Care of the controlled
substances
1
Learning Outcome
Define controlled substance and the
Dangerous Drug Act
Explain the responsibility of the nurse in
handling and administration of DD
2
Poison
Substance which on ingestion,
inhalation, absorption, application,
injection or development within the
body, relatively small amount, may
cause structural damage or functional
disturbance
Becomes poisonous to the body if not
given according to the prescription
3
Drug
Any substance that when taken into living
organism may modify one or more of its
function
All dangerous drugs are categorized as
poison but not all poisons are dangerous
drug
4
Controlled substances
Includes opium and its active
components and derivatives, such as
heroin and morphine; coca leaf and its
derivatives, principally cocaine;
hallucinogenic drugs, lysergic acid
diethylamide (LSD) and other
substances producing similar effects;
whether natural or synthetic, with the
physiological effects of a narcotic drug.
5
Controlled substances
These drugs must be safeguarded from an
unauthorized person.
Delivered to nursing units in stock supply
Nurses are responsible for an accurate
accounting of their use
6
Two ordinance that control
Poisons and Dangerous
Drugs
1. Poison Ordinance 1952
2. Dangerous Drug Act 1952
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Poison Ordinance
Law that controls all types of drugs
for internal and external use
8
Dangerous Drug Act 1952
An Act to make further and better provision
for the regulating of importation,
exportation, manufacture, sale, and use of
opium and of certain other dangerous
drugs and substances to make special
provision relating to the jurisdiction of
courts in respect of offences thereunder
and their trial, and the purposes connected
therewith.
9
Dangerous Drug Act (DDA)
Ordinance that controls any abuse and
selling of drugs, which may caused
addiction
Control the distribution and use of all
depressant and stimulant drugs of abuse
or potential abuse
10
MOH has the authority to control
poisonous drugs or dangerous drugs
from the following aspects:
1. Manufacture
2. Supply
3. Distribution
4. Dispensing
5. Storage
6. Sale
11
Medications listed under
controlled substances
Opium Methadone
Morphine Cocaine
Heroin Cannabis
Pethidine
12
Handling controlled substances
1. To provide a controlled method for
acquisition and dispensing of
controlled substances
13
Handling controlled substances
2. To maintain appropriate proof of use
documentation in a retrievable manner.
14
Handling controlled substances
3. To maintain a high level of security in the
storage of controlled substances
15
Recap
16
Nursing
responsibilities in
handling controlled
substances
17
Storage of controlled
substances
Dispensed to the ward using the stock
supply or floor stock.
Controlled substances must be stored
under a double lock system.
18
Storage of controlled
substances
The nurse in-charge of medication during
the shift is responsible to keep the key and
to hand over the key to the next nurse on
duty at the end of her shift
The nurse on duty must ensure that the
DD cupboard is locked at all times
19
Documentation of controlled
substances
The nurse must check narcotic supplies
at the change of shifts
The nurse completing the shift does
the narcotic count with the nurse
beginning the next shift
Both nurses sign the DD book to
indicate that the count is correct.
20
Documentation of controlled
substances
A special inventory record is used each
time a narcotic is dispensed and provides
an accurate ongoing count of drugs used
and remaining.
21
Documentation of controlled
substances
All usage of controlled substances will be
documented appropriately on the
controlled substances documentation
sheet or Dangerous Drug Act book (DDA
Book)
22
Documentation of controlled
substances
DDA book consists of these following
information:
1. Date
2. Name of client and RN number
3. Name of Dr ordering the controlled
substances
23
Documentation of controlled
substances
4. Signature of the nurse administering
medication
5. Name of drug dosage form
6. Amount given
7. Balance on hand
24
Inaccurate count?
Report immediately
Remain on duty and search for missing
narcotics.
Sign list as incorrect
Fill out incident report and sign with one
witness
25
Documentation of controlled
substances
These special precautions are used to
help control drug abuse
Drug abuse: inappropriate intake of a
substance either periodically or
continually.
26
Documentation of controlled
substances
If only one part of pre-measured dose of
drug is given, a second nurse witnesses
disposal of the unused portion and
documents such on the DDA book
27
Documentation of controlled
substances
In the event of wastage or breakage of
controlled substances, it must be
documented in the DDA book.
28
Documentation of controlled
substances
The nurse must state:
1. The date of event
2. Reason for waste eg accidentally broken,
expired or return to pharmacy
3. Amount wasted
4. Signature of the nurse wasting controlled
substances
5. Signature of witness
29
Example of a page from the DD
Book
Name of Substance and Dosage: ………………………………….
Date Client’ MRN Name Dose Balan Given Witne Remar
and s of Order ce by ss ks
time Name Doctor ed
30
Questions?
1. Define controlled substance and
dangerous drugs act
2. Explain the responsibility of the
nurse in handling and
administration of DD
31
End of Session
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