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Advice on the preparation and/or administration of contrast agents supplied under a Patient Group Direction

Jo Jenkins, Specialist Pharmacist (Patient Group Directions) SPS Medicines Use and Safety Division Published
Topics: Care SettingCommunity Health ServicesHospital Pharmacy and Medicines Optimisation Programme (HOPMoP) · Patient Group DirectionsPreparingTrusts ·

Questions have been asked as to whether or not it is acceptable for a registered or unregistered healthcare professional (HCP) to prepare and/or administer contrast to an individual that has been supplied by a Radiographer (or Speech and Language Therapist) under a Patient Group Direction (PGD).

For general principles of PGD use for the administration of contrast media see Patient Group Directions (PGDs) for administration of contrast media in radiology services and exemplar PGD templates

The legality of this preparation and/or administration will depend on the route of administration, the process being followed and the legal status of the contrast agent.

 

 

 

 

 

 

Parenteral contrast (e.g. IV)

 All parenteral contrast agents are Prescription Only Medicines (POMs).

 

No delegation of administration of a parenteral medicines supplied under a PGD is permissible under the legislation.

 

Therefore IV contrast must be supplied and administered by the registered Radiographer approved to operate under the PGD; this includes all preparation and required manipulation of the contrast (e.g. dilution) and/or loading of pre-filled syringes into injectors (including multi patient/use injectors).  No part of the process can be delegated to another registered or unregistered HCP (e.g. health care assistant, radiographic assistant, nurse or another radiographer).

 

For further information refer to Can supply or administration be delegated to another practitioner under a PGD?
 

 

 

 

 

 

Non-parenteral prescription only contrast (e.g. oral or rectal) requiring dilution before administration

 The contrast must first be supplied to the patient by the registered Radiographer (or Speech and Language Therapist) approved to operate under the PGD.

 

Once it has been supplied the contrast agent can then be diluted and administered by another registered or unregistered HCP (e.g. health care assistant, radiographic assistant, nurse or another radiographer).

 

The process of dilution and/or administration should follow a locally approved protocol/SOP which includes the required training and competence of the HCP undertaking the dilution and/or administration.

 

The MHRA and CQC have confirmed that single dose medicines which are non-parenteral and which are supplied by a healthcare professional under a PGD and immediately administered by another person, such as a HCP, in the same examination room or clinic do not require labelling.
 

 

 

Non-parenteral prescription only contrast (e.g. oral or rectal) requiring thickening before administration

 The contrast must first be supplied by the registered Radiographer (or Speech and Language Therapist) approved to operate under the PGD.

 

Once it has been supplied the contrast can then be thickened and administered by another registered or unregistered HCP (e.g. health care assistant, radiographic assistant, nurse or another radiographer).  The process of thickening and/or administration should follow a locally approved protocol/ SOP. This should include the required training and competence of the HCP undertaking the thickening and/or administration.

 

The MHRA and CQC have confirmed that single dose medicines which are non-parenteral and which are supplied by a healthcare professional under PGD and then immediately administered by another person, such as a HCP, in the same examination room or clinic do not require labelling.

 

For the supply and/or administration Pharmacy Only (P) and General Sales List (GSL) medications (these include some contrast) see When Patient Group Directions (PGDs) are not required. Guidance on when PGDs should not be used and advice on alternative mechanisms for supply and administration of medicines

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