Today’s question comes from a Registered Nurse who works:
… for a non for profit organisation which provides a care service for people with disabilities. The service is staffed primarily by volunteers … Occasionally the organisation will organise group trips or weekend getaways/camps to provide some rest for their full-time carers/parents.
Until now, I or another RN have attended these camps as some of the participants require regular medication to be administered. The organisation is now looking at getting some of their employees to complete the course titled “HLTHPS006 Assist clients with medication”. In doing so they were considering having those who complete the course replace the role of the RN thereby getting them to be in charge of medication administration instead.
We have been trying to workout whether or not this is legal within NSW and if there are any additional requirements other than this course to ensure the staff are properly accredited to assist clients in administering their medications. The employees would not be healthcare professionals, and will mostly only hold a maximum of a HLTAID003 Provide First Aid certification.
Hence what are the minimal requirements in to assist participants in our program with administering their prescribed medication?
Drugs in health care are (generally) either schedule 2, 3, 4 or 8 drugs. The relevant schedules are set out in the Poisons Standard. They are:
|Schedule 2||Pharmacy Medicine – Substances, the safe use of which may require advice from a pharmacist and which should be available from a pharmacy or, where a pharmacy service is not available, from a licensed person.|
|Schedule 3||Pharmacist Only Medicine – Substances, the safe use of which requires professional advice but which should be available to the public from a pharmacist without a prescription.|
|Schedule 4||Prescription Only Medicine, or Prescription Animal Remedy – Substances, the use or supply of which should be by or on the order of persons permitted by State or Territory legislation to prescribe and should be available from a pharmacist on prescription.|
|Schedule 8||Controlled Drug – Substances which should be available for use but require restriction of manufacture, supply, distribution, possession and use to reduce abuse, misuse and physical or psychological dependence.|
Schedule 2 and 3 drugs can be purchased from a pharmacist. Schedule 4 and 8 drugs require a prescription from an authorised prescriber eg a medical practitioner, a nurse practitioner, a dentist.
Where drugs have been prescribed for a person, then anyone can assist that person to take their drugs. If you are a parent, you will know that you go to the chemist, get the drugs, possess the drugs, supply them to your children or administer the drugs to them. Why is this not an offence? Because the law says that it is not.
With respect to schedule 4 drugs, section 10(3) of the Act makes it an offence to supply a person with a schedule 4 drug but that prohibition does not apply (s 10(4)(c1)) to ‘a person who has the care of, or is assisting in the care of, another person (for or to whom the supply of the substance has been authorised by the prescription of a medical practitioner, nurse practitioner, midwife practitioner or dentist) and who administers the restricted substance to the other person in accordance with that prescription’. A similar exemption applies for ‘prescribed restricted substances’ (s 16(1)(d1)) and for schedule 8 drugs (s 22).
With respect to schedule 2 and 3 drugs if a person has purchased the drugs for themselves, or for another person then they can administer them. What they cannot do (as I’ve tried to explain in other posts) is, without an appropriate authority, buy and carry these drugs ‘just in case’ ie so the person can decide whether someone needs those drugs and chose to give them. If the ‘not for profit’ organisation is going to have a first aid kit with schedule 2 or 3 drugs in it then the person in charge of the kit has to have the relevant authority (and what that authority is will depend on the drug). But if the person has bought their own drugs then they have had the opportunity to get advice from the pharmacist about their condition and the use of the drugs. They are then ‘their’ drugs, and they can ask someone else to assist them to take it. Equally if someone goes to a pharmacist in order to buy drugs for a person, they care for then they too can get pharmacists advice about the person they’re caring for (noting they don’t have to get that advice, it just has to be available).
In short if those participants that ‘require regular medication to be administered’ and the medication has been prescribed for them or bought by or for them then anyone can assist the administration of that medication. They don’t need any formal qualifications.
But one can understand why the not-for-profit concerned wants them to have some training. There are risks in administering medication and no doubt they want to reduce the risk to everyone. Under WHS legislation they have an obligation to ensure workers are trained and presumably their risk assessment has identified that this training is sufficient.
I don’t know what’s in the course HLTHPS006 Assist clients with medication but legally it’s more than required, at least under the Poisons legislation.