Takaloo Nursing Academy
The NMC (Nursing and Midwifery Council) and many NHS Trusts classify self-administration of medicines into three levels — Level 1, Level 2, and Level 3 — based on the patient’s ability and the nurse’s responsibility
The NMC (Nursing and Midwifery Council) and many NHS Trusts classify self-administration of medicines into three levels — Level 1, Level 2, and Level 3 — based on the patient’s ability and the nurse’s responsibility.
Here’s a clear breakdown:
🔵 Level 1 – Nurse Administers Medication
The nurse is fully responsible for the safe storage, preparation, and administration of all medication.
The patient is not involved in administering their own medicines.
Common for newly admitted, confused, or very unwell patients.
🔹 Key point: Full nurse control.
🔵 Level 2 – Supervised Self-Administration
The patient administers their own medicines but under the direct supervision of a registered nurse.
The nurse is responsible for storage (e.g., in a locked cabinet).
At the time of administration, the nurse unlocks the storage, and the patient self-administers the medication with the nurse watching or assisting if needed.
🔹 Key point: Shared responsibility. The nurse supervises, but the patient actively participates.
🔵 Level 3 – Independent Self-Administration
The patient is fully responsible for storing and taking their medication independently.
The nurse ensures that the patient is assessed as competent to handle their own medications safely.
The patient is given full control, but is monitored occasionally for compliance and safety.
🔹 Key point: Patient has full independence with oversight.
Here’s a clear breakdown:
🔵 Level 1 – Nurse Administers Medication
The nurse is fully responsible for the safe storage, preparation, and administration of all medication.
The patient is not involved in administering their own medicines.
Common for newly admitted, confused, or very unwell patients.
🔹 Key point: Full nurse control.
🔵 Level 2 – Supervised Self-Administration
The patient administers their own medicines but under the direct supervision of a registered nurse.
The nurse is responsible for storage (e.g., in a locked cabinet).
At the time of administration, the nurse unlocks the storage, and the patient self-administers the medication with the nurse watching or assisting if needed.
🔹 Key point: Shared responsibility. The nurse supervises, but the patient actively participates.
🔵 Level 3 – Independent Self-Administration
The patient is fully responsible for storing and taking their medication independently.
The nurse ensures that the patient is assessed as competent to handle their own medications safely.
The patient is given full control, but is monitored occasionally for compliance and safety.
🔹 Key point: Patient has full independence with oversight.
🧭 Types of #Advocacy in Health & Social Care (UK – NHS/NMC/Care Act)
🔹 1. Independent Advocacy
Supports individuals to express their views, secure rights, and make informed decisions.
Completely independent of health or social care services.
Used by those with difficulty communicating or navigating services.
🔹 2. IMCA (Independent Mental Capacity Advocate)
For those lacking capacity (Mental Capacity Act 2005).
No friends or family available to represent them.
Required for decisions on:
Serious medical treatment
Long-term accommodation changes
Ensures the person's views and rights are represented.
🔹 3. IMHA (Independent Mental Health Advocate)
For individuals detained under the Mental Health Act 1983.
Helps them:
Understand their rights
Appeal decisions
Be involved in care/treatment planning
Can access records and attend care plan meetings.
🔹 4. Care Act Advocacy
For people struggling to understand or engage in social care processes (Care Act 2014).
Must be provided if:
Person has substantial difficulty engaging
No appropriate person to support them
Applies in:
Needs assessments
Care planning
Safeguarding processes
🔹 5. Self-Advocacy
The person speaks up for themselves.
May need training, tools, or support.
Encourages confidence and independence.
🔹 6. Peer Advocacy
Advocacy by someone with similar lived experience.
Often seen in mental health, addiction recovery, or disability services.
Builds trust and relatable support.
✅ Quick Tip (NMC/NHS context):
Advocacy means “taking action to help people say what they want, secure their rights, represent their interests, and obtain the services they need.”
🔹 1. Independent Advocacy
Supports individuals to express their views, secure rights, and make informed decisions.
Completely independent of health or social care services.
Used by those with difficulty communicating or navigating services.
🔹 2. IMCA (Independent Mental Capacity Advocate)
For those lacking capacity (Mental Capacity Act 2005).
No friends or family available to represent them.
Required for decisions on:
Serious medical treatment
Long-term accommodation changes
Ensures the person's views and rights are represented.
🔹 3. IMHA (Independent Mental Health Advocate)
For individuals detained under the Mental Health Act 1983.
Helps them:
Understand their rights
Appeal decisions
Be involved in care/treatment planning
Can access records and attend care plan meetings.
🔹 4. Care Act Advocacy
For people struggling to understand or engage in social care processes (Care Act 2014).
