Appraise the legislation that regulates the scope of practice of the registered nurse and the midwife in terms of the procuring, storing, prescribing and dispensing of pharmaceutical products
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Aug 25, 2024
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About This Presentation
Summarise the Nursing Act and Regulations applicable to dispensing of medicine by a Professional Nurse or by a Midwife.
Compare the medicine control practice in a health facility with adherence to Nursing and Midwifery regulatory requirements.
Slide Content
Appraise the
legislation that
regulates the scope
of practice of the
registered nurse and
the midwife in terms
of the procuring,
storing, prescribing
and dispensing of
pharmaceutical
products
4/5/2024 Compiled by C Settley 1
legislation that
regulates the scope
of practice of the
registered nurse and
the midwife in terms
of the procuring,
storing, prescribing
and dispensing of
pharmaceutical
products
4/5/2024 Compiled by C Settley 1
Objectives
•Summarisethe Nursing Act and Regulations applicable to dispensing
of medicine by a Professional Nurse or by a Midwife.
•Compare the medicine control practice in a health facility with
adherence to Nursing and Midwifery regulatory requirements.
4/5/2024 Compiled by C Settley 2
•Summarisethe Nursing Act and Regulations applicable to dispensing
of medicine by a Professional Nurse or by a Midwife.
•Compare the medicine control practice in a health facility with
adherence to Nursing and Midwifery regulatory requirements.
4/5/2024 Compiled by C Settley 2
Introduction
•In healthcare, the roles of registered nurses (RNs) and midwives are
crucial, encompassing various responsibilities including the
procurement, storage, prescription, and dispensing of pharmaceutical
products.
•However, the scope of these activities is regulated by legislation to
ensure patient safety, quality care, and adherence to professional
standards.
•In this lesson, we'll appraise the legislation governing these aspects of
practice for RNs and midwives.
4/5/2024 Compiled by C Settley 3
•In healthcare, the roles of registered nurses (RNs) and midwives are
crucial, encompassing various responsibilities including the
procurement, storage, prescription, and dispensing of pharmaceutical
products.
•However, the scope of these activities is regulated by legislation to
ensure patient safety, quality care, and adherence to professional
standards.
•In this lesson, we'll appraise the legislation governing these aspects of
practice for RNs and midwives.
4/5/2024 Compiled by C Settley 3
Regulation and Scope of Practice
•In South Africa, the key legislative frameworks that govern the scope of practice
for Registered Nurses (RNs) and midwives in pharmaceutical management
include:
•Nursing Act, 2005 (Act No. 33 of 2005): This act provides the legal framework for the
regulation of the nursing profession in South Africa. It establishes the South African Nursing
Council (SANC) as the regulatory body responsible for setting standards for nursing
education, training, and practice. The Nursing Act outlines the scope of practice for various
categories of nurses, including RNs and midwives, and defines their responsibilities in
pharmaceutical management.
•Regulations Relating to the Scope of Practice of Nurses and Midwives: These regulations,
issued under the Nursing Act, provide specific details regarding the scope of practice for RNs
and midwives, including their roles and responsibilities related to pharmaceutical
management. They outline the tasks that nurses and midwives are authorized to perform in
this area, such as administering medications, managing medication orders, and providing
patient education on medication use.
4/5/2024 Compiled by C Settley 4
•In South Africa, the key legislative frameworks that govern the scope of practice
for Registered Nurses (RNs) and midwives in pharmaceutical management
include:
•Nursing Act, 2005 (Act No. 33 of 2005): This act provides the legal framework for the
regulation of the nursing profession in South Africa. It establishes the South African Nursing
Council (SANC) as the regulatory body responsible for setting standards for nursing
education, training, and practice. The Nursing Act outlines the scope of practice for various
categories of nurses, including RNs and midwives, and defines their responsibilities in
pharmaceutical management.
•Regulations Relating to the Scope of Practice of Nurses and Midwives: These regulations,
issued under the Nursing Act, provide specific details regarding the scope of practice for RNs
and midwives, including their roles and responsibilities related to pharmaceutical
management. They outline the tasks that nurses and midwives are authorized to perform in
this area, such as administering medications, managing medication orders, and providing
patient education on medication use.
4/5/2024 Compiled by C Settley 4
Regulation and Scope of Practice
•In South Africa, the key legislative frameworks that govern the scope of
practice for Registered Nurses (RNs) and midwives in pharmaceutical
management include:
•Medicines and Related Substances Act, 1965 (Act No. 101 of 1965): This legislation
governs the regulation of medicines and related substances in South Africa. It
establishes the Medicines Control Council (MCC), now known as the South African
Health Products Regulatory Authority (SAHPRA), as the regulatory authority
responsible for ensuring the safety, efficacy, and quality of medicines. RNs and
midwives must adhere to the provisions of this act when handling and
administering medications to patients.
•National Health Act, 2003 (Act No. 61 of 2003): This act sets out the legal
framework for the provision of health services in South Africa. It includes provisions
related to the roles and responsibilities of healthcare professionals, including
nurses and midwives, in the management and delivery of healthcare services,
including pharmaceutical management.
4/5/2024 Compiled by C Settley 5
•In South Africa, the key legislative frameworks that govern the scope of
practice for Registered Nurses (RNs) and midwives in pharmaceutical
management include:
•Medicines and Related Substances Act, 1965 (Act No. 101 of 1965): This legislation
governs the regulation of medicines and related substances in South Africa. It
establishes the Medicines Control Council (MCC), now known as the South African
Health Products Regulatory Authority (SAHPRA), as the regulatory authority
responsible for ensuring the safety, efficacy, and quality of medicines. RNs and
midwives must adhere to the provisions of this act when handling and
administering medications to patients.
•National Health Act, 2003 (Act No. 61 of 2003): This act sets out the legal
framework for the provision of health services in South Africa. It includes provisions
related to the roles and responsibilities of healthcare professionals, including
nurses and midwives, in the management and delivery of healthcare services,
including pharmaceutical management.
4/5/2024 Compiled by C Settley 5
Specific activities related to pharmaceutical procurement,
storage, prescription, and dispensing that fall within the
authorized scope of practice for RNs and midwives.
•In South Africa, the scope of practice for Registered Nurses (RNs) and
midwives in pharmaceutical management encompasses several
activities related to procurement, storage, prescription, and
dispensing of medications.
•Adhering to legal and professional standards in these areas is crucial
to ensure patient safety, quality of care, and compliance with
regulatory requirements.
•Next are the specific activities within the authorized scope of practice
for RNs and midwives in these pharmaceutical management aspects:
4/5/2024 Compiled by C Settley 6
storage, prescription, and dispensing that fall within the
authorized scope of practice for RNs and midwives.
•In South Africa, the scope of practice for Registered Nurses (RNs) and
midwives in pharmaceutical management encompasses several
activities related to procurement, storage, prescription, and
dispensing of medications.
•Adhering to legal and professional standards in these areas is crucial
to ensure patient safety, quality of care, and compliance with
regulatory requirements.
•Next are the specific activities within the authorized scope of practice
for RNs and midwives in these pharmaceutical management aspects:
4/5/2024 Compiled by C Settley 6
Procurement:
•RNs and midwives may be involved in the procurement process by
assisting in the selection and ordering of medications for their
healthcare facility or unit.
•They should ensure that medications are procured from licensed
suppliers or wholesalers and comply with regulatory standards set
by the South African Health Products Regulatory Authority
(SAHPRA).
•Emphasis should be placed on obtaining medications of appropriate
quality, efficacy, and safety for patient use.
4/5/2024 Compiled by C Settley 7
•RNs and midwives may be involved in the procurement process by
assisting in the selection and ordering of medications for their
healthcare facility or unit.
•They should ensure that medications are procured from licensed
suppliers or wholesalers and comply with regulatory standards set
by the South African Health Products Regulatory Authority
(SAHPRA).
•Emphasis should be placed on obtaining medications of appropriate
quality, efficacy, and safety for patient use.
4/5/2024 Compiled by C Settley 7
Storage:
•RNs and midwives are responsible for ensuring proper storage
conditions for medications to maintain their stability and efficacy.
•They should adhere to storage guidelines provided by medication
manufacturers and regulatory authorities to prevent degradation or
contamination.
•Monitoring of temperature, humidity, and storage expiry dates
should be conducted regularly to ensure compliance with legal and
professional standards.
4/5/2024 Compiled by C Settley 8
•RNs and midwives are responsible for ensuring proper storage
conditions for medications to maintain their stability and efficacy.
•They should adhere to storage guidelines provided by medication
manufacturers and regulatory authorities to prevent degradation or
contamination.
•Monitoring of temperature, humidity, and storage expiry dates
should be conducted regularly to ensure compliance with legal and
professional standards.
4/5/2024 Compiled by C Settley 8
Prescription:
•In some healthcare settings, RNs and midwives may have limited
prescribing authority for specific medications within their scope of
practice, as outlined by the Nursing Act and related regulations.
