#WeMDT - Thursday 19th July 2018 8pm (GMT Standard Time) The in’s & outs of storing medicines

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Hosted by WeNurses using #WeMDT

This chat is guest hosted by @Marie_Batey @Cleverestcookie

In March 2018 the Nursing and Midwifery Council (NMC) announced that they would be withdrawing the Standards for Medicines Management stating “We now recognise that it’s not within our remit as a regulator to provide clinical practice guidance of this nature, so we won’t be replacing these standards” The NMC instead will be working closely with the Royal Pharmaceutical Society (RPS) as they review their professional guidance on The Safe Handling of Medicines which could provide an ideal model for future guidance. 

Given that medicines management is extremely important to nurses, pharmacists and many more healthcare professionals, patients and members of the public where does this leave us? With the NMC Guidance on its way out and the RPS guidance under review there has never been a better time to think about the way we handle medicines in our clinical areas. 

As medicines management is quite a large topic area this #WeMDT discussion will be focussing on the safe storage of medicines and how we can all work together to ensure that we are meeting current guidance (such as it is) and how we can work together moving forward as guidance evolves. The Tweetchat will be exploring the following questions:

  • What do we mean by “safe storage of medicines” ?
  • What is involved in keeping controlled drugs (CD’s) safe ?
  • What about disposal of medicines and CD’s in our clinical areas?
  • How should we manage medicines that require cold storage? How do we deal with things like fridge failures?
  • What do we need to bear in mind regarding the safe storage and checking of other products such as IV fluids, O2 cylinders, medicines on resuscitation trollies etc?
  • How can nurses and pharmacists work together to ensure safe storage of medicines... and who does what?
  • How can we ensure, moving forward, that nurses and pharmacists communicate  well between especially in busy times and on hectic ward spaces?

    

About our guest hosts

Marie Batey is a registered nurse with ward to Board experience achieved across acute, regional and national health care organisations.  Currently leading on care quality and safety improvements at Imperial College Healthcare NHS Trust, Marie is very clear about what high quality care looks and feels like.  Having worked with others at the Trust to measure and start to develop safety culture, Marie is now working across the Medical Director and Nurse Directors Offices on a number of work streams, including improving practices associated with medicines storage, security and disposal.

Cathy Cooke is a pharmacist with broad practice experience of health and social care services including community pharmacy, general practice, prisons and immigration removal centres, police custody, medicines governance advisor to urgent care and domiciliary social care, and most recently elective surgical care.  Cathy has been a member of two NICE guideline development groups and has sat on a number of national advisory groups.  She is a fellow of the Royal Pharmaceutical Society and an honorary fellow of the Faculty of Forensic and Legal Medicine.