Must be provided if:
Person has substantial difficulty engaging
No appropriate person to support them
Applies in:
Needs assessments
Care planning
Safeguarding processes
🔹 5. Self-Advocacy
The person speaks up for themselves.
May need training, tools, or support.
Encourages confidence and independence.
🔹 6. Peer Advocacy
Advocacy by someone with similar lived experience.
Often seen in mental health, addiction recovery, or disability services.
Builds trust and relatable support.
✅ Quick Tip (NMC/NHS context):
Advocacy means “taking action to help people say what they want, secure their rights, represent their interests, and obtain the services they need.”
Takaloo Nursing Academy
quick and easy NHS/RCN Waste Disposal Cheat Sheet for Nurses
🟡 Offensive/Hygiene Waste
✅ Non-infectious but potentially offensive
🗑 Yellow/black "tiger" stripe bags
Examples:
Incontinence pads
Stoma bags
Catheter bags
Non-infectious wound dressings
Gloves, masks (not from infectious cases)
🔴 Infectious Waste
✅ Contaminated with blood/body fluids
🗑 Orange bags/containers
Examples:
Used wound dressings (infectious)
Items from patients with known infections
Swabs, PPE from isolation rooms
⚠️ Cytotoxic/Cytostatic Waste
✅ Toxic or cancer-treatment-related
🗑 Purple-lidded sharps bins / containers
Examples:
Chemotherapy drugs
Hormonal treatments
Used items exposed to cytotoxic agents
PPE used while handling cytotoxic drugs
🟠 Clinical Sharps Waste
✅ Needles and sharp instruments
🗑 Yellow-lidded sharps bins
Examples:
Needles, syringes
Scalpels
IV cannulas
🟣 Pharmaceutical Waste
✅ Unused or expired medicines
🗑 Blue-lidded bins/containers
Examples:
Tablets, vials
Liquids
Creams (unused or expired)
🔵 Domestic Waste
✅ Non-contaminated general waste
🗑 Black bags
Examples:
Paper towels
Packaging
Clean gloves or aprons (not used)
✅ Non-infectious but potentially offensive
🗑 Yellow/black "tiger" stripe bags
Examples:
Incontinence pads
Stoma bags
Catheter bags
Non-infectious wound dressings
Gloves, masks (not from infectious cases)
🔴 Infectious Waste
✅ Contaminated with blood/body fluids
🗑 Orange bags/containers
Examples:
Used wound dressings (infectious)
Items from patients with known infections
Swabs, PPE from isolation rooms
⚠️ Cytotoxic/Cytostatic Waste
✅ Toxic or cancer-treatment-related
🗑 Purple-lidded sharps bins / containers
Examples:
Chemotherapy drugs
Hormonal treatments
Used items exposed to cytotoxic agents
PPE used while handling cytotoxic drugs
🟠 Clinical Sharps Waste
✅ Needles and sharp instruments
🗑 Yellow-lidded sharps bins
Examples:
Needles, syringes
Scalpels
IV cannulas
🟣 Pharmaceutical Waste
✅ Unused or expired medicines
🗑 Blue-lidded bins/containers
Examples:
Tablets, vials
Liquids
Creams (unused or expired)
🔵 Domestic Waste
✅ Non-contaminated general waste
🗑 Black bags
Examples:
Paper towels
Packaging
Clean gloves or aprons (not used)
#Malnutrition #Risk Levels
Key Factors That Determine Malnutrition Risk:
Body Mass Index (BMI):
BMI can help assess whether someone is underweight, at a healthy weight, overweight, or obese.
A BMI under 18.5 kg/m² often suggests malnutrition risk.
Unintentional Weight Loss:
If someone has lost weight unintentionally, it could indicate inadequate nutrition intake or other health problems that affect absorption.
A significant loss in weight (e.g., 5% or more in a short time) raises malnutrition concerns.
Dietary Intake:
Poor food intake, whether due to difficulty eating, lack of access to food, or medical conditions (e.g., nausea, difficulty swallowing), can lead to inadequate nutrition.
Acute or Chronic Illness:
Serious illnesses, like cancer or chronic diseases (e.g., kidney disease, diabetes), can increase the risk of malnutrition by increasing energy requirements or reducing appetite.
Functional Status:
People who are immobile, have difficulty preparing food, or have conditions affecting their ability to eat properly are more likely to experience malnutrition.
Age and Other Demographic Factors:
Elderly individuals are often at higher risk due to factors like reduced appetite, difficulty chewing, and medical conditions that impact nutrient absorption.
Malnutrition Risk Levels:
Low Risk:
This is usually indicated by a score of 0 on screening tools like MUST.
