L3 Conveyance of patients with own meds and medical devices v1 September 2020 (1).pdf

Conveyance of patients with own medications and devices Component 21 © Department of Clinical Education & 1 Standards  Conveying patient medication- Component 21 Conveyance of Patients with Own Medication...

Conveyance of patients with own medications and devices Component 21 © Department of Clinical Education & 1 Standards  Conveying patient medication- Component 21 Conveyance of Patients with Own Medication and Medical Devices © Department of Clinical Education & 2 Standards  Conveying patient medication- Component 21 Patients own medications – the background 5-10% of hospital attendances are medication related 66% of these attendances are said to be avoidable The NHS spends around £16 billion a year on medicines Of which £300 million is wasted 50% of people encounter a medicines problem within 10days of starting a new medication This is mainly through lack of patient information How can we help? © Department of Clinical Education & 3 Standards Conveying patient medication- Component 21 When a patient is conveyed to hospital or transferred throughout care settings, they should be transported with their own medication. Why? This allows the hospital Pharmacy team to perform a ‘reconciliation’ process of checking the patients medications against their GP records Ensures the patient is only administered the correct medication during their stay Only medication that hasn’t been taken into hospital with the patient will be dispensed as a top-up if required © Department of Clinical Education & 4 Standards  Conveying patient medication- Component 21 A national ‘Green Medicines Bag’ system was designed to standardise medication conveyance within the wider care setting. Its purpose it to:- Provide accurate details of current medication & ensure they are administered on time whilst remaining with the patient Ensure ALL healthcare providers are familiar with & are using the system Reduces waste by ordering meds which the patient already has at their place of residence Reduce the amount of©prescribing errors Department of Clinical Education & 5 Standards Conveying patient medication- Component 21 The ‘Green bag’ MUST have the patients name, D.O.B and incident No. written on the outside At the time of writing , LAS follow the process but use SMARTsafe for patient’s personal belongings and medications which is used in place of the Green Bag © Department of Clinical Education & 6 Standards  Medical devices- Component 21 Intravenous (IV) Access IV access is undertaken to administer drugs and/or fluids. Patients with IV access in situ should be positioned on the trolley bed whilst being conveyed. If visible haemorrhage occurs at/or adjacent to the access site, place sterile gauze over insertion site and apply gentle pressure until bleeding stops. If patient is on coagulation therapy, extended pressure will be required. Cover with a dressing once bleeding ceased. © Department of Clinical Education & 7 Standards  Medical devices- Component 21 Catheterisation – Purpose A urinary catheter is usually used when people have difficulty urinating naturally. Urinary catheters are used to drain the bladder. Specific reasons a urinary catheter may be used include: Urinary incontinence Urinary retention Surgery on the prostate or genitals Other medical conditions © Department of Clinical Education & 8 Standards  Medical devices- Component 21 Types of Urinary Catheter There are 2 main types of urinary catheter: Intermittent catheters – these are temporarily inserted into the bladder and removed once the bladder is empty Indwelling catheters – these remain in place for many days or weeks and are held in position by an inflated balloon in the bladder. An indwelling catheter collects urine by attaching to a drainage bag. The bag has a valve that can be opened to allow urine to flow out. Suprapubic Catheter - Inserted through the abdomen straight into the bladder, also left in place. Usually changed every 4 to 8 weeks © Department of Clinical Education & 9 Standards  Medical devices- Component 21 Reasons for Catheter use Obstruction of urethra, due to scarring or prostate enlargement Bladder weakness / nerve damage During surgery or childbirth Deliver chemotherapy for bladder cancer To treat urinary incontinence if all other treatments fail © Department of Clinical Education & 10 Standards  Medical devices- Component 21 Types of urinary catheter Intermittent catheter: © Department of Clinical Education & 11 Standards  Medical devices- Component 21 Types of urinary catheter Indwelling catheter: © Department of Clinical Education & 12 Standards  Medical devices- Component 21 Complications Bleeding Device pulled out Device leaking Device torn or damaged Device blocked © Department of Clinical Education & 13 Standards  Medical devices- Component 21 Complications Leakage around the catheter is another problem associated with indwelling catheters. Leakage can also be a sign that the catheter is blocked, so it's essential to check that it's draining. Blood or debris in the catheter tube is also common with an indwelling catheter. This could become a problem if the catheter drainage system becomes blocked. © Department of Clinical Education & 14 Standards  Medical devices- Component 21 Reasons for Calls Blocked catheter Catheter has been removed Blockage Catheter leaking/bypassed Community teams unable to deal © Department of Clinical Education & 15 Standards  Medical devices- Component 21 Procedure If the catheter becomes clogged, painful, infected, has been pulled out/damaged or is leaking it will need to be replaced right away. If the patient’s own care provider is unable to attend or resolve the issue, the patient should be transported for review in A&E. Be mindful of exposure to bodily fluids – don appropriate PPE Consider the use of incontinence pads to absorb escaping fluid(s) Allow patient to assume a comfortable position during conveyance Manage patient’s pain © Department of Clinical Education & 16 Standards  Medical devices- Component 21 Transport Considerations Make sure to keep the catheter bag lower than the patient Be careful not to kink the catheter tube Be mindful not to pull the catheter out © Department of Clinical Education & 17 Standards Medical devices- Component 21 Syringe Drivers This Photo by Unknown Author is licensed under CC BY-ND © Department of Clinical Education & 18 Standards  Medical devices- Component 21 Reasons for use Feeling or being sick. ​ Difficulties swallowing and taking medications orally. ​ Too weak to take medications.​ Most appropriate route for delivering medications ​ Palliative care stage​ © Department of Clinical Education & 19 Standards  Medical devices- Component 21 Location Sites Anterior aspect of Scapula upper arm (risk of being pulled out) IV Cannular Site Anterior aspect of Anterior of the the thigh abdominal wall © Department of Clinical Education & 20 Standards  Medical devices- Component 21 Troubleshooting Alarms sounding and error messages on screen. Should the alarm sound or an error message appear on the device screen, the medical professional escort, who should be escorting the patient will be responsible for dealing with any alarm or error messages. © Department of Clinical Education & 21 Standards Medical devices- Component 21 Any Questions? © Department of Clinical Education & 22 Standards