Transcript Domicilliary Care – Medicines management

Domiciliary Care –
Medicines
Management
Hannah Blight
Lead Pharmacist – Medicine
Mid-Staffs NHS foundation trust
Introduction
Hospital admission – What do hospitals
need?
 Medication following Discharge –
understanding the discharge letter
 Medication issues – Medication timing,
swallowing difficulties and falls.
 Questions?

Hospital Admission
List of Medications – Most recent, up-todate, printed MAR chart.
 Allergy information.
 Copies of other relevant charts e.g.
warfarin charts or Insulin charts.
 May be asked to bring in patient own
medication.

Discharge Medication
Every patient leaving hospital should have
a discharge letter.
 List of medications on discharge.
 Information about changes to medication.
 At least 2 weeks supply of medication for
newly prescribed / changed medications.
 Communication of changes.

The Discharge Letter
Patient
details
Admission
information
The Discharge Letter continued…
Allergies /
sensitivities
Course Length
Discharge
Medication
Medication
Changes
Supply
Information
PH = Home
PL = Locker
* = Supply
made at
time of
discharge
Medication Issues
Medications where timing is critical.
 Medication administration for patients with
swallowing difficulties and / or enteral
tubes.
 Medication and Falls.

Medications where timing is critical
Parkinson's medication.
 Insulin.
 Antibiotics.
 Antiepileptic medication.

Swallowing difficulties / Enteral
tubes




May need converting to liquids / patches.
Not all medication is available as a liquid.
Not all solid oral dosage forms are suitable to be
crushed.
Modified Release MR / SR / XL
Swallowing Difficulties / Enteral
tubes continued …..




Film or enteric coated.
May need dosage adjustment.
Advice needs to be obtained before crushing or
dispersing in water.
Licensed and unlicensed routes of
administration.
Medication and Falls


4 or more medicines
High risk medications : Benzodiazepines,
Alcohol, Antidepressants, Laxatives, Diuretics,
Salbutamol, Beta blockers, vasodilators,
antihypertensives, Antiarrythmics
Anticoagulants, Urinary incontinence; abdominal
cramps and Eye preps.
Any Questions?