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 #WeMDT transcript

 
@WeNurses
19 July 2018 20:00
Helllloooooo everyone - welcome to #WeMDT https://t.co/bgBGN6vPoa
@Marie_Batey
19 July 2018 20:00
RT @WeNurses: 2 mins until we get going ... not #WeNurses tonight but #WeMDT https://twitter.com/WeNurses/status/1020017962579787777
@faebeth
19 July 2018 20:01
#WeMDT Hello, all.
@Soby16536799
19 July 2018 20:01
@WeNurses Hi all..#wemdt
@Marie_Batey
19 July 2018 20:01
@WeNurses Helllllllooooo to you too! #WeMDT :)
@WeNurses
19 July 2018 20:01
Tonights discussion is all about medicine storage with the ace @Marie_Batey and the fab @Cleverestcookie #WeMDT https://t.co/o0cbKBeXUT
@AgencyNurse
19 July 2018 20:02
hello Teresa here #WeMDT
@WeNurses
19 July 2018 20:02
@Marie_Batey Hi Marie :D #WeMDT
@WeNurses
19 July 2018 20:02
@Cleverestcookie Hi Cathy #WeMDT
@Cleverestcookie
19 July 2018 20:03
???? #WeMDT
@WeNurses
19 July 2018 20:04
So lets start with something simple (!!) QUESTION 1 What do we mean by “safe storage of medicines” ? #WeMDT https://t.co/So3RbCOQvp
@AgencyNurse
19 July 2018 20:04
@Ghazala82437113 Hi there #WeMDT :D
@Cleverestcookie
19 July 2018 20:04
Hashtag, James ?? #WeMDT
@Cleverestcookie
19 July 2018 20:05
RT @WeNurses: So lets start with something simple (!!) QUESTION 1 What do we mean by “safe storage of medicines” ? #WeMDT https://t.co/S…
@Marie_Batey
19 July 2018 20:05
RT @WeNurses: So lets start with something simple (!!) QUESTION 1 What do we mean by “safe storage of medicines” ? #WeMDT https://t.co/S…
@faebeth
19 July 2018 20:05
#WeMDT Storage that is appropriate to temperature, it is stored methodically and securely.
@DrMLJCarter
19 July 2018 20:06
@WeNurses Storing a medicine in an appropriate environment with appropriate security #WeMDT
@Soby16536799
19 July 2018 20:07
@WeNurses Storing medicines to prevent it from getting damaged due to heat,light,moisture etc..#wemdt
@Cleverestcookie
19 July 2018 20:07
Shall I start? Q1 - safe storage to me is protecting the meds and managing access to them to protect people from harm #WeMDT
@WeNurses
19 July 2018 20:08
What do others think ? #WeMDT
@amandalkitson
19 July 2018 20:09
RT @WeNurses: So lets start with something simple (!!) QUESTION 1 What do we mean by “safe storage of medicines” ? #WeMDT https://t.co/S…
@Cleverestcookie
19 July 2018 20:09
Seems to be a consensus so far, any other safety issues? #WeMDT
@WeNurses
19 July 2018 20:09
RT @faebeth: #WeMDT Storage that is appropriate to temperature, it is stored methodically and securely.
@WeMidwives
19 July 2018 20:09
Question 1 #WeMDT
@BryonyDF
19 July 2018 20:09
@WeNurses #WeMDT I'd say storage that reduces both the risk of medication errors occurring, and medication being ac… https://twitter.com/i/web/status/1020022877918236672
@WeNurses
19 July 2018 20:09
RT @DrMLJCarter: @WeNurses Storing a medicine in an appropriate environment with appropriate security #WeMDT
@faebeth
19 July 2018 20:09
#WeMDT Monitoring the temperature and ensuring the expiry dates are checked, keeping medicines sensitive to light safely stored
@markdevans77
19 July 2018 20:10
@WeNurses Agree......knowing the medicines are stored securely and reducing risk of intentional tampering and environmental damage #wemdt
@WeNurses
19 July 2018 20:10
Nicely said #WeMDT
@georgeinsoutham
19 July 2018 20:10
@WeNurses Appropriate enviromental conditions eg temperature and not accessible to anyone who may come to harm eg small children #WeMDT
@Marie_Batey
19 July 2018 20:10
RT @Cleverestcookie: Seems to be a consensus so far, any other safety issues? #WeMDT
@Marie_Batey
19 July 2018 20:10
RT @WeMidwives: Question 1 #WeMDT https://twitter.com/WeNurses/status/1020021476899131392
@WeNurses
19 July 2018 20:11
On to QUESTION 2 What is involved in keeping controlled drugs (CD’s) safe ? #WeMDT https://t.co/QLelIwnZcj
@faebeth
19 July 2018 20:11
@WeNurses I agree #WeMDT
@Marie_Batey
19 July 2018 20:12