•They must prescribe medications based on evidence-based practice
guidelines, patient assessment, and established protocols.
•Collaboration with other healthcare professionals, such as doctors or
pharmacists, may be necessary for more complex medication
regimens or conditions outside their scope of practice.
4/5/2024 Compiled by C Settley 9
•In some healthcare settings, RNs and midwives may have limited
prescribing authority for specific medications within their scope of
practice, as outlined by the Nursing Act and related regulations.
•They must prescribe medications based on evidence-based practice
guidelines, patient assessment, and established protocols.
•Collaboration with other healthcare professionals, such as doctors or
pharmacists, may be necessary for more complex medication
regimens or conditions outside their scope of practice.
4/5/2024 Compiled by C Settley 9
Dispensing:
•RNs and midwives may dispense medications to patients within the
context of their authorized scope of practice, such as in primary
healthcare clinics or community health centers.
•Dispensing activities should be carried out in accordance with legal
and professional standards, including accurate labeling, patient
education on medication use, and documentation of dispensing
transactions.
•RNs and midwives should also provide counseling to patients
regarding potential side effects, dosage instructions, and adherence
to prescribed medications.
4/5/2024 Compiled by C Settley 10
•RNs and midwives may dispense medications to patients within the
context of their authorized scope of practice, such as in primary
healthcare clinics or community health centers.
•Dispensing activities should be carried out in accordance with legal
and professional standards, including accurate labeling, patient
education on medication use, and documentation of dispensing
transactions.
•RNs and midwives should also provide counseling to patients
regarding potential side effects, dosage instructions, and adherence
to prescribed medications.
4/5/2024 Compiled by C Settley 10
Pharmaceutical Procurement
In South Africa, RNs and midwives involved in pharmaceutical procurement are subject to various legal obligations and
regulations to ensure the safety, efficacy, and quality of medications. These obligations are outlined in legislation such
as the Medicines and Related Substances Act, 1965 (Act No. 101 of 1965), and its associated regulations.
•Authorized Suppliers:RNs and midwives must procure pharmaceutical
products only from approved suppliers or wholesalers licensed by the
South African Health Products Regulatory Authority (SAHPRA). This
ensures that medications are sourced from reputable sources that comply
with regulatory standards for manufacturing, storage, and distribution.
•Product Quality and Authenticity:When procuring pharmaceutical
products, RNs and midwives are responsible for ensuring the quality and
authenticity of medications. They must verify that the medications
obtained are genuine, labeled correctly, and have not been tampered
with. This includes checking for proper packaging, labeling, and batch
numbers to track the origin and authenticity of each product.
4/5/2024 Compiled by C Settley 11
In South Africa, RNs and midwives involved in pharmaceutical procurement are subject to various legal obligations and
regulations to ensure the safety, efficacy, and quality of medications. These obligations are outlined in legislation such
as the Medicines and Related Substances Act, 1965 (Act No. 101 of 1965), and its associated regulations.
•Authorized Suppliers:RNs and midwives must procure pharmaceutical
products only from approved suppliers or wholesalers licensed by the
South African Health Products Regulatory Authority (SAHPRA). This
ensures that medications are sourced from reputable sources that comply
with regulatory standards for manufacturing, storage, and distribution.
•Product Quality and Authenticity:When procuring pharmaceutical
products, RNs and midwives are responsible for ensuring the quality and
authenticity of medications. They must verify that the medications
obtained are genuine, labeled correctly, and have not been tampered
with. This includes checking for proper packaging, labeling, and batch
numbers to track the origin and authenticity of each product.
4/5/2024 Compiled by C Settley 11
Pharmaceutical Procurement
•Compliance with Regulatory Standards:RNs and midwives must adhere to
regulatory standards set forth by SAHPRA regarding the procurement of
pharmaceutical products. This includes complying with regulations related
to Good Manufacturing Practice (GMP), Good Distribution Practice (GDP),
and other quality assurance requirements to safeguard the integrity of
medications throughout the supply chain.
•Documentation and Record-Keeping:It is essential for RNs and midwives
to maintain accurate records of pharmaceutical procurement activities.
This includes documenting details such as the name and quantity of
medications procured, supplier information, batch numbers, expiry dates,
and procurement dates. Proper documentation ensures transparency,
accountability, and traceability in the procurement process.
4/5/2024 Compiled by C Settley 12
•Compliance with Regulatory Standards:RNs and midwives must adhere to
regulatory standards set forth by SAHPRA regarding the procurement of
pharmaceutical products. This includes complying with regulations related
to Good Manufacturing Practice (GMP), Good Distribution Practice (GDP),
and other quality assurance requirements to safeguard the integrity of
medications throughout the supply chain.
•Documentation and Record-Keeping:It is essential for RNs and midwives
to maintain accurate records of pharmaceutical procurement activities.
This includes documenting details such as the name and quantity of
medications procured, supplier information, batch numbers, expiry dates,
and procurement dates. Proper documentation ensures transparency,
accountability, and traceability in the procurement process.
4/5/2024 Compiled by C Settley 12
Pharmaceutical Procurement
•Adverse Event Reporting:RNs and midwives have a legal obligation to report
any adverse events or medication errors related to procured pharmaceutical
products. This includes promptly notifying relevant authorities and healthcare
providers of any incidents that may compromise patient safety or public health.
Adverse event reporting helps identify and address potential risks associated with
medications and contributes to continuous quality improvement in
pharmaceutical procurement practices.
•Continuing Education and Training:To fulfill their legal obligations effectively,
RNs and midwives involved in pharmaceutical procurement should engage in
ongoing education and training on regulatory requirements, quality assurance
practices, and emerging issues in medication management. Staying updated on
best practices and regulatory changes enables healthcare professionals to make
informed decisions and uphold standards of excellence in pharmaceutical
procurement.
4/5/2024 Compiled by C Settley 13
•Adverse Event Reporting:RNs and midwives have a legal obligation to report
any adverse events or medication errors related to procured pharmaceutical
products. This includes promptly notifying relevant authorities and healthcare
providers of any incidents that may compromise patient safety or public health.
Adverse event reporting helps identify and address potential risks associated with
medications and contributes to continuous quality improvement in
pharmaceutical procurement practices.
•Continuing Education and Training:To fulfill their legal obligations effectively,
RNs and midwives involved in pharmaceutical procurement should engage in
ongoing education and training on regulatory requirements, quality assurance
practices, and emerging issues in medication management. Staying updated on
best practices and regulatory changes enables healthcare professionals to make
informed decisions and uphold standards of excellence in pharmaceutical
procurement.
4/5/2024 Compiled by C Settley 13
Ethical considerations
In the context of pharmaceutical procurement in South Africa, several ethical principles guide the actions
and decisions of Registered Nurses (RNs) and midwives. These principles are fundamental to ensuring
integrity, fairness, and patient-centered care in the procurement process.
•Patient Confidentiality:RNs and midwives must uphold patient
confidentiality at all times, particularly when handling medication
procurement information. This includes safeguarding patient-related data,
such as prescription records or medication preferences, to protect
individuals' privacy rights and maintain trust in the healthcare provider-
patient relationship.
•Avoiding Conflicts of Interest:Healthcare professionals involved in
pharmaceutical procurement must avoid conflicts of interest that could
compromise their impartiality or judgment. This entails refraining from
engaging in activities that could result in personal gain, financial incentives,
or preferential treatment from pharmaceutical suppliers. RNs and
midwives should prioritize the best interests of patients and healthcare
institutions over any potential conflicts of interest.
4/5/2024 Compiled by C Settley 14
In the context of pharmaceutical procurement in South Africa, several ethical principles guide the actions
and decisions of Registered Nurses (RNs) and midwives. These principles are fundamental to ensuring
integrity, fairness, and patient-centered care in the procurement process.
•Patient Confidentiality:RNs and midwives must uphold patient
confidentiality at all times, particularly when handling medication
procurement information. This includes safeguarding patient-related data,
such as prescription records or medication preferences, to protect
individuals' privacy rights and maintain trust in the healthcare provider-
patient relationship.
•Avoiding Conflicts of Interest:Healthcare professionals involved in
pharmaceutical procurement must avoid conflicts of interest that could
compromise their impartiality or judgment. This entails refraining from
engaging in activities that could result in personal gain, financial incentives,
or preferential treatment from pharmaceutical suppliers. RNs and
midwives should prioritize the best interests of patients and healthcare
institutions over any potential conflicts of interest.
4/5/2024 Compiled by C Settley 14
Ethical considerations
•Promoting Equitable Access to Medications:Ethical procurement practices strive
to ensure equitable access to medications for all patients, regardless of
socioeconomic status, geographic location, or other factors. RNs and midwives
should advocate for policies and practices that promote affordability,
availability, and accessibility of essential medications, particularly for
underserved or marginalized populations. This includes advocating for the
inclusion of essential medications on formularies and supporting initiatives to
reduce barriers to medication access, such as generic substitution programs.
