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SAFE AND SECURE HANDLING OF MEDICINES

Section 6:
Patients own medicines in hospital

It is NHS Tayside policy to ask patients to bring with them on admission their current medication in the original containers. This is to facilitate medicine history taking and to enable the pharmacist and the hospital clinician to identify what treatment regime the patient is following.

Unlike medicines supplied by the pharmacy services within the hospital, there is no continuous control of the quality of the medicines brought in by patients. Therefore, patients own medicines may be used only where their quality has been assessed and approved in accordance with guidance in this document.

In handling and dealing with these medicines on the ward/department it is important to be aware that:

(a)	these medicines are the property of the patient, and must not, therefore, be destroyed or otherwise disposed of without the patient's agreement.
(b)	medicines brought in by the patient may be used in the treatment of that patient only where they can be positively identified, are of the appropriate quality, and are approved for use, unless there is evidence that the medicines are likely to cause harm or their use is illicit.
(c)	Practitioners involved in the use of Patients Own Medicines will adhere to the principles outlined in the Medicines Management 1 - Use of Patients Own Medicines

These medicines must not be used in the treatment of any other patient.

Responsibility for and security of patient’s own medicines are the same as for ward/department stocks of medicines.

A record of medicines brought into hospital by a patient need to be maintained irrespective of whether it is used or not. On discharge a record must also be made of medicines returned to the patient.

One of the following procedures shall be observed and all actions recorded: -

6.1 Medicines That Are Not Used In The Hospital

The medicines may be stored in the ward/department until returned to the patient at time of discharge.
A record is made of the receipt and return of Patient's Own Medicines.
Patient’s own Controlled Drugs must be entered into the ward Patients’ Own Controlled Drug Record Book and stored in the Controlled Drug cupboard.
The medicines may be returned home via an identified adult if the patient does not agree to use their medicine in hospital. (Responsibility for security is transferred to that adult).
If the patient or the patient's agent agrees, the medicines may be sent to the pharmacy for destruction.

For controlled drugs - see Section 6.3 below.

6.2 Patient’s Own Medicines That Are Used In The Hospital
The clinical pharmacist/pharmacy technician/nurse will assess the suitability of the patient’s own medicines for use on the ward. The Guidelines, which define the acceptability, or otherwise, of the medicines are detailed in Appendix 1. The consent of the patient must be sought to use their own medicines and documented in the nursing records.

In such situations, the ward medicine chart must be annotated "POD" to indicate that the medicine is accepted for use and the entry must be initialled by the Registered Nurse.

Once this process has been carried out the patients own medicine must be stored securely in the patients own medicines locker, or in an appropriate medicine trolley at ward level.
A patient must not be discharged with his own medicines or medicines supplied for use on the ward before the discharge prescription/ interim letter is written and the medicines checked against the current ward prescription by a pharmacist, pharmacy technician, Doctor or suitably Registered Nurse.

6.3 Patient’s own Controlled Drugs
When a patient brings their own Controlled Drug into hospital, the following additional procedures shall take place, unless it is sent home immediately: -

The patient’s Controlled Drug is stored in the Controlled Drug cupboard on the ward.
The Controlled Drug shall be entered into the ward Patients’ Own Controlled Drug Record Book.
If the patient is in agreement, their own medicines may be used in their own treatment. In these circumstances, the Medicines Management 1 - Use of Patients Own Medicines and guidance contained in Section 8.8.12 must be followed.
At the time of discharge, if the medicines are returned to the patient, an entry to that effect shall be made in the ward Patients’ Own Controlled Drug Record Book.
If the Controlled Drug is no longer required by the patient it may be destroyed on the ward with his/her agreement by arrangement with the clinical pharmacist.
An entry to that effect shall be recorded in the ward Patients’ Own Controlled Drug Record Book.
If the Controlled Drug is to be used to treat the patient on the ward, the Controlled Drug will be entered in the ward Patients’ Own Controlled Drug Record Book as described above and administration recorded in the Record Book. It must only be used for the named patient.
If it is suspected that there is a Controlled Drug in a Monitored Dosage System (e.g. Nomad, Venalink), store in the Controlled Drugs Cupboard and the Clinical Pharmacist must be contacted for clarification.

Updated: 26 April 2018