GROUP PROTOCOL FOR THE MANAGEMENT OF SYMPTOMS OF COUGHS. Version 5 December 2017

Transcription

1 GROUP PROTOCOL FOR THE MANAGEMENT OF SYMPTOMS OF COUGHS Version 5 December 2017 RATIFYING COMMITTEE Drugs and Therapeutics Group DATE RATIFIED MAUP EXPIRES December 2020 EXECUTIVE SPONSOR Chief Nurse MAUP ORIGINAL AUTHOR Louise Noble - Pharmacist REVIEWED BY Clare Butler Pharmacy technician KEY POLICY ISSUES: Key indication for the use of Simple Linctus Staff eligible to work under the protocol If you require this document in an alternative format, ie easy read, large text, audio, Braille or a community language please contact the Pharmacy Team on

2 GROUP PROTOCOL FOR THE MANAGEMENT OF SYMPTOMS OF COUGHS Version: 5 December 2017 Group Protocol drawn up by: Name Title Louise Noble Pharmacist Group Protocol authorised by: (on behalf of the Trust). Chief Medical Officer Chief Nurse Chief Pharmacist Rick Fraser Diane Hull Ray Lyon Appointed Practitioner in Charge (on behalf of the ward) Date Protocol agreed December 2017 Proposed review date December 2020 Date Protocol expires December 2020 Ward Protocol relates to

3 GROUP PROTOCOL FOR THE MANAGEMENT OF SYMPTOMS OF COUGHS 1. CLINICAL CONDITION 1.1 Clinical condition Symptoms of coughs. 1.2 Inclusion Criteria Patients with the above symptoms. 1.3 Exclusion Criteria Patients under 12 years of age. Known sensitivity to simple linctus. If the cough has been present for two weeks or longer. 1.4 Action to be taken if patient is excluded from treatment under protocol Consult with ward Medical Officer 9.00 am 5.00 pm Monday to Friday. Contact duty Medical Officer out of hours if persistent or acute discomfort warrants. 1.5 Action to be taken if patient refuses treatment under protocol Discuss with Medical Officer if problem continues and nursing staff have significant concerns. 2. STAFF AND LOCATION 2.1 Location 2.2 Staff Inpatient units Trustwide. Qualified nursing staff that have been signed off as competent by the Appointed Practitioner in Charge of the ward following training and successful completion of the 'Key Aspects of Pharmacy' questionnaire for simple linctus. 2.3 Continued Training Requirements. Not required unless changes to protocol

4 3 TREATMENT 3.1 Name of medicine Simple linctus. 3.2 Legal status (POM, P or GSL) GSL (General sales list) 3.3 Dose or dose range and criteria for determining dose 5 ml of simple linctus. 3.4 Method of route of administration Oral. 3.5 Frequency of administration Up to four times a day. Maximum period of continuous treatment must not exceed 72 hours without a medical review of the underlying symptoms. 3.6 Follow up treatment Documented review by ward Medical Officer if needed. 3.7 Side effects and possible drug interactions Side effects are rare when taken at normal doses. Glycerol may cause headache, stomach upset and diarrhoea in high doses. 3.8 Instruction on identifying and managing possible adverse outcomes Normal ward observations. If there is a decline in the patient s physical condition or the nurse suspects an adverse reaction, contact the ward Medical Officer or duty Medical Officer. Document concerns in patient s notes. 3.9 Arrangement for referral to medical advice Contact ward Medical Officer in normal working hours. Contact duty Medical Officer outside working hours.

5 4. INFORMATION AND DOCUMENTATION 4.1 Advice (including written advice) to be given to client or carer before or after treatment. A verbal instruction of the drug being administered. Advise the patient or carer to inform nursing staff if symptoms persist. Offer leaflet patient information on coughs if appropriate-see appendix. 4.2 Details of treatment records required Completion of MAUP section of patient s drug chart. Record entry in Carenotes. This should record the presence of a cough, and that administration of Simple Linctus occured in line with MAUP (or equivalent statement). 5. MANAGEMENT AND MONITORING 5.1 Advisory group approving the protocol Drugs and Therapeutics Group. 5.2 Lines of accountability Clinical Service Managers. 5.3 Method to report any adverse drug reactions to the doctor Normal ward policy for communicating with the Medical Officer. 5.4 Audit Arrangements Pharmacy supervision. Clinical audit. 5.5 Review Date and by Whom Every three years by the Drugs and Therapeutics Group or earlier if significant new evidence or manufacturers advice on simple linctus use is made available.

6 6. Staff authorized to work under the Group Protocol I have read the group protocol and agree to use it: - Nurses agreeing to and authorized to work under the protocol Appointed Practitioner in Charge assessing competence Name Signature Name Signature Date

7 KEY ASPECTS OF PHARMACY QUESTIONNAIRE (To be completed without access to the Protocol or drug text books, eg BNF.) Key aspects of pharmacy for simple linctus Professional's name: Grade: 1. Symptoms/criteria under which the patient will be eligible for treatment under the Protocol 2. Forms and strengths available 3. Mode of action 4. Exclusion criteria 5. Dose 6. Route of administration 7. What potentially significant side effects and drug interactions are there? 8. What written/verbal advice must be given to the patient/carer on the identification and management of significant potential side effects? I confirm that at the time of completion the answers provided showed an acceptable level knowledge. Name: Designation: Signature: Date:

8 Patient Information on Coughs A cough is a reflex action to clear the airways of mucus, phlegm, irritants or a foreign body. A cough may also be caused by inflammation of the upper respiratory tract due to a viral infection (common cold or flu). A cough may also be a symptom of another illness or condition such as asthma, whooping cough, smoking or as a side effect of prescribed medication (such as an ACE inhibitor). Symptoms Coughs are usually classified as being dry or chesty. A dry cough occurs because the throat and upper airways become inflamed. It is a non-productive cough (phlegm is not produced). Dry coughs are usually felt in the throat as a tickle. A chesty cough is usually productive (phlegm is produced). If a cough feels chesty but is non-productive, this should be described as a chesty cough as phlegm may be present but is not loose enough to be coughed up. Causes The common cold or flu causes a dry cough because the throat and upper airways get inflamed. The body tries to remove the inflammation by coughing. Treatment Cough medicines do not work for everyone and should not be taken for more than two weeks. Simple cough mixtures (such as simple linctus) coat the throat and relieve the irritation that causes coughing. They can be used for any type of cough. Cough suppressants (such as pholcodeine and dextromethorphan) act on the brain to stop the cough reflex. They are used for dry coughs only. Expectorants (such as guaiphenesin) help bring up phlegm so coughing is easier. They are used for chesty coughs. If you require this document in an alternative format, ie easy read, large text, audio, Braille or a community language please contact the Pharmacy Team on Reviewed unchanged 2017