•Transparency and Accountability:Ethical pharmaceutical procurement requires
transparency and accountability in decision-making processes and resource
allocation. RNs and midwives should be transparent about procurement
practices, including supplier selection criteria, pricing negotiations, and budgetary
considerations. Additionally, they should be accountable for their actions and
decisions, with mechanisms in place for oversight, review, and continuous
improvement of procurement practices to ensure adherence to ethical standards
and regulatory requirements.
4/5/2024 Compiled by C Settley 15
•Promoting Equitable Access to Medications:Ethical procurement practices strive
to ensure equitable access to medications for all patients, regardless of
socioeconomic status, geographic location, or other factors. RNs and midwives
should advocate for policies and practices that promote affordability,
availability, and accessibility of essential medications, particularly for
underserved or marginalized populations. This includes advocating for the
inclusion of essential medications on formularies and supporting initiatives to
reduce barriers to medication access, such as generic substitution programs.
•Transparency and Accountability:Ethical pharmaceutical procurement requires
transparency and accountability in decision-making processes and resource
allocation. RNs and midwives should be transparent about procurement
practices, including supplier selection criteria, pricing negotiations, and budgetary
considerations. Additionally, they should be accountable for their actions and
decisions, with mechanisms in place for oversight, review, and continuous
improvement of procurement practices to ensure adherence to ethical standards
and regulatory requirements.
4/5/2024 Compiled by C Settley 15
Example:Promoting Equitable Access to
Medications
Maria is a Registered Nurse (RN) working at a community health center in a rural area. The health center serves a diverse population with varying
socioeconomic statuses, including many low-income families and individuals without health insurance. Maria is passionate about promoting equitable
access to medications and improving health outcomes for all patients in her community.
One day, Maria encounters Mrs. Rodriguez, a 55-year-old woman who recently moved to the area and is struggling to manage her diabetes due to limited
access to affordable medications. Mrs. Rodriguez explains to Maria that she was unable to afford her prescribed diabetes medications at the local
pharmacy and has been rationing her insulin injections to make them last longer.
Concerned about Mrs. Rodriguez's health and well-being, Maria conducts a thorough assessment and learns that Mrs. Rodriguez's financial struggles are
preventing her from accessing essential medications regularly. Maria recognizes the importance of advocating for policies andpractices that promote
medication affordability and accessibility, particularly for underserved populations like Mrs. Rodriguez.
Maria decides to take action to address Mrs. Rodriguez's medication access issues and advocate for broader systemic changes within the health center.
She discusses Mrs. Rodriguez's case with the center's healthcare team and highlights the need to expand the formulary to includemore affordable
options for diabetes medications. Maria emphasizes the importance of ensuring that essential medications like insulin are accessible to all patients,
regardless of their socioeconomic status.
Additionally, Maria collaborates with the center's pharmacist to explore options for generic substitution programs that couldlower medication costs for
patients like Mrs. Rodriguez. Together, they review Mrs. Rodriguez's prescription and identify generic alternatives that are equally effective but more
affordable. Maria educates Mrs. Rodriguez about the benefits of generic medications and helps her navigate the process of switching to a lower-cost
option.
Furthermore, Maria advocates for the implementation of telemedicine services or mobile health clinics to reach patients in remote areas who face
barriers to accessing healthcare services. She believes that expanding access to healthcare resources will not only benefit individual patients like Mrs.
Rodriguez but also contribute to addressing broader health disparities within the community.
Through her proactive advocacy efforts, Maria successfully improves Mrs. Rodriguez's access to affordable diabetes medications and helps her better
manage her condition. Moreover, Maria's commitment to promoting equitable access to medications inspires positive changes withinthe health center,
leading to improved medication access and health outcomes for all patients in the community.
4/5/2024 Compiled by C Settley 16
Medications
Maria is a Registered Nurse (RN) working at a community health center in a rural area. The health center serves a diverse population with varying
socioeconomic statuses, including many low-income families and individuals without health insurance. Maria is passionate about promoting equitable
access to medications and improving health outcomes for all patients in her community.
One day, Maria encounters Mrs. Rodriguez, a 55-year-old woman who recently moved to the area and is struggling to manage her diabetes due to limited
access to affordable medications. Mrs. Rodriguez explains to Maria that she was unable to afford her prescribed diabetes medications at the local
pharmacy and has been rationing her insulin injections to make them last longer.
Concerned about Mrs. Rodriguez's health and well-being, Maria conducts a thorough assessment and learns that Mrs. Rodriguez's financial struggles are
preventing her from accessing essential medications regularly. Maria recognizes the importance of advocating for policies andpractices that promote
medication affordability and accessibility, particularly for underserved populations like Mrs. Rodriguez.
Maria decides to take action to address Mrs. Rodriguez's medication access issues and advocate for broader systemic changes within the health center.
She discusses Mrs. Rodriguez's case with the center's healthcare team and highlights the need to expand the formulary to includemore affordable
options for diabetes medications. Maria emphasizes the importance of ensuring that essential medications like insulin are accessible to all patients,
regardless of their socioeconomic status.
Additionally, Maria collaborates with the center's pharmacist to explore options for generic substitution programs that couldlower medication costs for
patients like Mrs. Rodriguez. Together, they review Mrs. Rodriguez's prescription and identify generic alternatives that are equally effective but more
affordable. Maria educates Mrs. Rodriguez about the benefits of generic medications and helps her navigate the process of switching to a lower-cost
option.
Furthermore, Maria advocates for the implementation of telemedicine services or mobile health clinics to reach patients in remote areas who face
barriers to accessing healthcare services. She believes that expanding access to healthcare resources will not only benefit individual patients like Mrs.
Rodriguez but also contribute to addressing broader health disparities within the community.
Through her proactive advocacy efforts, Maria successfully improves Mrs. Rodriguez's access to affordable diabetes medications and helps her better
manage her condition. Moreover, Maria's commitment to promoting equitable access to medications inspires positive changes withinthe health center,
leading to improved medication access and health outcomes for all patients in the community.
4/5/2024 Compiled by C Settley 16
Example: Transparency and Accountability
At St. Joseph's Hospital, a team of Registered Nurses (RNs) and midwives is responsible for managing pharmaceutical procurement to ensure the
availability of essential medications for patients. Recently, the hospital administration has emphasized the importance of transparency and accountability
in the procurement process to uphold ethical standards and regulatory requirements.
One of the RNs, Sarah, is tasked with leading the procurement team and implementing these principles into their practices. Sarahrecognizes the
significance of transparent decision-making and accountability in pharmaceutical procurement and is committed to integrating these principles into the
hospital's processes.
Sarah convenes a meeting with the procurement team to discuss the importance of transparency and accountability in their work. During the meeting,
she emphasizes the need for clear documentation of supplier selection criteria, pricing negotiations, and budgetary considerations. Sarah ensures that all
team members understand the importance of disclosing relevant information to stakeholders and maintaining transparency throughout the procurement
process.
To promote transparency, Sarah establishes guidelines for supplier selection that prioritize factors such as product quality,reliability, and ethical business
practices. The procurement team collaborates with various departments within the hospital to gather input on their medicationneeds and preferences,
ensuring that decisions are made with the best interests of patients in mind.
Sarah also implements measures to ensure accountability within the procurement team. She assigns specific roles and responsibilities to team members,
clearly defining expectations and performance metrics. Regular meetings are scheduled to review progress, address any challengesor concerns, and
identify opportunities for improvement.
Furthermore, Sarah establishes mechanisms for oversight and review of procurement practices to monitor compliance with ethical standards and
regulatory requirements. This includes conducting periodic audits of procurement processes, soliciting feedback from stakeholders, and implementing
corrective actions as needed to address any deficiencies.
As a result of Sarah's leadership and the team's commitment to transparency and accountability, the hospital's pharmaceuticalprocurement practices
become more transparent, efficient, and ethical. Stakeholders have confidence in the integrity of the process, and patients benefit from improved access
to high-quality medications that meet their healthcare needs. Sarah's proactive approach to promoting transparency and accountability sets a positive
example for other healthcare facilities and contributes to the overall integrity of pharmaceutical procurement practices in the healthcare industry
4/5/2024 Compiled by C Settley 17
At St. Joseph's Hospital, a team of Registered Nurses (RNs) and midwives is responsible for managing pharmaceutical procurement to ensure the
availability of essential medications for patients. Recently, the hospital administration has emphasized the importance of transparency and accountability
in the procurement process to uphold ethical standards and regulatory requirements.
One of the RNs, Sarah, is tasked with leading the procurement team and implementing these principles into their practices. Sarahrecognizes the
significance of transparent decision-making and accountability in pharmaceutical procurement and is committed to integrating these principles into the
hospital's processes.
