Supervision In Action
Guiding Midwives Through The
Medicines Maze
ZOE MENEILLY
LABOUR WARD SISTER
SUPERVISOR OF MIDWIVES
SOUTH EASTERN TRUST
2010
 New medicine kardex
introduced province wide
 Training rolled out
 Medicines workshops for
SOM’s
 Audit of kardex included
in SOM record keeping
audit
The medicines nerd is born!
Som workshops
Midwives and medicines
LSA medicines management for
midwives working party set up
Meanwhile, back at the ranch..........
THE EXTENT OF THE
PROBLEM
 out of date PGDs
 No PGD register
 No midwife able to give exact
details of existing PGDs
 No formal PGD/ exemptions
training
 Midwives not utilising
exemptions legislation
 No agreed method of
documenting admin under
exemptions
PGD working group (2011)
 Supervisor representation
 Included: PD midwife, governance MW, pharmacy






governance, medical representation
Streamline number of PGD’s / eliminate unnecessary
Update required PGD’s
Reduce duplication of medicines covered by exemptions
legislation / increase use of exemptions by midwives
Create PGD registers for all areas
Agree exemptions recording method
Look at training needs
16/01/12
16/01/12
PETHIDINE
PHENERGAN
100MG
50 MG
IM
IM
MW EXEMPTION
PGD
Medicine Kardex Audit
AREA AUDITED
YES %
NO %
PATIENT LABEL/ NAME ON ALL IN USE PAGES
28
72
ALLERGY STATUS RECORDED
96
4
NAMED CONSULTANT RECORDED
84
16
TIME RECORDED ON ALL ENTRIES
68
32
ALL ENTRIES DATED
88
12
ALL REGULAR PRESCRIPTIONS GIVEN AS PRESCRIBED
6
93
REASON FOR OMITTED DRUGS CORRECTLY RECORDED
0
100
ALL ADMINISTERED MEDICINES SIGNED FOR
60
40
USE OF PGD CORRECTLY RECORDED
72
28
USE OF MIDWIVES EXEMPTION CORRECTLY RECORDED
61
39
MEDICINE CORRECTLY IDENTIDIFIED AS PGD OR MIDWIVES
EXEMPTION
52
48
STAFF GROUP RECORDED FOR MEDICINES GIVEN UNDER PGD OR
MIDWIVES EXEMPTION
0
100
More work was needed
 More training sessions
planned
 Rolled out to midwifery led
units
 Medicines and PGD folders
created for all areas
 Laminated aide memoires
created
Medicines Training (2012)
 Agreement from HOM to role out
medicines and exemptions
training for midwives, trustwide.
 Sessions arranged in ulster
maternity, lagan valley and
Downpatrick MLU’s and
community
 Certificates of attendance given
 Drawbacks – not made mandatory
so no time given for staff to
attend. Not always staff who need
it most that attend
2012 – Small Interruption In Progress!
2013- Back on Track
 Some confusion still evident
 Formal training programme
negotiated and starting in FEB
 All year groups at QUB now
receiving consistent exemption
and PGD training
Dreams…….
 Northern Ireland midwives
formulary
 Province wide maternity
medicine kardex
 Pharmacology module at QUB
Questions?