Controlled drugs are something that many of us administer with a huge amount of frequency – whether it be for a patients post operative pain or as part of a long term pain management regime or as part of end of life care the administration of controlled medication can be an everyday part of the nurses role.  However how often to we actually stop and realise the implications of controlled drug administration and why safeguards, policies, procedures and best practice are in place?

Controlled drugs are “classified (by law) based on their benefit when used in medical treatment and their harm if misused.  The Misuse of Drugs Regulations  include five schedules that classify all controlled medicines and drugs. Schedule 1 has the highest level of control,but drugs in this group are virtually never used as medicines. Schedule 5 has amuch lower level of control”  (NHS Choices 2015) Many of the controlled drug nurses are used to administering are in Schedule 2: “Schedule2 includes drugs such as diamorphine (heroin), morphine, nabilone, remifentanil, pethidine, secobarbital, glutethimide, the amfetamines, sodium  oxybate, and cocaine and are subject to the full controlled drug requirements relating to prescriptions, safe custody (except for secobarbital),the need to keep registers, etc.” (NICE 2015)

The NMC have specific guidance in the Standards for Medicines Management in relation to the administration of controlled drugs, in essence they state:

• Controlled drugs should be administered in line with relevant legislation and local standard operating procedure
• Controlled drugs administration should have two signatories (unless the patient is at home and then this should be based on local risk assessment)
• The second signatory should be another registered healthcare professional or student nurse or a second suitable person who has been assessed competent to sign.

(For full details please refer to The Standards for Medicines Management)

This WeNurses discussion aims to explore some of the following questions:

• What do nurses need to understand about controlled drugs?
• What do we need to consider when administering controlled medication?
• What is best and safe practice in relation to controlled drugs?
• What are the pitfalls of administering controlled drugs and how can we avoid them?
• How can we reduce nurse administration errors in relation to controlled drugs?
• What are your top best practice tips for administration of controlled drugs?