Sarah convenes a meeting with the procurement team to discuss the importance of transparency and accountability in their work. During the meeting,
she emphasizes the need for clear documentation of supplier selection criteria, pricing negotiations, and budgetary considerations. Sarah ensures that all
team members understand the importance of disclosing relevant information to stakeholders and maintaining transparency throughout the procurement
process.
To promote transparency, Sarah establishes guidelines for supplier selection that prioritize factors such as product quality,reliability, and ethical business
practices. The procurement team collaborates with various departments within the hospital to gather input on their medicationneeds and preferences,
ensuring that decisions are made with the best interests of patients in mind.
Sarah also implements measures to ensure accountability within the procurement team. She assigns specific roles and responsibilities to team members,
clearly defining expectations and performance metrics. Regular meetings are scheduled to review progress, address any challengesor concerns, and
identify opportunities for improvement.
Furthermore, Sarah establishes mechanisms for oversight and review of procurement practices to monitor compliance with ethical standards and
regulatory requirements. This includes conducting periodic audits of procurement processes, soliciting feedback from stakeholders, and implementing
corrective actions as needed to address any deficiencies.
As a result of Sarah's leadership and the team's commitment to transparency and accountability, the hospital's pharmaceuticalprocurement practices
become more transparent, efficient, and ethical. Stakeholders have confidence in the integrity of the process, and patients benefit from improved access
to high-quality medications that meet their healthcare needs. Sarah's proactive approach to promoting transparency and accountability sets a positive
example for other healthcare facilities and contributes to the overall integrity of pharmaceutical procurement practices in the healthcare industry
4/5/2024 Compiled by C Settley 17
Ethical considerations
•Evidence-Based Decision Making:Ethical procurement practices are grounded in
evidence-based decision-making processes that prioritize the safety, efficacy,
and quality of medications. RNs and midwives should rely on scientific evidence,
clinical guidelines, and best practices to inform medication selection, formulary
management, and therapeutic decisions. This ensures that patient care is based
on sound clinical judgment and informed by the latest research and evidence.
•Cultural Sensitivity and Respect for Diversity:RNs and midwives should
demonstrate cultural sensitivity and respect for diversity in pharmaceutical
procurement practices. This includes recognizing and addressing cultural beliefs,
preferences, and practices related to medication use among diverse patient
populations. Additionally, healthcare professionals should consider the social,
cultural, and economic contexts that may influence medication access and
adherence, striving to provide culturally competent care that respects patients'
autonomy and dignity.
4/5/2024 Compiled by C Settley 18
•Evidence-Based Decision Making:Ethical procurement practices are grounded in
evidence-based decision-making processes that prioritize the safety, efficacy,
and quality of medications. RNs and midwives should rely on scientific evidence,
clinical guidelines, and best practices to inform medication selection, formulary
management, and therapeutic decisions. This ensures that patient care is based
on sound clinical judgment and informed by the latest research and evidence.
•Cultural Sensitivity and Respect for Diversity:RNs and midwives should
demonstrate cultural sensitivity and respect for diversity in pharmaceutical
procurement practices. This includes recognizing and addressing cultural beliefs,
preferences, and practices related to medication use among diverse patient
populations. Additionally, healthcare professionals should consider the social,
cultural, and economic contexts that may influence medication access and
adherence, striving to provide culturally competent care that respects patients'
autonomy and dignity.
4/5/2024 Compiled by C Settley 18
Pharmaceutical Storage: Storage standards
In South Africa, proper storage of pharmaceutical products within healthcare settings is governed by various standards and
guidelines aimed at ensuring medication safety, efficacy, and quality. These standards and guidelines are established by regulatory
authorities, such as the South African Health Products Regulatory Authority (SAHPRA), and professional organizations, including the
South African Pharmacy Council (SAPC) and the South African Nursing Council (SANC).
•Temperature Control:Proper temperature control is critical to
maintaining the stability and efficacy of pharmaceutical products.
Healthcare facilities are required to establish and maintain
appropriate temperature-controlled storage areas, such as
refrigerators and temperature-monitored storage rooms, to store
medications according to their specific temperature requirements.
Temperature monitoring devices, such as data loggers or
thermometers, should be used to regularly monitor storage
temperatures and ensure compliance with recommended
temperature ranges.
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In South Africa, proper storage of pharmaceutical products within healthcare settings is governed by various standards and
guidelines aimed at ensuring medication safety, efficacy, and quality. These standards and guidelines are established by regulatory
authorities, such as the South African Health Products Regulatory Authority (SAHPRA), and professional organizations, including the
South African Pharmacy Council (SAPC) and the South African Nursing Council (SANC).
•Temperature Control:Proper temperature control is critical to
maintaining the stability and efficacy of pharmaceutical products.
Healthcare facilities are required to establish and maintain
appropriate temperature-controlled storage areas, such as
refrigerators and temperature-monitored storage rooms, to store
medications according to their specific temperature requirements.
Temperature monitoring devices, such as data loggers or
thermometers, should be used to regularly monitor storage
temperatures and ensure compliance with recommended
temperature ranges.
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Pharmaceutical Storage: Storage standards
•Security Measures:Healthcare facilities must implement security
measures to prevent unauthorized access to pharmaceutical storage
areas and safeguard medications from theft, diversion, or tampering.
This includes restricting access to authorized personnel only,
implementing secure locking mechanisms on storage units, and
conducting regular audits or inspections of storage areas to detect
any security breaches.
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•Security Measures:Healthcare facilities must implement security
measures to prevent unauthorized access to pharmaceutical storage
areas and safeguard medications from theft, diversion, or tampering.
This includes restricting access to authorized personnel only,
implementing secure locking mechanisms on storage units, and
conducting regular audits or inspections of storage areas to detect
any security breaches.
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Pharmaceutical Storage: Storage standards
•Inventory Management:Effective inventory management practices
are essential to prevent medication errors, stockouts, or expired
medications. Healthcare facilities should establish standardized
procedures for receiving, storing, and dispensing medications,
including accurate documentation of inventory transactions and
regular stock reconciliations. Automated inventory management
systems may be utilized to track medication stock levels, expiration
dates, and reorder points, enabling timely replenishment of supplies
and reducing the risk of medication-related incidents.
4/5/2024 Compiled by C Settley 21
•Inventory Management:Effective inventory management practices
are essential to prevent medication errors, stockouts, or expired
medications. Healthcare facilities should establish standardized
procedures for receiving, storing, and dispensing medications,
including accurate documentation of inventory transactions and
regular stock reconciliations. Automated inventory management
systems may be utilized to track medication stock levels, expiration
dates, and reorder points, enabling timely replenishment of supplies
and reducing the risk of medication-related incidents.
4/5/2024 Compiled by C Settley 21
Pharmaceutical Storage: Storage standards
•Storage Conditions:Pharmaceutical products should be stored in
conditions that protect them from environmental factors, such as
light, moisture, and humidity, which may degrade their quality or
stability. Medications should be stored in their original packaging
and containers, away from direct sunlight, heat sources, or
moisture-prone areas. Additionally, certain medications may require
special handling or storage considerations, such as refrigeration or
protection from freezing, which should be clearly communicated and
adhered to by healthcare personnel.
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•Storage Conditions:Pharmaceutical products should be stored in
conditions that protect them from environmental factors, such as
light, moisture, and humidity, which may degrade their quality or
stability. Medications should be stored in their original packaging
and containers, away from direct sunlight, heat sources, or
moisture-prone areas. Additionally, certain medications may require
special handling or storage considerations, such as refrigeration or
protection from freezing, which should be clearly communicated and
adhered to by healthcare personnel.
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Pharmaceutical Storage: Storage standards
•Labeling and Organization:Proper labeling and organization of
pharmaceutical storage areas are essential to facilitate accurate
identification, retrieval, and dispensing of medications. Medication
containers should be clearly labeled with their generic and brand
names, strength, dosage form, and expiration date. Storage shelves or
bins should be organized logically, with medications arranged
according to therapeutic category, alphabetical order, or storage
requirements to minimize the risk of medication errors and promote
efficient inventory management.
4/5/2024 Compiled by C Settley 23
•Labeling and Organization:Proper labeling and organization of
pharmaceutical storage areas are essential to facilitate accurate
identification, retrieval, and dispensing of medications. Medication
containers should be clearly labeled with their generic and brand
names, strength, dosage form, and expiration date. Storage shelves or
bins should be organized logically, with medications arranged
according to therapeutic category, alphabetical order, or storage
requirements to minimize the risk of medication errors and promote
efficient inventory management.
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Compliance with regulations
•Patient Safety:Compliance with regulatory requirements ensures that
pharmaceutical products are stored under appropriate conditions to maintain
their potency, stability, and integrity. Proper storage minimizes the risk of
medication degradation, contamination, or adulteration, which could
compromise patient safety and lead to adverse health outcomes. By adhering to
regulatory standards, healthcare facilities prioritize patient safety and uphold
their duty to provide quality care.
