Registrants (nurses, midwives, and nursing associates) must only supply and administer #medicines under recognized legal frameworks. The processes that are acceptable include:

✅ Patient Medicines Administration Record (MAR)
Example:
In a care home, a nurse administers paracetamol 500 mg four times a day to Mrs. Smith. The prescription is written by the GP and transcribed onto a MAR chart, which the nurse signs each time the dose is given.

🩺 Used in: Care homes, community nursing, domiciliary care
🧾 MAR chart = legal record of administration.

✅ Patient Group Direction (PGD)
Example:
In a walk-in clinic, a nurse gives a flu vaccine to patients under a PGD authorised by the NHS Trust. The PGD outlines which patients are eligible (e.g., over 65, pregnant women) and what to do if complications occur.

🩺 Used in: Immunisations, emergency contraception, minor ailments
📃 PGD = Legal written instruction for groups of patients.

✅ Medicines Act Exemption
Example:
A midwife administers Vitamin K injection to a newborn without a prescription under a statutory exemption in the Medicines Act 1968.

🩺 Used by: Midwives, paramedics, optometrists (under specific rules)
⚖️ Allows giving certain medicines in specific settings.

In the UK, certain groups of people are exempt from paying for prescription #medications. Here’s a breakdown:

#Exempt from #prescription charges:
معاف
a) Children under 16 – ✅ exempt

c) People receiving income-related benefits (e.g., income support, income-based Jobseeker’s Allowance, income-related Employment and Support Allowance) – ✅ exempt

d) Pensioners over 60 years old – ✅ exempt

b) Women of childbearing age – ❌ NOT automatically exempt

Only pregnant women or those who’ve had a baby in the past 12 months AND have a valid Maternity Exemption Certificate are exempt.

When a #medication #error occurs, the first priority is patient safety, followed by clear communication and documentation. Here's the correct process:

1- Assess the patient for any potential or actual harm caused by the error.
2- Inform the prescriber (to evaluate and provide any corrective treatment if needed).
3- Notify your line manager (as part of the governance and reporting protocol).
4- Document the incident clearly in the patient notes.
5- Follow up with local incident reporting systems, such as DATIX in the NHS.

Who is a Line #Manager in Nursing?
A line manager in nursing is the person directly responsible for overseeing your work and providing management, supervision, and support in your role. They are often your immediate supervisor and may have titles such as:

Ward Manager
Senior Nurse / Charge Nurse
Team Leader
Nurse-in-Charge
Clinical Nurse Manager / Sister

📋 Their responsibilities include:
Supervising your clinical practice
Managing staffing and rotas
Supporting your professional development
Addressing concerns, incidents, or errors
Conducting performance appraisals

🧠 Example:
If you're a staff nurse working on a hospital ward and you make a medication error, your line manager is likely the Ward Manager or Senior Nurse on duty who you must inform immediately.

#Nursing #Hierarchy (UK)

Healthcare Assistant (HCA) / Nursing Assistant
Role: Provides direct care and support to patients under the supervision of registered nurses.
Tasks: Bathing, dressing, assisting with mobility, helping with feeding, and monitoring vital signs.

Staff Nurse (RN)
Role: A registered nurse responsible for providing direct care to patients.
Tasks: Administering medications, wound care, monitoring patient progress, and liaising with doctors.

Senior Nurse / Charge Nurse / Team Leader
Role: Oversee a team of nurses on a ward or unit, ensuring efficient and safe patient care.
Tasks: Supervision of staff, managing patient care, ensuring safety protocols are followed, addressing patient issues, and liaising with management.

Sister / Charge Nurse
Role: Typically seen in larger wards or departments; acts as a senior nurse and takes charge of the clinical and operational management of the team.
Tasks: Supervising staff, managing patient care, handling complex situations, and conducting audits and training.

Clinical Nurse Specialist (CNS)
Role: A nurse with advanced expertise in a specific area of healthcare, such as oncology, palliative care, or tissue viability.
Tasks: Providing specialized care, advising other nurses, and developing care plans for complex cases.

Ward Manager / Clinical Nurse Manager
Role: Responsible for the overall management of a ward or department.
Tasks: Staffing, budgets, patient care coordination, ensuring clinical standards are met, and addressing complaints or concerns.

