Do you have good order and safety in the medicine room?

This article is written from Swedish conditions. Hopefully, it can inspire interested individuals from other countries.

Errors in drug management entail risks for the residents of the elderly home. A well-functioning medication room is a good basis for safe drug handling. By carefully planning and organizing the medication room, the elderly home can create a safe and efficient environment for handling drugs, which in turn contributes to a high standard of care and service for the residents.

Foto: Mostphotos

Safe storage of medicines

Most often, the medicines used in nursing homes are the property of the individual. This means that healthcare staff may not borrow medicines between patients. Many units have a basic stock of medicines that may need to be administered at short notice. These drugs are paid for by the region. This could involve certain antibiotics or pain relief. These medicines then belong to the unit.

The storage of medicines needs to be controllable

Medicines have certain common properties with food. Some medicines need to be stored in the fridge. When it comes to refrigerated storage, specific checks are required at least every two weeks to ensure that the fridge maintains the correct temperature. Just like with food, it is important to be able to trace that there is an unbroken cold chain for the storage of the drug. The control of the fridge temperature is signed. Other medicines may have a shortened shelf life if they are stored in warm spaces. It is therefore important to check that the temperature in the medicine room does not exceed 25 degrees C.

Some medicines have a short shelf life in an opened package. Eye and ear drops, as well as insulin, often have a shelf life of one month. When opening such a package, it is important to note the date on the package, so that the shelf life of the medicines is not exceeded. In a residence, packages should also be marked with the social security number and name. It is important that there are routines for checking the expiry date so that no one receives medicines that have become too old.

A safe working environment in the medicine room

Some medicines can be toxic if handled improperly and are surrounded by specific occupational health regulations. There may also be reasons to inform about risks, signpost, and so forth. Medicines may also need to be marked according to the fire department's directives. This applies primarily to gases. Medicines that have been dispensed from the pharmacy may not be used by another person and must be discarded for safety reasons.

Many medicines in themselves pose a higher risk level and may need special checks. Such medicines are, for example, Waran and Insulin. They require special attention and delegation of the handling of these medicines takes place in a special order and to a limited group of employees.

Medicines are also prone to theft. There may therefore be reasons to consider how burglar-proof the medicine room is. There are also environmental aspects on how much should be in the medicine storage of both private and common medicines.

Optimal design and organization of the medicine room in the nursing home

Having a well-functioning and correctly organized medicine room in the nursing home is of crucial importance to ensure a safe and effective handling of medicines for the residents. A well-planned medicine room contributes to minimizing the risk of mistakes and promotes a smooth and efficient handling of medicines. Below are some guidelines on how the medicine room should be designed and organized to meet high safety standards and facilitate the workflow for the staff.

Room design and layout

It is important that the medicine room is ergonomically designed to facilitate the work process and minimize the risk of errors. The room should be large enough to accommodate all necessary equipment and to allow easy access to all medicine cabinets and storage spaces. A suitable layout may include:

- Separate areas for storing different types of medicines, such as prescription drugs, over-the-counter medicines, and medicines that require refrigeration.
- Clear signage and labeling of different storage spaces to facilitate identification and access.
- A workspace for preparing and administering medicines, with access to necessary consumables and equipment such as syringes, dosing measures, and gloves.
- Good lighting to facilitate reading of labels and preparation of medicines.
- Easy access to refrigeration for medicines that require refrigeration, with clear markings of temperature requirements.

Storage and handling of medicines

Proper storage and handling of medicines are of utmost importance to ensure their stability and effectiveness. The following measures should be considered:

- Storage of medicines should be done according to the manufacturer's recommendations and current laws and regulations.
- Prescription medicines should be stored locked and only accessible to authorized personnel.
- Medicines should be clearly labeled with name, strength, and expiry date to facilitate identification and control of stock status.
- Regular inventory and control of stock to identify and handle expired or outdated medicines.
- Proper handling of refrigerated medicines to ensure they are kept within the recommended temperature range.

Reflection questions - the medicine room
Care staff:
- Do you keep track of the date marking on insulin and eye drops?
- How do you handle medicines that are with the residents and need to be kept cool?
- Do you have good routines for replenishing as-needed medicines in time?

Manager, nurse, occupational therapist and physiotherapist:
- Do you have a local instruction for medicine handling?
- Is it updated?
- Is the medicine room in good order?
- Does it meet the requirements from a storage point of view?

Residents and relatives:
- Does the medicine handling work well at the residence.

Erland Olsson
Specialist Nurse
Better care every day

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