•Legal Obligations:Healthcare facilities in South Africa are legally obligated to
comply with regulatory requirements governing pharmaceutical storage, as
outlined by regulatory authorities such as the South African Health Products
Regulatory Authority (SAHPRA) and professional bodies like the South African
Pharmacy Council (SAPC) and the South African Nursing Council (SANC). Failure to
comply with these regulations may result in legal consequences, including fines,
sanctions, or loss of licensure, which can have serious repercussions for
healthcare providers and institutions.
4/5/2024 Compiled by C Settley 24
•Patient Safety:Compliance with regulatory requirements ensures that
pharmaceutical products are stored under appropriate conditions to maintain
their potency, stability, and integrity. Proper storage minimizes the risk of
medication degradation, contamination, or adulteration, which could
compromise patient safety and lead to adverse health outcomes. By adhering to
regulatory standards, healthcare facilities prioritize patient safety and uphold
their duty to provide quality care.
•Legal Obligations:Healthcare facilities in South Africa are legally obligated to
comply with regulatory requirements governing pharmaceutical storage, as
outlined by regulatory authorities such as the South African Health Products
Regulatory Authority (SAHPRA) and professional bodies like the South African
Pharmacy Council (SAPC) and the South African Nursing Council (SANC). Failure to
comply with these regulations may result in legal consequences, including fines,
sanctions, or loss of licensure, which can have serious repercussions for
healthcare providers and institutions.
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Compliance with regulations
•Quality Assurance:Regulatory requirements for pharmaceutical storage serve as
a framework for implementing quality assurance measures to safeguard the
integrity of medications throughout the supply chain. Compliance with storage
standards ensures that medications are handled, stored, and dispensed according
to best practices, reducing the risk of medication errors, product recalls, or
adverse events. By maintaining quality assurance standards, healthcare facilities
demonstrate their commitment to excellence in pharmaceutical management
and patient care.
•Inspections and Audits:Regulatory authorities conduct periodic inspections and
audits of healthcare facilities to assess compliance with pharmaceutical storage
regulations and standards.These inspections serve as opportunities to identify
deficiencies, assess risks, and implement corrective actions to enhance storage
practices and ensure regulatory compliance. By proactively addressing areas of
non-compliance identified during inspections, healthcare facilities can mitigate
risks and improve the quality and safety of pharmaceutical storage operations.
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•Quality Assurance:Regulatory requirements for pharmaceutical storage serve as
a framework for implementing quality assurance measures to safeguard the
integrity of medications throughout the supply chain. Compliance with storage
standards ensures that medications are handled, stored, and dispensed according
to best practices, reducing the risk of medication errors, product recalls, or
adverse events. By maintaining quality assurance standards, healthcare facilities
demonstrate their commitment to excellence in pharmaceutical management
and patient care.
•Inspections and Audits:Regulatory authorities conduct periodic inspections and
audits of healthcare facilities to assess compliance with pharmaceutical storage
regulations and standards.These inspections serve as opportunities to identify
deficiencies, assess risks, and implement corrective actions to enhance storage
practices and ensure regulatory compliance. By proactively addressing areas of
non-compliance identified during inspections, healthcare facilities can mitigate
risks and improve the quality and safety of pharmaceutical storage operations.
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Compliance with regulations
•Record-Keeping and Reporting:Proper record-keeping and reporting
of pharmaceutical storage activities are essential components of
regulatory compliance. Healthcare facilities are required to maintain
accurate records of medication inventory, storage conditions,
temperature monitoring, and any deviations or incidents that occur
during storage or handling. Timely reporting of deviations,
incidents, or adverse events enables regulatory authorities to
investigate, address, and mitigate risks to patient safety and public
health effectively.
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•Record-Keeping and Reporting:Proper record-keeping and reporting
of pharmaceutical storage activities are essential components of
regulatory compliance. Healthcare facilities are required to maintain
accurate records of medication inventory, storage conditions,
temperature monitoring, and any deviations or incidents that occur
during storage or handling. Timely reporting of deviations,
incidents, or adverse events enables regulatory authorities to
investigate, address, and mitigate risks to patient safety and public
health effectively.
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Pharmaceutical Prescription:
Prescribing authority
•In South Africa, the extent of prescribing authority granted to Registered Nurses (RNs) and midwives is
limited compared to that of medical doctors. While RNs and midwives may have some prescribing privileges
within their authorized scope of practice, there are significant restrictions and limitations imposed by the
legal framework.
•Limited Prescribing Authority:RNs and midwives may be authorized
to prescribe a limited range of medications within their area of
expertise and scope of practice. This typically includes medications
commonly used in primary healthcare settings, such as basic over-
the-counter medications, certain antibiotics, contraceptives, and
medications for minor ailments or chronic conditions managed by
nurses and midwives.
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Prescribing authority
•In South Africa, the extent of prescribing authority granted to Registered Nurses (RNs) and midwives is
limited compared to that of medical doctors. While RNs and midwives may have some prescribing privileges
within their authorized scope of practice, there are significant restrictions and limitations imposed by the
legal framework.
•Limited Prescribing Authority:RNs and midwives may be authorized
to prescribe a limited range of medications within their area of
expertise and scope of practice. This typically includes medications
commonly used in primary healthcare settings, such as basic over-
the-counter medications, certain antibiotics, contraceptives, and
medications for minor ailments or chronic conditions managed by
nurses and midwives.
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Pharmaceutical Prescription:
Prescribing authority
•Supervised Prescribing:In some cases, RNs and midwives may be allowed to
prescribe medications under the supervision or collaborative agreement with a
medical doctor or advanced practice nurse, depending on the specific
requirements established by regulatory authorities or healthcare institutions.
Supervised prescribing arrangements may involve periodic review and oversight
by a prescribing practitioner to ensure safe and appropriate medication
management.
•Restrictions and Limitations:The prescribing authority of RNs and midwives is
subject to strict restrictions and limitations to safeguard patient safety and ensure
accountability. These may include limitations on the types of medications that
can be prescribed, dosage limitations, and restrictions on prescribing controlled
substances or medications with a high potential for abuse. Additionally, RNs and
midwives may be prohibited from prescribing medications for certain complex or
specialized medical conditions that fall outside their area of expertise.
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Prescribing authority
•Supervised Prescribing:In some cases, RNs and midwives may be allowed to
prescribe medications under the supervision or collaborative agreement with a
medical doctor or advanced practice nurse, depending on the specific
requirements established by regulatory authorities or healthcare institutions.
Supervised prescribing arrangements may involve periodic review and oversight
by a prescribing practitioner to ensure safe and appropriate medication
management.
•Restrictions and Limitations:The prescribing authority of RNs and midwives is
subject to strict restrictions and limitations to safeguard patient safety and ensure
accountability. These may include limitations on the types of medications that
can be prescribed, dosage limitations, and restrictions on prescribing controlled
substances or medications with a high potential for abuse. Additionally, RNs and
midwives may be prohibited from prescribing medications for certain complex or
specialized medical conditions that fall outside their area of expertise.
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Pharmaceutical Prescription:
Prescribing authority
•Requirements for Prescribing Privileges:To obtain prescribing privileges, RNs and
midwives may be required to complete additional training, education, or
certification programs approved by regulatory authorities or professional bodies.
This may include specialized courses in pharmacology, prescribing practices,
patient assessment, and medication management, designed to equip nurses and
midwives with the knowledge and skills necessary to prescribe medications safely
and effectively within their scope of practice.
•Collaborative Practice:Collaborative practice models involving interdisciplinary
teams of healthcare providers, including nurses, midwives, doctors, pharmacists,
and other professionals, may facilitate the safe and effective prescribing of
medications within healthcare settings. Collaborative practice promotes
communication, coordination, and shared decision-making among healthcare
providers, ensuring that prescribing decisions are based on evidence-based
practice, patient needs, and interprofessionalcollaboration.
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Prescribing authority
•Requirements for Prescribing Privileges:To obtain prescribing privileges, RNs and
midwives may be required to complete additional training, education, or
certification programs approved by regulatory authorities or professional bodies.
This may include specialized courses in pharmacology, prescribing practices,
patient assessment, and medication management, designed to equip nurses and
midwives with the knowledge and skills necessary to prescribe medications safely
and effectively within their scope of practice.
•Collaborative Practice:Collaborative practice models involving interdisciplinary
teams of healthcare providers, including nurses, midwives, doctors, pharmacists,
and other professionals, may facilitate the safe and effective prescribing of
medications within healthcare settings. Collaborative practice promotes
communication, coordination, and shared decision-making among healthcare
providers, ensuring that prescribing decisions are based on evidence-based
practice, patient needs, and interprofessionalcollaboration.
