Independent Nurse: Practical Prescribing

May 20, 2008 by admin 

We are a team of nurse practitioners prescribers working for a social enterprise company. We currently work for a PCT providing in and out-of-hour’s primary care. Occasionally we supply medication direct to patients. The PCT has supplies of common antibiotics etc either stored in our car or at base. Sometimes these supplies do not equate to the course and we label the drugs ourselves. What is the difference between supplying and dispensing? We believe the procedure for the storage of medicines, both at base and in the car is unsafe. We have discussed this with the relevant manager and some changes have been made, however, we still feel things are unsafe. A follow-up audit has been promised. How do we stand legally and professionally whilst maintaining a duty of care to our patients?

As you are labelling the medicines from a stock supply that is then administered to a patient, you are dispensing. Wherever possible, nurse prescribers should ensure the separation of prescribing and dispensing (NMC 2006). In exceptional circumstances where nurses are involved in both activities for a patient, a second suitable competent person should be involved in checking the accuracy of the medicine provided. Within the context of the situation you have described, this could be a patient or a relative.

As your car is being used to transport medicines, it should be insured for PCT business purposes. Medicines should be transported in your car in a cool, dry, lockable container, out of sight, in your boot. Medicines should not be stored in your car but in a secure, locked cupboard located in a cool area (or fridge if appropriate) at base. As long as you are working within the policy of the PCT, you are practicing legally. However, you should raise any concerns at the follow-up audit.

Reference
NMC (2006). Standards of Proficiency for nurse and midwife prescribers. London: NMC

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