When Required Medication
When Required Medication
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On completion of this section you should have a general understanding of:
Classification of medicines
When required medication
Homely remedies
Supporting patients to self care
Classification of Medicines
There are three classes of medicine available under The Human Medicines Regulations 2012. Can you think of these?
Remember: Each of these three classes of medicines has different legal requirements for manufacture, import, distribution, sale, supply, labelling, advertising and monitoring.
Understanding PRN (when required) medicines
PRN or ‘when required’ medicines are prescribed to patients to take when they need them. As the name suggests they do not need to be taken regularly e.g. one every day.
What should be in place to support you?
There should be information e.g. ‘care plan’ available to support you to administer when required medicines. It should state:
The condition the medicine is prescribed to for
Dose instructions, including the maximum amount to take in a day and minimum interval between doses (risk of overdose)
Appropriate alternative support to use before medicines e.g. what personal distractions techniques should be tried first when calming an anxious patient.
Where more than one ‘when required’ medicine is available for the same condition, it should state how and in what order they will be administered
Is should also include:
If the patient can ask for the medicine or if they need prompting or observing for signs of need. For example, non-verbal cues.
If you need to observe signs of need it should be clear what signs or symptoms to look for and when to offer the medicine.
Understanding PRN (when required) medicines (cont')
Other considerations:
Care plans should detail how the medicines will be offered to the person when they are experiencing the symptoms
For care homes this should, not be limited to medicines rounds or times printed on MARs
For Domiciliary Style settings the care plan should describe how PRN medicines will be managed outside of a visit time.
Maintain appropriate stock levels
Maintain accurate records, reason given, time administered, quantity
Monitor patient for effectiveness/need for PRN medicine/side effects.
For more information please visit CQC Medicines: information for all adult social care services and read the CQC guide: ‘When required medicines in adult social care’
Types of medicines often prescribed PRN:
analgesics
anti-psychotics
laxatives
Homely remedies
A homely remedy is a medicine used to treat minor, self-limiting conditions which would not normally require consultation with a doctor. They are purchased over the counter and do not need to be prescribed.
Homely remedy stock should be stored securely and kept separate to prescribed medication and clearly identifiable as a ‘homely remedy’
Advice from a healthcare professional is required. Advice can be sought in advance or at the time of need.
Care providers who offer treatment for minor ailments with homely remedies, should have a process on how to do this safely.
Homely remedies must be:
Administered by competent, trained persons
Recorded on a MAR Chart/electronic patient record
Administered only in accordance with the manufacturers directions and licensed use
Homely remedies - Plans
Plan must state:
Name of medicine
Indication for use
Dose, frequency and maximum dose
Duration of use before referral to a GP/independent prescriber (usually 48 hours)
Cautions and contra-indications for use
For more information please visit CQC Medicines: information for all adult social care services and read the CQC guide: ‘Over the counter medicines and homely remedies’.
Supporting patients to self care
The care provider that you work for should have appropriate safeguards in place to support patients to access over the counter (OTC) products to enable them to self-care.
Access to OTC medicines to self care is an issue of equality. The care provider you work for should support people who wish to access OTC products in a timely manner.
This is different to the use of homely remedies.
A GP may recommend the person, relatives or care staff buy a specific product. This may be to treat a minor ailment for a particular person, such as olive oil for treatment of ear wax. You must record instructions in the individual care plan.
For more information please visit CQC Medicines: information for all adult social care services and read the CQC guide: ‘Over the counter medicines and homely remedies’
For more information please visit CQC Medicines: information for all adult social care services and read the CQC guide: ‘Over the counter medicines and homely remedies’
Considerations for care providers
Patients (or their relatives) may provide their own over the counter (OTC) products. This should be in consultation with a healthcare professional, such as a GP or pharmacist. These products are not for general use and must remain the property of the patient.
All OTC products purchased on behalf of the patient or brought into a care setting should be:
• checked, to make sure they are suitable for use
• in date
• stored according to the manufacturer guidance
• recorded
If you are responsible for administration, record this on a MAR in line with your organisation's policy
Section 2: When Required Medication
In this section we have looked at:
Classification of medicines
When required medication
Homely remedies
Supporting patients to self care
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