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Pharmaceutical Prescription:
Collaborative practice
•Optimizing Patient Care:Interprofessionalcollaboration brings together diverse
healthcare professionals, including physicians, nurses, midwives, pharmacists,
and other specialists, to collectively assess patient needs, develop comprehensive
treatment plans, and make informed prescribing decisions. By leveraging the
expertise and perspectives of multiple disciplines, healthcare teams can tailor
medication therapy to individual patient needs, preferences, and clinical
circumstances, resulting in more personalized and effective care.
•Ensuring Comprehensive Assessment:Collaboration among healthcare
professionals facilitates comprehensive patient assessment, including thorough
evaluation of medical history, current health status, medication history, and social
determinants of health. By pooling their knowledge and skills, interdisciplinary
teams can identify potential medication-related issues, such as drug interactions,
allergies, or contraindications, and mitigate risks through collaborative decision-
making and medication management strategies.
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Collaborative practice
•Optimizing Patient Care:Interprofessionalcollaboration brings together diverse
healthcare professionals, including physicians, nurses, midwives, pharmacists,
and other specialists, to collectively assess patient needs, develop comprehensive
treatment plans, and make informed prescribing decisions. By leveraging the
expertise and perspectives of multiple disciplines, healthcare teams can tailor
medication therapy to individual patient needs, preferences, and clinical
circumstances, resulting in more personalized and effective care.
•Ensuring Comprehensive Assessment:Collaboration among healthcare
professionals facilitates comprehensive patient assessment, including thorough
evaluation of medical history, current health status, medication history, and social
determinants of health. By pooling their knowledge and skills, interdisciplinary
teams can identify potential medication-related issues, such as drug interactions,
allergies, or contraindications, and mitigate risks through collaborative decision-
making and medication management strategies.
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Pharmaceutical Prescription:
Collaborative practice
•Promoting Medication Safety:Interprofessionalcollaboration enhances
medication safety by promoting medication reconciliation, review, and
monitoring throughout the continuum of care. Healthcare professionals
collaborate to ensure accurate medication lists, reconcile discrepancies, and
identify opportunities to optimize therapy, minimize adverse drug events, and
prevent medication errors. Pharmacists, in particular, play a critical role in
medication safety through their expertise in drug interactions, dosing regimens,
and medication management principles.
•Facilitating Shared Decision-Making:Collaborative prescribing involves shared
decision-making processes that engage patients as active participants in their
care. Interprofessionalteams work collaboratively with patients to discuss
treatment options, address concerns, and establish mutually agreed-upon
treatment goals. By involving patients in the decision-making process, healthcare
professionals promote patient autonomy, adherence to treatment plans, and
satisfaction with care.
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Collaborative practice
•Promoting Medication Safety:Interprofessionalcollaboration enhances
medication safety by promoting medication reconciliation, review, and
monitoring throughout the continuum of care. Healthcare professionals
collaborate to ensure accurate medication lists, reconcile discrepancies, and
identify opportunities to optimize therapy, minimize adverse drug events, and
prevent medication errors. Pharmacists, in particular, play a critical role in
medication safety through their expertise in drug interactions, dosing regimens,
and medication management principles.
•Facilitating Shared Decision-Making:Collaborative prescribing involves shared
decision-making processes that engage patients as active participants in their
care. Interprofessionalteams work collaboratively with patients to discuss
treatment options, address concerns, and establish mutually agreed-upon
treatment goals. By involving patients in the decision-making process, healthcare
professionals promote patient autonomy, adherence to treatment plans, and
satisfaction with care.
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Pharmaceutical Prescription:
Collaborative practice
•Enhancing Continuity of Care:Interprofessionalcollaboration promotes
seamless transitions of care and enhances continuity of medication therapy
across healthcare settings. Healthcare professionals communicate and
coordinate effectively to ensure that prescribing decisions are communicated
clearly, medication orders are transmitted accurately, and follow-up care is
coordinated appropriately. This collaborative approach reduces the risk of
treatment discontinuity, medication errors, and gaps in care, particularly during
transitions between hospital, community, and primary care settings.
•Supporting Professional Development:Interprofessionalcollaboration fosters a
culture of lifelong learning and professional development among healthcare
professionals. By working collaboratively with colleagues from different
disciplines, nurses, midwives, physicians, and pharmacists have opportunities to
expand their knowledge, share best practices, and learn from each other's
expertise. This collaborative learning environment contributes to professional
growth, innovation, and excellence in pharmaceutical prescribing and patient
care.
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Collaborative practice
•Enhancing Continuity of Care:Interprofessionalcollaboration promotes
seamless transitions of care and enhances continuity of medication therapy
across healthcare settings. Healthcare professionals communicate and
coordinate effectively to ensure that prescribing decisions are communicated
clearly, medication orders are transmitted accurately, and follow-up care is
coordinated appropriately. This collaborative approach reduces the risk of
treatment discontinuity, medication errors, and gaps in care, particularly during
transitions between hospital, community, and primary care settings.
•Supporting Professional Development:Interprofessionalcollaboration fosters a
culture of lifelong learning and professional development among healthcare
professionals. By working collaboratively with colleagues from different
disciplines, nurses, midwives, physicians, and pharmacists have opportunities to
expand their knowledge, share best practices, and learn from each other's
expertise. This collaborative learning environment contributes to professional
growth, innovation, and excellence in pharmaceutical prescribing and patient
care.
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Pharmaceutical Dispensing:
Dispensing guidelines
•In South Africa, Registered Nurses (RNs) and midwives may be involved in dispensing medications in certain healthcare settings,
particularly in primary healthcare clinics, community health centers, and other outpatient facilities. While dispensing medications
is typically within the purview of pharmacists, RNs, and midwives may be authorized to dispense medications under specific
circumstances and within their scope of practice
•Authorization and Scope of Practice:RNs and midwives must operate within the
scope of practice defined by the South African Nursing Council (SANC) and any
additional regulations or policies established by healthcare institutions.
Dispensing medications may be permitted under specific circumstances, such as
in emergency situations, for the provision of certain types of medications, or in
settings where access to a pharmacist is limited.
•Dosage Calculations:Before dispensing medications, RNs and midwives must
accurately calculate dosages based on patient-specific factors, such as age,
weight, renal function, and other clinical parameters. They should follow
established medication dosage guidelines, protocols, or prescriber orders to
ensure safe and effective medication administration. Any dosage calculations
should be double-checked for accuracy to minimize the risk of medication errors.
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Dispensing guidelines
•In South Africa, Registered Nurses (RNs) and midwives may be involved in dispensing medications in certain healthcare settings,
particularly in primary healthcare clinics, community health centers, and other outpatient facilities. While dispensing medications
is typically within the purview of pharmacists, RNs, and midwives may be authorized to dispense medications under specific
circumstances and within their scope of practice
•Authorization and Scope of Practice:RNs and midwives must operate within the
scope of practice defined by the South African Nursing Council (SANC) and any
additional regulations or policies established by healthcare institutions.
Dispensing medications may be permitted under specific circumstances, such as
in emergency situations, for the provision of certain types of medications, or in
settings where access to a pharmacist is limited.
•Dosage Calculations:Before dispensing medications, RNs and midwives must
accurately calculate dosages based on patient-specific factors, such as age,
weight, renal function, and other clinical parameters. They should follow
established medication dosage guidelines, protocols, or prescriber orders to
ensure safe and effective medication administration. Any dosage calculations
should be double-checked for accuracy to minimize the risk of medication errors.
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Pharmaceutical Dispensing:
Dispensing guidelines
•Labeling Requirements:When dispensing medications, RNs and midwives
must ensure that each medication container is properly labeled with
essential information, including the patient's name, medication name,
strength, dosage instructions, route of administration, frequency, and any
relevant cautionary or storage instructions. Proper labeling helps prevent
medication errors, promotes medication adherence, and enables patients
to use medications safely and effectively.
•Patient Education:RNs and midwives play a crucial role in providing
patient education and counseling regarding medication use, including
proper administration techniques, potential side effects, adverse reactions
to watch for, and precautions or contraindications. Patient education
should be tailored to the individual patient's needs, literacy level, cultural
background, and language preferences to ensure comprehension and
adherence to prescribed medication regimens.
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Dispensing guidelines
•Labeling Requirements:When dispensing medications, RNs and midwives
must ensure that each medication container is properly labeled with
essential information, including the patient's name, medication name,
strength, dosage instructions, route of administration, frequency, and any
relevant cautionary or storage instructions. Proper labeling helps prevent
medication errors, promotes medication adherence, and enables patients
to use medications safely and effectively.
•Patient Education:RNs and midwives play a crucial role in providing
patient education and counseling regarding medication use, including
proper administration techniques, potential side effects, adverse reactions
to watch for, and precautions or contraindications. Patient education
should be tailored to the individual patient's needs, literacy level, cultural
background, and language preferences to ensure comprehension and
adherence to prescribed medication regimens.
