Narcotic dispensing and storage.pptx

Narcotic dispensing and storage.pptx

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  1 Narcotic and Psychotropicsubstances SH/QUA/FMT/17 w.e.f Mar2021 Rev No.00 7/11/2023 Dr.Irfanul Haque Clinical Pharmacologist
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  7/11/2023 2 Controlled substances Definitions •A controlled (scheduled) drug is one whose use and distribution is tightly controlled because of its abuse potential or risk. • Narcotic Drugs and Psychotropic Substances Act (NDPS) 1985 is operational in India that limits the use of these agents for medicinal purposes
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  7/11/2023 3 Controlled substances •Narcotic drugs include all dosage forms of opioids derivatives such as Morphine, Pethidine, Fentanyl and Sufentanil which require a seprate license from regulatory authority(excise Office). • Psychotropic drugs (e.g. other opioid derivatives like Pentazocin, Tramadol; Benzodiazepine group like Midazolam, Diazepam, and Alprazolam etc.) but do not require a separate license from regulatory authority.
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  7/11/2023 4 Narcotic andPsychotropic substances Standard protocol for narcotic drugs and psychotropic substances: – All narcotic drugs and psychotropic substances will be dispensed on a physician order. – A proper record is kept for the uses of the narcotic drugs for the next two years. – Policy violation results in disciplinary action. Procurement of Narcotic drugs
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  Procurement procedure forNarcotic Drugs 7/11/2023 5 Pharmacy approved quota exhausted Based on Requirement, HOD Anesthesia will give requirement to MS Nurse will write application to Hod Anaesthesia MS will give requirement in the name of vendor to the pharmacy Narcotic permit Goods received from Vendor Pharmacy will inform to Nursing Incharge Order placed to vendor
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  7/11/2023 6 Narcotic Prescription –Prescriptions for Narcotic drugs must be written legibly with drug name in capital letters. Dose, frequency and route of administration must be mentioned. Full name and signature with registration number of prescribing Physician must be included. – Prescription/Replacement format as specified in Form no.3E
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  7/11/2023 7 Narcotic Consumption –Consumption format as specified in Form no.3E+Form 3H
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  7/11/2023 8 Narcotic Replacement Formno. 3 E + Narcotic Indent – Replacement/prescription sheets are to be used in triplet copy, One copy to be handed over to Pharmacy during replenishment, second copy should be kept in patient file and third copy should be maintained at secondary location. – For maintaining proof of consumption of Narcotic drugs, Narcotics Replacement/prescription sheets in book form (Form no.3 E) should be maintained in every secondary location.
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  7/11/2023 9 Narcotic DailyCount Register – Strict accounting of all Narcotic drugs will be observe in the secondary locations – e.g. inventory control, stock taking and count during shift change handover. A Narcotic Drug Daily Count Register is to be used for this purpose.
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  7/11/2023 10 Policy onNarcotic Drugs • A medication double check or second provider verification will be required prior to administration of selected high-risk medications. • Documentation of the double check will be on the Medication Administration Record (MAR). • The minimum requirement for the medication double check or second provider verification will be double checks occurring: – At the time of initiation of therapy. – At the time of concentration change – As part of the Nursing Bedside Safety Check at the change of each shift or any transfer of care. – With any dose change for selected medications where noted in the list of “Medication Requiring double Check” – With any bag (bottle) change for selected medications where noted in the list of “Medication requiring double check”.
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  7/11/2023 11 • Procedure Forinitial dose or initiation of new infusions: • Nurse preparing to administer medication will prepare the medication and second nurse will double check the medication preparation • The prepared medication ready for administration with labeling intact. A second nurse will assure the following: • The medication is prepared according to the order (using the MAR). • The medication prepared for administration matches the five rights: • Right patient • Right medication • Right dose • Right time • Right route Once the second nurse performs the double check and both nurses are satisfied that the medication is accurate, they will each document on the MAR by writing their initials next to the administration for that dose in MAR. the second nurse should write “checked by” or similar wording next to his/her initials to indicate that he/she performed this check.
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  7/11/2023 12 • Storageareas will be secured and shall be accessible only to designated and authorized personnel for Ordering and receiving narcotic drugs and psychotropic substances. Patient care areas daily orders for stock narcotics are filled out by the nurse according to the following procedure: • The quantity on hand is checked against the quantity used from the documentation records. • The Indent form is completed and sent to the appropriate pharmacy area making sure it contains the following: – Medications and quantity required – Date – Department Name – Signature of person making the request • The narcotic drugs are issued to the user department and the nurse responsible does receiving sign. • The original copy of the indent form is kept with the pharmacy and the duplicate copy is with the user department.
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  7/11/2023 13 Disposal ofnarcotic drugs and psychotropic substances • The entire amount of narcotic drugs and psychotropic substances obtained is accounted . • The smallest ampoule or tube available to satisfy dosage is used. • When the dose administered is less than the total dose contained in the ampoule, the left over portion is disposed of by pouring down the drain in the presence of senior nurse and record maintained by the responsible nurse.
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