New Poisons Guidelines – FAQs

Q) Does there have to be a Registered Nurse (RN) on site when an aged care worker is administering medications?

A) A RN must be onsite and accessible at all times.

Q) Should a nurse be onsite at all times?

A) According to the DHHS Guidelines, which are referred to in Regulation 95EA, residents must have access to PRN medication. PRN medication can only be initiated by a registered or medication endorsed Enrolled Nurse (EN). To be compliant with the Guidelines and the relevant legislation,  a nurse should be onsite, or ‘readily available’, at all aged care facilities at all times to enable a clinical assessment and judgement to be made by a nurse as to whether a PRN medication is required by a resident.

Q) Does it have to be a RN on site, ‘readily available’ at all times, or can it be an EN?

A) Depending on organisational policy, a RN can be on call/offsite and indirectly supervising an EN on duty. It is now within EN scope of practice to initiate an assessment on a resident, for the purposes of assessing whether a resident may need an ordered PRN. The EN must consult with the on call/offsite RN (as the EN works under the general supervision of the RN). The RN must make the judgement based on the information received from the EN whether the resident requires the ordered PRN medication. The on call/off site RN is also responsible for evaluating the effectiveness of the PRN medication given to that particular resident.

The DHHS Guidelines are intended to ensure that there is consistency in the quality of care provided to all nursing home residents and that safe medication management systems are maintained. The State Government has committed to an independent review process of Regulation 95EA, to be conducted within the next 3 years, to enable all reported issues associated with the implementation of this regulation to be considered. 

In accordance with their professional and ethical responsibilities for quality of care to residents, all staff involved in medication administration must report any concerns they have to their immediate supervisor, in the first instance.

Key Messages – Poisons Guidelines

The DHHS Guidelines for the ‘Administration of certain substances by aged-care workers in residential aged care services’ came into affect on 1 September 2010. All residential aged care Approved Providers and employees are legally and ethically obliged to comply with these Guidelines.

It is important that all staff involved in medication administration in residential aged care facilities are aware of the following requirements in relation to medication administration:

  • The DHHS Guidelines are the minimum requirement. Policies and procedures of the aged care facility, in relation to medication administration, may be over and above these. 
  • All policies and procedures, in relation to medication administration, must be transparent and accessible to all staff involved in medication administration.  
  • Comprehensive staff education around policies and procedures should have occurred prior to the implementation of changes affecting staff roles and resident care, in relation to medication administration. 
  • All staff involved in medication administration should be aware of the roles and responsibilities of each level of worker, including exactly who is allowed to administer medications at their facility. 
  • All staff involved in medication administration must have easy access to their facility’s policy and procedures in relation to medication administration and the DHHS Guidelines and the APAC Guidelines.
  • Systems to report incidents, including near-misses must be transparent and accessible to all staff involved in medication administration.  
  • All reported incidents must be reviewed by a Medical Advisory Committee (MAC) that has broad stakeholder representation, and staff who are involved in medication administration should be aware of the implementation of continuous improvement outcomes, to prevent future adverse medication incidents.

CommentsComments

Add Your CommentAdd Your Comment

Poisons Amendment Bill

Guidelines for the ‘Administration of certain substances by aged-care workers in residential aged care services’

ANF is currently drafting a submission on the second consultation paper of the draft guidelines for the administration of certain substances by aged-care workers.

ANF letter – April 2010
Draft 2B Consultation Paper – April 2010
Draft 2 Consultation Paper – April 2010
Draft 1 Consultation Paper - March 2010   
ANF letter – March 2010: Addressing key issues regarding safe medication administration in residential aged care

Poisons Amendment Bill (no.2) & Poisons Amendment Regulations 2009

The ANF has prepared a joint submission paper with the NBT, addressing our position in relation to the poisons amendment bill and regulations.

CommentsComments

Add Your CommentAdd Your Comment

  • 1 Anonymous Mar 27th

    This all makes me wonder why I did my nursing training and so much ongoing medication study when carers in aged care are going to be doing our job. What are we going to be doing. I am an enrolled nurse and much of my work involves medication administration