@markdevans77 @WeNurses And accidental, for example when patients own drugs are being self administered in clinical areas... #WeMDT
@AgencyNurse
19 July 2018 20:13
Double locked cupboard and a register of all CDs in stock is a start #WeMDT
@DrMLJCarter
19 July 2018 20:13
@georgeinsoutham @WeNurses #WeMDT
@alimully
19 July 2018 20:13
Would say this also answers Q2 #WeMDT
@faebeth
19 July 2018 20:13
#WeMDT CD's have an extra layer of security due to the nature of the drugs.
@WeNurses
19 July 2018 20:14
Of course self administration can cause much confusion ... what are the rules here ? #WeMDT
@Cleverestcookie
19 July 2018 20:14
Important points #WeMDT
@Soby16536799
19 July 2018 20:14
@WeNurses Proper recording,keeping it always locked in a safe metal unit attached to wall,proper disposal...#wemdt
@WeMidwives
19 July 2018 20:15
Question 2 #WeMDT
@WeMHNurses
19 July 2018 20:15
Question 2 - would be fab to get a MH perspective here #WeMDT
@WeNurses
19 July 2018 20:15
RT @Soby16536799: @WeNurses Proper recording,keeping it always locked in a safe metal unit attached to wall,proper disposal...#wemdt
@WeNurses
19 July 2018 20:15
Anyone ? #WeMDT
@markdevans77
19 July 2018 20:16
@Soby16536799 @WeNurses #WeMDT with someone appropriate holding the keys!!!!!! ALL the time
@Cleverestcookie
19 July 2018 20:16
Robust ordering and transportation procedures #WeMDT
@AgencyNurse
19 July 2018 20:16
Ahhh that sounds good ... what a fab idea ... is it working ?? #WeMDT
@WeNurses
19 July 2018 20:17
#WeMDT
@Ghazala82437113
19 July 2018 20:17
RT @markdevans77: @Soby16536799 @WeNurses #WeMDT with someone appropriate holding the keys!!!!!! ALL the time
@WeNurses
19 July 2018 20:17
RT @Cleverestcookie: Robust ordering and transportation procedures #WeMDT https://twitter.com/wenurses/status/1020023225802264576
@Cleverestcookie
19 July 2018 20:17
@alimully Yes, you’re right! #WeMDT
@Marie_Batey
19 July 2018 20:17
@WeNurses And making sure that the nurse, midwife or ODP in charge has the CD keys in their possession #WeMDT I'm n… https://twitter.com/i/web/status/1020024856405045255
@WeNurses
19 July 2018 20:17
A really important point #WeMDT
@Marie_Batey
19 July 2018 20:17
RT @markdevans77: @Soby16536799 @WeNurses #WeMDT with someone appropriate holding the keys!!!!!! ALL the time
@Soby16536799
19 July 2018 20:17
RT @markdevans77: @Soby16536799 @WeNurses #WeMDT with someone appropriate holding the keys!!!!!! ALL the time
@AgencyNurse
19 July 2018 20:18
Does checking CDs become a "task" though ? And as such do we forget the true purpose ? #WeMDT
@SianEBee
19 July 2018 20:18
@WeNurses #WeMDT @WroeClaire and I were talking about this: Paying attention to the location of Cd cupboard is imp… https://twitter.com/i/web/status/1020025118255452161
@georgeinsoutham
19 July 2018 20:18
@WeNurses #WeMDT
@WeNurses
19 July 2018 20:19
All good points #WeMDT
@Marie_Batey
19 July 2018 20:19
@AgencyNurse We are just about to go live with this, so we'll let you know :) #WeMDT
@WeNurses
19 July 2018 20:19
Great question ... thoughts ?? #WeMDT
@_Luqman_Ahmad_
19 July 2018 20:20
RT @WeNurses: So lets start with something simple (!!) QUESTION 1 What do we mean by “safe storage of medicines” ? #WeMDT https://t.co/S…
@Cleverestcookie
19 July 2018 20:20
It’s really important to adhere to the SOPs for CDs, ensures they’re kept safely and protects staff #WeMDT
@WeNurses
19 July 2018 20:20
Interesting ... a whole different set of challenges to overcome #WeMDT
@AgencyNurse
19 July 2018 20:21
*nods* ... agree #WeMDT
@_Luqman_Ahmad_
19 July 2018 20:21
RT @WeNurses: On to QUESTION 2 What is involved in keeping controlled drugs (CD’s) safe ? #WeMDT https://t.co/QLelIwnZcj
@Marie_Batey
19 July 2018 20:21
@Cleverestcookie And then to audit compliance - SOP??standards??audit etc #WeMDT
@Marie_Batey
19 July 2018 20:21
RT @Cleverestcookie: It’s really important to adhere to the SOPs for CDs, ensures they’re kept safely and protects staff #WeMDT https://t.c…
@faebeth
19 July 2018 20:22
#WeMDT. Codeine phospate in vial form is treated as a CD.
