Self-administration of medication by patients

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Self-administration of medication takes place when a patient has responsibility for managing their medication, and is encouraged and supported to play an active role in taking their medication. This has been shown to improve treatment adherence and is important for rehabilitation. The value and importance of self-administration is recognised and promoted by the Care Quality Commission (CQC) and the respective bodies in Scotland (HIS) and Wales (HIW).

Uptake of self-administration can be low in many hospitals and this is mainly due to the nurses’ concerns about liability if the patient makes a mistake. But nursing staff would not be liable, according to the Nursing and Midwifery Council (NMC), providing the hospital’s policies are followed and appropriate patient risk assessments are carried out. Ashtons can provide a sample risk assessment tool for this purpose which will help to determine whether a patient is suitable to be included in a self-assessment programme.

It is relatively common for patients to be allowed to self-administer creams and other external preparations, and in many settings patients are encouraged to carry their own asthma inhaler or similar medication which may be required in an emergency. However, it is important that risk assessments and care plans are in place for this.

There is guidance for self-administration in the NMC Standards for Medicines Management. In particular, it recommends that there are 3 levels which culminate with the patient being completely responsible for storage and administration.

Medication for self-administration must be patient-named and dispensed, not supplied from stock, and patients will need secure lockable storage for these medicines if they have them in their possession.

Ashtons have revised the Guide to Self-Administration of Medicines and this will be available to all hospitals.

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