drug refresher courses????

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Specializes in medical with other stuff chucked in!.

Hi. just a quick question. In the UK once you qualify, do you have to go on regular medication refresher courses to keep you up to date with things?

Also, how many of you guys knew that crushing tablets/ opening capsules is illegal?

The reason i am asking is because i have to do a report for my course. I am doing it on the practice of tablet crushing, and i just need abit more information for it.

Thanks.

Emma

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Hi. just a quick question. In the UK once you qualify, do you have to go on regular medication refresher courses to keep you up to date with things?

Also, how many of you guys knew that crushing tablets/ opening capsules is illegal?

The reason i am asking is because i have to do a report for my course. I am doing it on the practice of tablet crushing, and i just need abit more information for it.

Thanks.

Emma

Hi Emma

Yes if tablets / capsules are opened / crushed you change the way the drug maybe absorbed by the patient and therefore could cause untoward adverse reactions, I found this out when needing to give meds via gastrostomy feed sites and had to look into getting soluble or liquid forms instead. As an extended nurse prescriber i voluntary attend any update refresher courses about medicines etc. but am not required to do so compulsory

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yes i did know crushing/opening tablets is illegal, as i work on paeds we have it told to us all the time. if child can not take tablets we give liquid form if available, which in most cases it is.

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Specializes in RN, BSN, CHDN.

Talk to somebody in your pharmacy dept they have all the upto date information. If you work on the rule that tablets are meant to be given in the form that they are dispensed in then if you need to do anything else with them get the evidence to back it up. As far as I am aware most common drugs with come in all shapes sizes and forms, drugs which are scored can be broken in half so you may give half the dose but if they are not scored then you shouldn't break to give. You must obtain the correct dosage tablet.

We dont have yearly updates but as a RN I give drugs the respect they deserve and always check the adminisration and side effects of them if I am unsure.

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Hi,

We don't crush drugs in the ED, but when I worked on a respiratory ward, it was a regular practice, I've never been told it is illegal... but then we don't have an oral drugs course. I'd never open a capsule for a patient, since if it is in a capsule, clearly it is intended to dissolve further down the GI tract.

As for IV drug courses, the idea is that they are yearly, but nurses who have been in my department for 25 years have not had refreshers. I think the problem is the vast turnover of nurses in the trust means that the study days of IV admin are taken up by new nurses.

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Specializes in midwifery, ophthalmics, general practice.

hi

I'm an extended/supplementary prescriber.......and yep dont crush drugs either. but hadnt heard it was illegal? there are often alternatives if you need it- just need to look. my BNF is the most thumbed book i have!

Karen

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Specializes in medical with other stuff chucked in!.

Thanks for your replies guys, i apprechiate it.

Karen G. Yes apparently it is. I didn't know that either until i read up for my assignment. It is a breach of legal and professional requirements. Nurses can be struck off the register if they change the formulation of a drug, which ultimately causes harm to the patient.

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oops, double post

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I was aware of concerns about covert administration and consent issues, but I would not have put it so baldly as "this is illegal". Crushing a tablet however, changes its form and form is part of a drug's prescription, and its licence for use.This article covers the topic.

http://www.professionalnurse.net/nav?page=pronurse.article&resource=588487&fixture_article=588487&category=LAW_ETHICS

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Specializes in midwifery, ophthalmics, general practice.

ok..

as I am curious......... I have checked out some of the stuff I got during my extended/supplementary prescribing course. I have found a list of drugs which must not be crushed or altered.... but I also have a list of drugs- capsule form, which it states the capsule may be 'opened and the contents taken without crushing or chewing or may be given in a nasogastric tube' (pharmacology;principles and applications 2003)

so now ... point me in the direction of the legislation that says its illegal to crush drugs or open capsules. there a fair few of us who have in the past crushed drugs!!

Karen

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Specializes in medical with other stuff chucked in!.

It is what i have read during my research for my assignment. Maybe i have got the wrong end of the stick. I really aprechiate you guys help and comments.

Here is a list of my references if you want to check:

Griffiths R 2003 Tablet crushing and the law. The implications for nursing ]Professional nurse 19(01; 34-37

IHCP The basic legal issues surrounding the crushing of tablets or opening of capsules - online

available at: http://www.swallowingdifficulties.com/professional/legal.htm

Wright D 2002 Tablet crushing is a widespread practice but it is not safe and may not be legal The Pharmaceutical journal 269(7208); 132

Bending A 2001 Does a spoonful of sugar help the medicine go down? Primary nursing care magazine - online

Available at http://www.cdna.tvu.ac.uk/pnc/JunePNCOI.html

Wright D 2002 Swallowing difficulties protocol:medication administration Nursing standard 17(14-15); 43-45

Griffith R, Griffiths H and Jordan S 2003 Administration of medicines part i: the law and nursing Nursing standard 18(2); 47-53

NMC 2000 Guidelines for the administration of medicines NMC, London

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Specializes in RN, BSN, CHDN.

hI,

Second link doesn't work :)

I know in my trust, we are not allowed to crush or open capsules before we clear that is ok with pharmacy. They will research all up to date information and give us guidelines with relevent documented information. For example if a patient is on warfarin and it is NG feed or PEG fed the feed should be stopped 2 hours either side of the medication the rationale is that if the feed contains vitamin K then it counter-indicates the warfarin. Of course you can give clexaine S/C, but I am just saying there are more things to consider when administrating drugs if they are not being given in their prescribed form. It is not only due to the drug licence.

The reason majority of pregnant woman are not prescribed lots of different kinds of medication is not because we know it harms their new born baby it because we cant guarentee it wont. Good research on the drugs cannot be carried out because when asked 'Will you trail this new drug, we dont what side effects it may have on your unborn child, it may cause...... but we dont know' how many pregnant women would be in the queue???? NONE

Sorry gone off the thread,

:)

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