@WeNurses
19 July 2018 20:22
RT @Cleverestcookie: It’s really important to adhere to the SOPs for CDs, ensures they’re kept safely and protects staff #WeMDT https://t.c…
@Marie_Batey
19 July 2018 20:23
@alimully @AgencyNurse We only need one thing to go wrong though or a patient harm to happen for us to realise the benefit #WeMDT
@WeMidwives
19 July 2018 20:24
Question 3 #wemdt
@Cleverestcookie
19 July 2018 20:24
@Darth_Roo Yes it is, but doesn’t legally require recording or secure storage so doesn’t usually get it #WeMDT
@markdevans77
19 July 2018 20:24
@faebeth Morphine in liquid form......sometimes not... #WeMDT
@WeNurses
19 July 2018 20:25
#WeMDT
@WeMHNurses
19 July 2018 20:27
RT @WeMidwives: Question 3 #wemdt https://twitter.com/WeNurses/status/1020026013005344768
@Cleverestcookie
19 July 2018 20:29
It’s down to local risk assessment. Again, if not monitored in some way, at risk of being diverted #WeMDT
@faebeth
19 July 2018 20:29
#WeMDT I have never come across an area where students are allowed to hold keys.
@AgencyNurse
19 July 2018 20:30
RT @Cleverestcookie: It’s down to local risk assessment. Again, if not monitored in some way, at risk of being diverted #WeMDT https://t.co…
@AgencyNurse
19 July 2018 20:30
@SianEBee @markdevans77 @faebeth consistency is vital #WeMDT
@AgencyNurse
19 July 2018 20:31
@Marie_Batey we use a lot of patches too .. and i have to admit i have no idea how to dispose of these ?? #WeMDT (I… https://twitter.com/i/web/status/1020028480883445760
@WeNurses
19 July 2018 20:32
#WeMDT
@WeNurses
19 July 2018 20:32
#WeMDT
@Marie_Batey
19 July 2018 20:33
@AgencyNurse Medicines technologies and the speed at which everything evolves challenges us all #WeMDT
@AgencyNurse
19 July 2018 20:34
Related to question 4 and tweeted earlier #WeMDT
@Marie_Batey
19 July 2018 20:35
@AgencyNurse Again, we've developed a 'disposal of medicines' algorithm @ImperialNHS which includes safely disposing of patches. #WeMDT
@AgencyNurse
19 July 2018 20:36
@Cleverestcookie thanks Cathy #WeMDT
@JJPJ
19 July 2018 20:36
RT @Cleverestcookie: It’s down to local risk assessment. Again, if not monitored in some way, at risk of being diverted #WeMDT https://t.co…
@AgencyNurse
19 July 2018 20:37
@Marie_Batey @ImperialNHS sounds like you are on the ball :D #WeMDT
@_Luqman_Ahmad_
19 July 2018 20:37
RT @WeNurses: Staying with CDs for moment ... QUESTION 3 What about disposal of medicines and CD’s in our clinical areas? #WeMDT https:…
@AgencyNurse
19 July 2018 20:37
Wow really ? #WeMDT
@faebeth
19 July 2018 20:38
#WeMDT I work in theatre, if half an ampoule is used that it is recorded in the cd book as exactly how much given… https://twitter.com/i/web/status/1020030045916749829
@Marie_Batey
19 July 2018 20:38
@AgencyNurse @ImperialNHS We like to think so! #ShinesFingernails #WeMDT
@WeNurses
19 July 2018 20:38
All excellent points here #WeMDT
@AgencyNurse
19 July 2018 20:38
@Marie_Batey @ImperialNHS :D #WeMDT
@WeNurses
19 July 2018 20:39
RT @faebeth: #WeMDT I work in theatre, if half an ampoule is used that it is recorded in the cd book as exactly how much given and how muc…
@Marie_Batey
19 July 2018 20:39
@Ghazala82437113 @WeNurses Brilliantly put! #WeMDT
@BryonyDF
19 July 2018 20:39
@AgencyNurse Yes, doses more likely to be given on time, less likely to be omitted, and no more likely to be incorrect... #WeMDT
@aptaim
19 July 2018 20:40
@Cleverestcookie Home Office licensing too for IHSP!... #WeMDT
@Soby16536799
19 July 2018 20:42
#WeMDT
@faebeth
19 July 2018 20:42
@AgencyNurse #WeMDT The hot weather is proving difficult when trying to kepp drugs under 25C, but our fridges seem ok.
@Ghazala82437113
19 July 2018 20:43
@WeNurses With regards to fridge failures, a back up fridge in each area would be more cost effective. #WeMDT
@WeNurses
19 July 2018 20:43
Good idea ? #WeMDT
@DrMLJCarter
19 July 2018 20:44
@BryonyDF @alimully @georgeinsoutham @WeNurses Amazing! Thank you very much! #WeMDT
@Marie_Batey
19 July 2018 20:45