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Pharmaceutical Dispensing:
Dispensing guidelines
•Monitoring for Adverse Reactions:After dispensing medications, RNs and
midwives should monitor patients for any adverse reactions, side effects, or
medication-related problems. They should educate patients on the importance of
reporting any unusual symptoms or adverse events and provide guidance on
when to seek medical attention. RNs and midwives should document any
observed or reported adverse reactions and communicate findings to the
appropriate healthcare provider for further evaluation and management.
•Documentation and Record-Keeping:Accurate documentation of medication
dispensing activities is essential for maintaining accountability, tracking
medication usage, and ensuring continuity of care. RNs and midwives should
document details such as the medication dispensed, dosage administered,
patient education provided, any adverse reactions or patient concerns, and
follow-up recommendations. Proper documentation facilitates communication
among healthcare providers, supports continuity of care, and contributes to
quality assurance and patient safety efforts.
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Dispensing guidelines
•Monitoring for Adverse Reactions:After dispensing medications, RNs and
midwives should monitor patients for any adverse reactions, side effects, or
medication-related problems. They should educate patients on the importance of
reporting any unusual symptoms or adverse events and provide guidance on
when to seek medical attention. RNs and midwives should document any
observed or reported adverse reactions and communicate findings to the
appropriate healthcare provider for further evaluation and management.
•Documentation and Record-Keeping:Accurate documentation of medication
dispensing activities is essential for maintaining accountability, tracking
medication usage, and ensuring continuity of care. RNs and midwives should
document details such as the medication dispensed, dosage administered,
patient education provided, any adverse reactions or patient concerns, and
follow-up recommendations. Proper documentation facilitates communication
among healthcare providers, supports continuity of care, and contributes to
quality assurance and patient safety efforts.
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Pharmaceutical Dispensing:
Dispensing guidelines
•Collaboration with Pharmacists and Prescribers:While RNs and
midwives may dispense medications in certain circumstances,
collaboration with pharmacists and prescribers remains essential to
ensure comprehensive medication management and adherence to
legal and professional standards. RNs and midwives should consult
with pharmacists and prescribers as needed for medication-related
inquiries, clarification of orders, or assistance with complex
medication regimens.
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Dispensing guidelines
•Collaboration with Pharmacists and Prescribers:While RNs and
midwives may dispense medications in certain circumstances,
collaboration with pharmacists and prescribers remains essential to
ensure comprehensive medication management and adherence to
legal and professional standards. RNs and midwives should consult
with pharmacists and prescribers as needed for medication-related
inquiries, clarification of orders, or assistance with complex
medication regimens.
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Patient counseling:
•Promotes Patient Understanding:Counseling helps patients
understand how to take their medications correctly, including dosage
instructions, frequency, and route of administration. By explaining
medication use in simple and clear language, healthcare professionals
empower patients to adhere to their prescribed treatment regimens
and achieve optimal health outcomes.
•Enhances Medication Adherence:Patients who receive thorough
counseling are more likely to adhere to their medication schedules
and follow prescribed treatment plans. Understanding the
importance of medication adherence and potential consequences of
non-adherence, such as treatment failure or exacerbation of
symptoms, motivates patients to take their medications as directed.
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•Promotes Patient Understanding:Counseling helps patients
understand how to take their medications correctly, including dosage
instructions, frequency, and route of administration. By explaining
medication use in simple and clear language, healthcare professionals
empower patients to adhere to their prescribed treatment regimens
and achieve optimal health outcomes.
•Enhances Medication Adherence:Patients who receive thorough
counseling are more likely to adhere to their medication schedules
and follow prescribed treatment plans. Understanding the
importance of medication adherence and potential consequences of
non-adherence, such as treatment failure or exacerbation of
symptoms, motivates patients to take their medications as directed.
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Patient counseling:
•Prevents Medication Errors:Thorough counseling reduces the risk of
medication errors by ensuring that patients understand how to use
their medications safely and appropriately. Patients are less likely to
make mistakes, such as taking incorrect dosages or skipping doses,
when they receive clear instructions and guidance from healthcare
professionals.
•Empowers Patients to Manage Side Effects:Counseling prepares
patients for potential side effects or adverse reactions associated with
their medications, enabling them to recognize and manage these
symptoms effectively. Patients who are informed about common side
effects are less likely to discontinue their medications prematurely or
experience unnecessary anxiety or distress.
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•Prevents Medication Errors:Thorough counseling reduces the risk of
medication errors by ensuring that patients understand how to use
their medications safely and appropriately. Patients are less likely to
make mistakes, such as taking incorrect dosages or skipping doses,
when they receive clear instructions and guidance from healthcare
professionals.
•Empowers Patients to Manage Side Effects:Counseling prepares
patients for potential side effects or adverse reactions associated with
their medications, enabling them to recognize and manage these
symptoms effectively. Patients who are informed about common side
effects are less likely to discontinue their medications prematurely or
experience unnecessary anxiety or distress.
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Patient counseling:
•Improves Patient Safety:By discussing precautions and warnings related to medication
use, healthcare professionals help patients avoid potential risks and complications.
Patients learn how to recognize warning signs of adverse reactions, drug interactions, or
contraindications, and when to seek medical attention if necessary, thereby enhancing
their safety and well-being.
•Fosters Patient Engagement and Shared Decision-Making:Counseling promotes patient
engagement in their healthcare by involving them in shared decision-making processes.
When patients understand the rationale behind their treatment plans and potential
benefits and risks of medication therapy, they become active participants in their care
and are more likely to collaborate with healthcare providers in making informed
decisions about their health.
•Builds Trust and Patient Satisfaction:Thorough counseling demonstrates a commitment
to patient-centered care and fosters trust between patients and healthcare providers.
Patients appreciate the time and effort invested in addressing their concerns, answering
their questions, and ensuring they feel informed and supported in managing their
medications, leading to greater satisfaction with their healthcare experiences.
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•Improves Patient Safety:By discussing precautions and warnings related to medication
use, healthcare professionals help patients avoid potential risks and complications.
Patients learn how to recognize warning signs of adverse reactions, drug interactions, or
contraindications, and when to seek medical attention if necessary, thereby enhancing
their safety and well-being.
•Fosters Patient Engagement and Shared Decision-Making:Counseling promotes patient
engagement in their healthcare by involving them in shared decision-making processes.
When patients understand the rationale behind their treatment plans and potential
benefits and risks of medication therapy, they become active participants in their care
and are more likely to collaborate with healthcare providers in making informed
decisions about their health.
•Builds Trust and Patient Satisfaction:Thorough counseling demonstrates a commitment
to patient-centered care and fosters trust between patients and healthcare providers.
Patients appreciate the time and effort invested in addressing their concerns, answering
their questions, and ensuring they feel informed and supported in managing their
medications, leading to greater satisfaction with their healthcare experiences.
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Patient counselling example
Sarah, a Registered Nurse (RN) working at a local community clinic, is responsible for providing patient counseling on medication management. Today, she
encounters Mr. Jones, a 65-year-old man who has been prescribed a new medication for high blood pressure.
Mr. Jones arrives at the clinic feeling overwhelmed and uncertain about his new medication. He expresses concerns about potential side effects and
worries about how the medication will affect his daily routine. Sarah recognizes the importance of patient counseling in ensuring Mr. Jones's
understanding and adherence to his medication regimen.
Sarah begins by introducing herself to Mr. Jones and creating a comfortable environment for open communication. She listens attentively to his concerns
and addresses each one with empathy and expertise.
First, Sarah explains the purpose of the medication prescribed for high blood pressure and its importance in managing his condition effectively. She uses
layman's terms to describe how the medication works to lower blood pressure and reduce the risk of complications such as heart disease and stroke.
Next, Sarah discusses the potential side effects of the medication with Mr. Jones, emphasizing that while side effects are possible, not everyone
experiences them. She provides information on common side effects such as dizziness, fatigue, and upset stomach, and advises Mr.Jones to report any
unusual symptoms to his healthcare provider.
To help alleviate Mr. Jones's concerns about integrating the medication into his daily routine, Sarah offers practical tips and suggestions. She explains the
importance of taking the medication at the same time each day and recommends using pill organizers or setting reminders to ensure consistency. Sarah
also encourages Mr. Jones to ask questions or seek clarification if he encounters any challenges while taking the medication.
Furthermore, Sarah discusses the importance of adherence to the prescribed medication regimen and its impact on Mr. Jones's overall health outcomes.
She stresses the significance of following the healthcare provider's instructions precisely and avoiding interruptions in medication therapy without
consulting a healthcare professional.
Before concluding the counseling session, Sarah invites Mr. Jones to express any additional questions or concerns he may haveabout his medication. She
reassures him that the clinic's healthcare team is available to support him throughout his treatment journey.
