Managing medicines in care homes – implementing the NICE Quality Standard
In a previous blog I looked at the implications of implementing the NICE Guideline on Managing Medicines in Care Homes.
Here I reflect on the NICE Quality Standard for Managing Medicines in Care Homes. Like the Guidelines the Quality Standard is wide ranging, with huge implications for Care Homes. To help make practical sense of the NICE Quality Standard here are tips for delivering three of its overarching quality statements.
The focus is on safety of residents and is based on what I have learned from my role as a NICE Medicines and Prescribing Associate.
Meeting Quality Standards represents a challenge for care home providers and staff, not least because many of them rely on other services and providers to help deliver a joined up approach to medicines management.
Care Homes must have a medicines policy that is regularly reviewed.
It’s worth considering how your policy links to staff training and how user friendly it is. Are procedures outlined clearly in the policy and do you use checklists?
For example, we recently helped a care home produce a checklist on the key information needed when contacting a doctor. It is based on the SBAR (situation-background- assessment-recommendation) principle to help focus on the key information. This is proving popular as it saves time on the ‘phone, and the structured approach is popular with GPs.
People must have an accurate listing of their medicines on the day they transfer to the care home.
This is an area where care home staff are dependent on others. Hours can be spent trying to sort out problems. My advice here is for managers to ensure that discrepancies are always reported back to the source (in writing), and ask for feedback on how they are followed up. Additionally it’s helpful to record your satisfaction with good quality and complete discharge information, and our experience is that can electronic systems greatly improve quality of this information.
An NHS Patient Safety Alert highlights the importance of communication of discharge information.
People who live in care homes should have at least 1 multidisciplinary medication review per year.
There is considerable variation in practice around medicines reviews, with help available from Clinical Commissioning Group Medicines Management Teams and Specialist Clinicians in most areas.
Although this is an area largely outside the control of care homes there are 3 things which can help.
- Firstly, by consistently referring back any prescriptions which don’t have complete and unambiguous directions.
- Secondly, by ensuring that there is an easily accessible record of what each medicine is being prescribed for, (regular medicines, one-off prescriptions and as required medicines). I am still amazed that this isn’t always the case.
- And thirdly, whilst staff residents / relatives are not expected to be experts on medicines, access to basic information the each medicine, including on side-effects and interactions should be readily available (see www,medsinfo.guru ).
Author: Steve Turner, Managing Director Care Right Now CIC
‘Safe handling and administration of medicines in care homes – supporting person centred care’ http://goo.gl/JdBBhP
Quick links to trusted medicines information: http://goo.gl/ikM968
Author: Steve Turner
m :07931 919 330