.g., oral tablets,
injectables, topical preparations) separately to avoid confusion and cross-
contamination.
• b. Emergency Medications
• Emergency drugs should be stored in easily accessible, clearly marked
locations. They should be regularly checked to ensure they are within their
expiration date and ready for immediate use.

5. Cold Chain Management
• For medications requiring refrigeration or freezing:
• Temperature Monitoring: Use calibrated thermometers to monitor
temperatures continuously. Maintain logs to record temperature
readings.
• Backup Systems: Have backup power systems in place to ensure that
refrigeration is maintained during power outages.

6. Handling and Transport
• Proper Handling: Medications should be handled with care to
prevent damage. For instance, vials should not be shaken, and tablets
should be kept in their original containers until dispensed.
• Transport Conditions: When transporting medications between units
or facilities, ensure that appropriate conditions (temperature,
security) are maintained throughout the journey.

7. Unit-Specific Procedures
• a. Standard Operating Procedures (SOPs)
• Each unit should have detailed SOPs outlining the procedures for the storage,
handling, and management of medications. These SOPs should align with legislative
and regulatory requirements and be regularly reviewed and updated.
• b. Staff Training
• Ensure that all staff involved in medication management are adequately trained in
storage requirements, security measures, and emergency procedures.
• c. Spill and Waste Management
• Implement procedures for handling medication spills and disposing of
pharmaceutical waste safely and in compliance with environmental regulations.

Case scenario 1
• Nurse Sam is responsible for storing a new batch of vaccines that has
just arrived at the clinic. The manufacturer's instructions indicate that
the vaccines must be stored at a temperature between 2°C and 8°C.
Nurse Sam notices that the refrigerator designated for vaccine storage
is currently reading 10°C.
• Questions:
• What should Nurse Sam do immediately to ensure the vaccines are stored
correctly?
• What steps should be taken to prevent this issue from occurring again?
• What are the potential consequences of storing vaccines at an incorrect
temperature?

Case scenario 2
• A pharmacy technician, Lisa, is tasked with restocking the controlled
substances cabinet. She notices that the cabinet is unlocked, and the
inventory log shows discrepancies with the actual stock count.
• Questions:
• What immediate actions should Lisa take upon discovering the unlocked
cabinet and inventory discrepancies?
• What are the best practices for ensuring the security of controlled substances
in the pharmacy?
• What could be the implications of failing to secure controlled substances
properly?

Case scenario 3
• Dr. Patel needs to send a prescription of insulin to a patient in a rural
area. The insulin must be kept cold during transport. The courier
service indicates that the transport will take approximately 6 hours.
• Questions:
• What steps should Dr. Patel take to ensure the insulin is kept at the correct
temperature during transport?
• What instructions should be given to the patient regarding the handling and
storage of the insulin upon receipt?
• What could happen if the insulin is not kept at the correct temperature during
transport?

Case scenario 4
• Pharmacist John discovers a batch of antihypertensive medications
that have recently expired on the pharmacy shelf.
• Questions:
• What should John do with the expired medications?
• What procedures should be in place to prevent medications from expiring on
the shelf?
• What are the risks of dispensing expired medications to patients?

Factors in administering medications.pdf

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