@BryonyDF @DrMLJCarter @alimully @georgeinsoutham @WeNurses Thank you for the link :) #WeMDT
@faebeth
19 July 2018 20:47
@WeNurses #WeMDT Cyclinders need to be stored in a separate cage or holder and need to be transported with care. I… https://twitter.com/i/web/status/1020032287986135042
@AgencyNurse
19 July 2018 20:47
@SarahJPharm @faebeth We have fans ... but generally they just circulate the warm air !! #WeMDT
@WeNurses
19 July 2018 20:47
No this sounds like heaven ! #WeMDT
@AgencyNurse
19 July 2018 20:48
#WeMDT
@Marie_Batey
19 July 2018 20:48
@WeNurses We seem to not be so good at rotating IV fluid stock... and this can lead to expired fluids being in stock areas #WeMDT
@WeNurses
19 July 2018 20:48
RT @faebeth: @WeNurses #WeMDT Cyclinders need to be stored in a separate cage or holder and need to be transported with care. IV fluids ne…
@Marie_Batey
19 July 2018 20:48
RT @faebeth: @WeNurses #WeMDT Cyclinders need to be stored in a separate cage or holder and need to be transported with care. IV fluids ne…
@Ghazala82437113
19 July 2018 20:49
RT @faebeth: @WeNurses #WeMDT Cyclinders need to be stored in a separate cage or holder and need to be transported with care. IV fluids ne…
@_Luqman_Ahmad_
19 July 2018 20:49
@faebeth @WeNurses Fluids should also be kept in original boxes and stored off the floor #weMDT
@DrMLJCarter
19 July 2018 20:50
@WeNurses Weekly full-stock checks of the resuscitation trolleys including checking the medicines are in date and not compromised #WeMDT
@faebeth
19 July 2018 20:50
@Ghazala82437113 @WeNurses #WeMDT Good idea
@Soby16536799
19 July 2018 20:51
@WeNurses Daily checks to make sure adequate stock when needed...we have records..#wemdt
@WeNurses
19 July 2018 20:51
Sounds like best practice #WeMDT
@Ghazala82437113
19 July 2018 20:51
@WeNurses IV fluids need to be stored in a locked room and rotated on a regular bases #WeMDT
@Cleverestcookie
19 July 2018 20:52
@AgencyNurse @SarahJPharm @faebeth We have brought in equipment to reduce the temperature in one of our storage areas #WeMDT
@faebeth
19 July 2018 20:52
@Cleverestcookie #WeMDT That is what we have been doing. This is only an issue in one small area of where I work.
@Marie_Batey
19 July 2018 20:53
RT @_Luqman_Ahmad_: @faebeth @WeNurses Fluids should also be kept in original boxes and stored off the floor #weMDT
@AgencyNurse
19 July 2018 20:53
@Cleverestcookie @SarahJPharm @faebeth it is possible to buy mobile air conditioning units #WeMDT
@Marie_Batey
19 July 2018 20:53
RT @Ghazala82437113: @WeNurses IV fluids need to be stored in a locked room and rotated on a regular bases #WeMDT
@markdevans77
19 July 2018 20:54
@WeNurses And #PharmacyTechnicians #WeMDT
@Cleverestcookie
19 July 2018 20:54
@AgencyNurse @SarahJPharm @faebeth Yes! #WeMDT
@faebeth
19 July 2018 20:54
@Cleverestcookie @AgencyNurse @SarahJPharm #WeMDT I will have to suggest that.
@kch888
19 July 2018 20:55
@WeNurses #WeMDT an aside-safety first, but must also think about ways to safely store that don't impact on patient… https://twitter.com/i/web/status/1020034298890670080
@AgencyNurse
19 July 2018 20:55
@Cleverestcookie @SarahJPharm @faebeth which is infinitely more cost effective to the NHS than destroying medicines en-masse #WeMDT
@AgencyNurse
19 July 2018 20:55
Important point #WeMDT
@Marie_Batey
19 July 2018 20:56
RT @kch888: @WeNurses #WeMDT an aside-safety first, but must also think about ways to safely store that don't impact on patient care. I.e.…
@WeNurses
19 July 2018 20:56
Great points #WeMDT
@WeNurses
19 July 2018 20:56
Interesting thoughts #WeMDT
@faebeth
19 July 2018 20:57
@WeNurses #WeMDT Need to have a good relationship between nurses and pharmacists. I have a good relationship with… https://twitter.com/i/web/status/1020034974924369923
@WeNurses
19 July 2018 20:58
RT @faebeth: @WeNurses #WeMDT Need to have a good relationship between nurses and pharmacists. I have a good relationship with our pharmac…




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