By providing comprehensive patient counseling, Sarah empowers Mr. Jones to make informed decisions about his medication and encourages him to take
an active role in managing his health. Through her compassionate approach and expertise, Sarah builds trust and confidence with Mr. Jones, ultimately
enhancing his medication adherence and overall well-being.
4/5/2024 Compiled by C Settley 40
Sarah, a Registered Nurse (RN) working at a local community clinic, is responsible for providing patient counseling on medication management. Today, she
encounters Mr. Jones, a 65-year-old man who has been prescribed a new medication for high blood pressure.
Mr. Jones arrives at the clinic feeling overwhelmed and uncertain about his new medication. He expresses concerns about potential side effects and
worries about how the medication will affect his daily routine. Sarah recognizes the importance of patient counseling in ensuring Mr. Jones's
understanding and adherence to his medication regimen.
Sarah begins by introducing herself to Mr. Jones and creating a comfortable environment for open communication. She listens attentively to his concerns
and addresses each one with empathy and expertise.
First, Sarah explains the purpose of the medication prescribed for high blood pressure and its importance in managing his condition effectively. She uses
layman's terms to describe how the medication works to lower blood pressure and reduce the risk of complications such as heart disease and stroke.
Next, Sarah discusses the potential side effects of the medication with Mr. Jones, emphasizing that while side effects are possible, not everyone
experiences them. She provides information on common side effects such as dizziness, fatigue, and upset stomach, and advises Mr.Jones to report any
unusual symptoms to his healthcare provider.
To help alleviate Mr. Jones's concerns about integrating the medication into his daily routine, Sarah offers practical tips and suggestions. She explains the
importance of taking the medication at the same time each day and recommends using pill organizers or setting reminders to ensure consistency. Sarah
also encourages Mr. Jones to ask questions or seek clarification if he encounters any challenges while taking the medication.
Furthermore, Sarah discusses the importance of adherence to the prescribed medication regimen and its impact on Mr. Jones's overall health outcomes.
She stresses the significance of following the healthcare provider's instructions precisely and avoiding interruptions in medication therapy without
consulting a healthcare professional.
Before concluding the counseling session, Sarah invites Mr. Jones to express any additional questions or concerns he may haveabout his medication. She
reassures him that the clinic's healthcare team is available to support him throughout his treatment journey.
By providing comprehensive patient counseling, Sarah empowers Mr. Jones to make informed decisions about his medication and encourages him to take
an active role in managing his health. Through her compassionate approach and expertise, Sarah builds trust and confidence with Mr. Jones, ultimately
enhancing his medication adherence and overall well-being.
4/5/2024 Compiled by C Settley 40
Compare the medicine control practice in a health
facility with adherence to Nursing and Midwifery
regulatory requirements.
Medicine Control Practices in a Health Facility:
•a. Procurement and Stock Management: Health facilities implement procedures for procuring
medications from approved suppliers, ensuring the authenticity and quality of pharmaceutical
products. Stock management involves maintaining adequate inventory levels, monitoring
expiration dates, and implementing proper storage conditions.
•b. Prescription and Dispensing: Physicians or other authorized prescribers issue medication
orders based on patient assessment and diagnosis. Pharmacists or pharmacy technicians dispense
medications according to these orders, ensuring accurate dosing, labeling, and patient education.
•c. Storage and Security: Medications are stored under controlled conditions to maintain their
stability and efficacy. Security measures such as restricted access, surveillance, and inventory
tracking are implemented to prevent theft or unauthorized access to pharmaceuticals.
•d. Documentation and Reporting: Health facilities maintain comprehensive records of medication
procurement, dispensing, administration, and disposal. Adverse events, medication errors, or
discrepancies in inventory are documented and reported as per regulatory requirements.
4/5/2024 Compiled by C Settley 41
facility with adherence to Nursing and Midwifery
regulatory requirements.
Medicine Control Practices in a Health Facility:
•a. Procurement and Stock Management: Health facilities implement procedures for procuring
medications from approved suppliers, ensuring the authenticity and quality of pharmaceutical
products. Stock management involves maintaining adequate inventory levels, monitoring
expiration dates, and implementing proper storage conditions.
•b. Prescription and Dispensing: Physicians or other authorized prescribers issue medication
orders based on patient assessment and diagnosis. Pharmacists or pharmacy technicians dispense
medications according to these orders, ensuring accurate dosing, labeling, and patient education.
•c. Storage and Security: Medications are stored under controlled conditions to maintain their
stability and efficacy. Security measures such as restricted access, surveillance, and inventory
tracking are implemented to prevent theft or unauthorized access to pharmaceuticals.
•d. Documentation and Reporting: Health facilities maintain comprehensive records of medication
procurement, dispensing, administration, and disposal. Adverse events, medication errors, or
discrepancies in inventory are documented and reported as per regulatory requirements.
4/5/2024 Compiled by C Settley 41
Compare the medicine control practice in a health
facility with adherence to Nursing and Midwifery
regulatory requirements.
Adherence to Nursing and Midwifery Regulatory Requirements:
•a. Scope of Practice: Nurses and midwives adhere to legal and professional standards regarding
their roles in medication management. This includes understanding their scope of practice related
to prescribing, administering, and monitoring medications within the parameters established by
regulatory bodies.
•b. Competency and Training: Nurses and midwives receive education and training on medication
administration, dosage calculation, and medication safety protocols. They are expected to
maintain competency in these areas and seek additional training as needed to stay updated with
best practices.
•c. Documentation and Communication: Nurses and midwives document medication
administration accurately, including dosage, route, time, and patient response. They
communicate effectively with other members of the healthcare team regarding medication
orders, changes in patient condition, and medication-related concerns.
•d. Patient Safety and Advocacy: Nurses and midwives prioritize patient safety by verifying
medication orders, checking for allergies or contraindications, and advocating for appropriate
medication therapy. They monitor patients for adverse reactions, provide education on
medication use, and address any concerns or questions raised by patients or caregivers.
4/5/2024 Compiled by C Settley 42
facility with adherence to Nursing and Midwifery
regulatory requirements.
Adherence to Nursing and Midwifery Regulatory Requirements:
•a. Scope of Practice: Nurses and midwives adhere to legal and professional standards regarding
their roles in medication management. This includes understanding their scope of practice related
to prescribing, administering, and monitoring medications within the parameters established by
regulatory bodies.
•b. Competency and Training: Nurses and midwives receive education and training on medication
administration, dosage calculation, and medication safety protocols. They are expected to
maintain competency in these areas and seek additional training as needed to stay updated with
best practices.
•c. Documentation and Communication: Nurses and midwives document medication
administration accurately, including dosage, route, time, and patient response. They
communicate effectively with other members of the healthcare team regarding medication
orders, changes in patient condition, and medication-related concerns.
•d. Patient Safety and Advocacy: Nurses and midwives prioritize patient safety by verifying
medication orders, checking for allergies or contraindications, and advocating for appropriate
medication therapy. They monitor patients for adverse reactions, provide education on
medication use, and address any concerns or questions raised by patients or caregivers.
4/5/2024 Compiled by C Settley 42
Compare the medicine control practice in a health
facility with adherence to Nursing and Midwifery
regulatory requirements.
•Comparison:
•a. Collaboration and Communication: Both medicine control practices and
nursing/midwifery regulatory requirements emphasize the importance of collaboration
and communication among healthcare professionals. Effective teamwork ensures
accurate medication management, reduces the risk of errors, and promotes patient
safety.
•b. Adherence to Standards: Health facilities and nursing/midwifery regulatory bodies
both emphasize adherence to standards and guidelines to ensure the safe and effective
use of medications. Compliance with regulatory requirements, protocols, and best
practices is essential in both contexts to maintain quality care and protect patient
welfare.
•c. Patient-Centered Care: Both approaches prioritize patient-centered care, focusing on
individualized assessment, education, and support to promote optimal health outcomes.
Nurses and midwives play a crucial role in advocating for patients' medication needs,
addressing concerns, and empowering patients to actively participate in their care.
4/5/2024 Compiled by C Settley 43
facility with adherence to Nursing and Midwifery
regulatory requirements.
•Comparison:
•a. Collaboration and Communication: Both medicine control practices and
nursing/midwifery regulatory requirements emphasize the importance of collaboration
and communication among healthcare professionals. Effective teamwork ensures
accurate medication management, reduces the risk of errors, and promotes patient
safety.
•b. Adherence to Standards: Health facilities and nursing/midwifery regulatory bodies
both emphasize adherence to standards and guidelines to ensure the safe and effective
use of medications. Compliance with regulatory requirements, protocols, and best
practices is essential in both contexts to maintain quality care and protect patient
welfare.
•c. Patient-Centered Care: Both approaches prioritize patient-centered care, focusing on
individualized assessment, education, and support to promote optimal health outcomes.
Nurses and midwives play a crucial role in advocating for patients' medication needs,
addressing concerns, and empowering patients to actively participate in their care.
4/5/2024 Compiled by C Settley 43
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