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New draft NICE guidance on medicines in care homes

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NICE has published new draft good practice guidance on the provision of medicines in care homes.

It is aimed at those involved in handling, prescribing, commissioning and decision-making about medicines in adults’ and children’s care homes.

NICE makes a series of recommendations about the systems and processes that are necessary to ensure the safe and effective use of medicines in nursesuch settings.

Care home staff spend as much as half of their time on activities related to medicines, according to the
2009 Care Homes’ Use of Medicines Study (CHUMS).

When stories break about substandard care, the incorrect provision of medicines to residents is a common theme, whether that is in terms of residents being given the wrong medicine, given what they need but at the wrong time or not being given their medicine at all.

Errors in prescribing, monitoring, administration and dispensing medicines in care homes are surprisingly common, the evidence suggests, with CHUMS identifying an “unacceptable level” of medication errors among older residents living in care homes.

In most cases there were negligible consequences for residents and no cases of harm were seen, but there are potentially serious or life-threatening implications when medication errors do occur.

Professor Mark Baker, director of the Centre for Clinical Practice at NICE, picked up on the finding that medication errors appear to be “commonplace” despite existing guidance and standards on the management of medication in care homes.

“Sadly, the high profile cases that make it into the news are just the tip of the iceberg,” he said.

“It’s therefore very important that there are clear, documented, systems and processes in place for managing medicines in care homes which use the best available evidence.

“A person-centred approach should be adopted with consideration of the residents’ wishes being paramount when devising these processes to ensure safe use of medicines in the care home.”

Under the new NICE draft guidance, health and social care practitioners should ensure residents have the same right to be involved in decisions about their care and treatment as people who do not live in care homes.

The guidance states residents should also have access to any support they need to enable them to take part in decision-making.

Health and social care practitioners also need to ensure that all information about a resident’s medication, including who will be responsible for ongoing prescribing, is accurately recorded.

A resident’s medicine information must be transferred with that individual if he or she moves from one care setting to another, the guidance states.


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