Assessment of Patient’s Own Drugs (PODs)
Medicines that the individual has brought in from home are always preferable to continue to use, as long as they are appropriate.
PODs should be assessed for suitability using the organisation’s assessment tool. The following points should be covered as a minimum to ensure the:
- individual is currently prescribed the medication
- medicines are in date
- labels have the correct patient details and full dosing instructions
- formulation is suitable for use by the individual
- individual is able to open containers and read the labels
Where PODs are deemed not suitable for use, they should be disposed of in line with the organisation’s medicines policy.
Infection risk of PODs
Appropriate infection prevention controls must be used where staff are concerned that the PODs may constitute an infection risk.
Depending on the nature and spread of the perceived contamination, the organisation should make available procedures for decontamination if this is deemed more appropriate than destruction.
There must also be an identified protocol to ensure that the PODs follow the individual on their journey through the hospital, including the management of contamination.
These medicines have additional safe storage requirements.
Organisations should make their own decisions whether they can support the self-administration of medicines which are controlled drugs, based on the clinical setting and the individuals involved.
Individual patient bedside POD lockers should be available for the safe, secure storage of medicines and meet the following requirements:
- the medicines must be within the reach of the individual (or their carers if carer administration is being undertaken) and in a form that the individual can use
- POD locker may be secured by any suitable means including an individual key, digilock or swipe card lock
- the individual’s responsibility for the secure storage of their medicines is agreed during the consent process for SAM
Exempt from secure storage
Organisations may choose to exempt certain medicines from secure storage to support ease of access to some medicines e.g. reliever inhalers, glyceryl trinitrate (GTN) spray, insulin. This should be risk assessed and referenced in the organisation’s medicines management policy.
A risk assessment must be undertaken to determine the appropriateness of SAM, where medicines cannot be stored in accordance with the organisation’s medicines policy.
In exceptional circumstances, such as a major incident where it may be impossible to have locked storage, SAM may still be achievable where supported by the outcome of a risk assessment.
Organisations must have processes to risk assess the medicines storage requirements for patients being treated in their own homes. Most medicines will not require secure storage. Safe storage will depend on the home situation and the potential risk to others.
The following examples illustrate the rationale for supporting secure storage exemption requirements with certain medicines.
- individuals with diabetes frequently monitor their blood glucose and inject insulin multiple times each day
- they usually manage their diabetes independently whilst at home, linking insulin with meals as required
- individuals should be included for SAM to enable them to link insulin with hospital mealtimes and manage their blood glucose levels as normal
- in-use insulin does not require refrigeration and may be stored in the same secure storage as the rest of the individual’s medicines i.e. bedside POD locker
- organisations should risk assess the need for locked storage of insulin and support alternatives
- timing of medication in Parkinson’s disease is crucial and often falls outside the traditional times for nursing drug rounds
- individuals or carers who wish to self-administer should be assessed in the usual way with particular consideration being given to which medicines may be administered if the individual requires additional care
- individuals who are self-administering their own medicines should not require nurse administration of “homely remedies”
- organisations should have an identified process whereby a suitable supply of any necessary homely remedy is made if required to a individual undertaking SAM.
- the organisation must have a defined list of such products and the circumstances under which they may be supplied
- a PGD will be required for the supply of Pharmacy Only (P) medicines
- General Sales List (GSL) medicines may be supplied by any suitably trained healthcare professional
Further information for homely remedies
The Regional Medicines Optimisation Committee has issued guidance on homely remedies in care homes and this can be adapted for different care settings.
SPS has issued guidance on when a PGD is not required and this includes a series of template protocols to support the supply of several GSL medications. These protocols may be locally adapted where individuals are self-administering their regular medicines and a supply of a GSL medication, as a homely remedy, is deemed appropriate.
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