It suggests that the person has a minimal or no risk of malnutrition, and no immediate intervention is required.
Medium Risk:
A score of 1 typically signifies medium risk.
People in this category may need some monitoring and dietary adjustments to prevent further issues.
High Risk:
A score of 2 or higher (such as 2-3) generally indicates high risk.
Individuals in this group need immediate attention, nutritional support, and possibly specialized care to address the underlying causes of malnutrition.
Assessment Tools (Example: MUST):
BMI Score: Based on height and weight.
Unplanned Weight Loss: How much weight has been lost unintentionally.
Food Intake Decline: How much food intake has been reduced due to illness, inability to eat, or other factors.
Overall Risk: Calculated based on the above components, leading to low, medium, or high risk.
Early identification and intervention in malnutrition can prevent complications like delayed wound healing, increased infection risk, and longer recovery times. It is crucial for healthcare providers, like nurses, to assess malnutrition risk routinely, especially for hospitalized patients, elderly individuals, or those with chronic illnesses.
Key Factors That Determine Malnutrition Risk:
Body Mass Index (BMI):
BMI can help assess whether someone is underweight, at a healthy weight, overweight, or obese.
A BMI under 18.5 kg/m² often suggests malnutrition risk.
Unintentional Weight Loss:
If someone has lost weight unintentionally, it could indicate inadequate nutrition intake or other health problems that affect absorption.
A significant loss in weight (e.g., 5% or more in a short time) raises malnutrition concerns.
Dietary Intake:
Poor food intake, whether due to difficulty eating, lack of access to food, or medical conditions (e.g., nausea, difficulty swallowing), can lead to inadequate nutrition.
Acute or Chronic Illness:
Serious illnesses, like cancer or chronic diseases (e.g., kidney disease, diabetes), can increase the risk of malnutrition by increasing energy requirements or reducing appetite.
Functional Status:
People who are immobile, have difficulty preparing food, or have conditions affecting their ability to eat properly are more likely to experience malnutrition.
Age and Other Demographic Factors:
Elderly individuals are often at higher risk due to factors like reduced appetite, difficulty chewing, and medical conditions that impact nutrient absorption.
Malnutrition Risk Levels:
Low Risk:
This is usually indicated by a score of 0 on screening tools like MUST.
It suggests that the person has a minimal or no risk of malnutrition, and no immediate intervention is required.
Medium Risk:
A score of 1 typically signifies medium risk.
People in this category may need some monitoring and dietary adjustments to prevent further issues.
High Risk:
A score of 2 or higher (such as 2-3) generally indicates high risk.
Individuals in this group need immediate attention, nutritional support, and possibly specialized care to address the underlying causes of malnutrition.
Assessment Tools (Example: MUST):
BMI Score: Based on height and weight.
Unplanned Weight Loss: How much weight has been lost unintentionally.
Food Intake Decline: How much food intake has been reduced due to illness, inability to eat, or other factors.
Overall Risk: Calculated based on the above components, leading to low, medium, or high risk.
Early identification and intervention in malnutrition can prevent complications like delayed wound healing, increased infection risk, and longer recovery times. It is crucial for healthcare providers, like nurses, to assess malnutrition risk routinely, especially for hospitalized patients, elderly individuals, or those with chronic illnesses.
NEWS2 (National Early Warning Score 2)
🔍 What is NEWS2?
NEWS2 is an updated version of the original National Early Warning Score developed by the Royal College of Physicians (RCP). It provides a standardised approach to detecting and responding to clinical deterioration in adults (aged ≥16).
🧠 Purpose of NEWS2:
To identify early signs of acute illness or deterioration
To trigger timely medical intervention
To standardise communication across healthcare professionals (e.g., SBAR)
It is used across NHS hospitals, community care, and ambulance services to ensure consistent, safe care.
✅ Benefits of NEWS2:
Early detection of sepsis, COVID-19 deterioration, or cardiac events
Promotes clinical judgement alongside objective scoring
Standardises care across multiple healthcare settings
🔍 What is NEWS2?
NEWS2 is an updated version of the original National Early Warning Score developed by the Royal College of Physicians (RCP). It provides a standardised approach to detecting and responding to clinical deterioration in adults (aged ≥16).
🧠 Purpose of NEWS2:
To identify early signs of acute illness or deterioration
To trigger timely medical intervention
To standardise communication across healthcare professionals (e.g., SBAR)
It is used across NHS hospitals, community care, and ambulance services to ensure consistent, safe care.
✅ Benefits of NEWS2:
Early detection of sepsis, COVID-19 deterioration, or cardiac events
Promotes clinical judgement alongside objective scoring
Standardises care across multiple healthcare settings