Nurse Consultant
Role: Highly experienced nurses with advanced qualifications in a specialist area.
Tasks: Providing leadership in clinical practice, advising on policy, and contributing to research and education.

Director of Nursing
Role: The senior leadership role in nursing within a hospital or healthcare organization.
Tasks: Responsible for the nursing strategy, patient care standards, and overseeing nursing practice across the organization.

Summary of Responsibilities:
Line Manager: The immediate supervisor (usually a Senior Nurse or Charge Nurse) to whom you report directly for support and guidance.

Ward Manager: Oversees the operational management of the entire ward/unit.

Clinical Nurse Manager: Oversees the clinical care within specific departments or wards.

Time-sensitive #medications are a top #priority during morning medication rounds.

Diabetic patients often require insulin or oral hypoglycemics before meals.

Patients with Parkinson’s disease must receive their medications on time to prevent deterioration in motor function and maintain therapeutic levels.

داروهای حساس به زمان در طول دوره های دارویی صبحگاهی در اولویت هستند.

بیماران دیابتی اغلب به انسولین یا داروهای هیپوگلیسمی خوراکی قبل از غذا نیاز دارند.

بیماران مبتلا به بیماری پارکینسون برای جلوگیری از بدتر شدن عملکرد حرکتی و حفظ سطوح درمانی باید داروهای خود را به موقع دریافت کنند.

self-administration level (SAM Level)

🔹Level 1: Nurse Administers, Patient Involved
Who is responsible?
The nurse/registrant is fully responsible for storing and administering medication.

What does the patient do?
The patient may participate by learning about their medications, but does not physically handle or take them independently.

Purpose:
To educate and involve the patient gradually while ensuring safety.

🔹 Level 2: Patient Self-Administers with Supervision
Who is responsible?
The nurse/registrant is responsible for safe storage and supervision during administration.

What does the patient do?
The patient takes the medication themselves (e.g., from a blister pack or bottle), but only under nurse supervision.
Purpose:
To build the patient's confidence and autonomy while still ensuring safety and compliance.

🔹 Level 3: Independent Self-Administration
Who is responsible?
The patient is fully responsible for storing (in their own locked drawer or cupboard) and administering their own medication.

What does the patient do?
They store, manage, and take all medications independently without direct nurse supervision.

Purpose:
Suitable for patients who are competent, safe, and capable — especially in preparation for discharge.

📌 Important Notes:
Patients are assessed by a nurse or pharmacist before being assigned a level.
The level can change at any time if the patient's condition or capability changes.
Documentation and ongoing review are required at all levels.
#medication

MARS (Medication Administration Record Sheet)
MARS (برگه سوابق تجویز دارو)
#medication

#UK #Drug #Classification

Common side effects of oral #corticosteroids

Common mood-related side effects include:

Mood swings
Euphoria
Irritability
Anxiety
Insomnia
Even psychosis in rare cases

#WHO #Analgesic #Ladder (3-Step Model)
Key Terms:
Non-opioid: Basic analgesics (e.g., paracetamol, NSAIDs).
Weak opioid: Lower potency opioids (e.g., codeine, tramadol).
Strong opioid: High potency opioids (e.g., morphine).
Adjuvant: Co-analgesics for neuropathic pain or symptom control (e.g., antidepressants, anticonvulsants, steroids).

📌 Principles of the WHO Ladder:
By the mouth – Use oral medications whenever possible.
By the clock – Give at regular intervals (not PRN) to maintain pain control.
By the ladder – Start at the step that matches the patient's pain severity.
Tailor to the individual – Adjust for effectiveness and side effects.
Monitor and reassess – Pain control should be evaluated regularly.

When to use adjuvants:
Neuropathic pain (e.g., gabapentin, amitriptyline)
Bone pain (e.g., NSAIDs, bisphosphonates)
Inflammation (e.g., corticosteroids)

Bristol #Stool Chart (Types 1–7)

Clinical Use:
Types 1–2 suggest constipation.
Types 3–4 are normal and ideal.
Types 5–7 suggest urgency or diarrhea, with Type 7 being the most severe.