Appendix 1 Example f Hmely Remedy Plicy Hmely Remedy Plicy - EXAMPLE This plicy applies t (insert name f Care Hme) Definitin A hmely (r husehld) remedy is a medicinal prduct fr the shrt-term treatment f minr ailments such as indigestin, mild t mderate pain and cnstipatin. These prducts can be btained withut a prescriptin and are usually purchased ver the cunter by the care hme r smetimes by the resident. Having a hmely remedy plicy in place ensures that access t treatment fr minr ailments is as it wuld be fr a patient living in their wn hme. Scpe The use f this plicy allws residents t be treated with the hmely remedies frm the list f prducts fr the relief f specific symptms (See appendix 2 fr list). Members f staff administering a hmely remedy must understand that these remedies can nly be given t a resident fr whm they are suitable. Only members f staff wh have been trained in the use f hmely remedies are allwed t administer treatment under this plicy. The list f trained staff is attached t this plicy. Apprpriate measures must be taken t ensure that the resident t be given the hmely remedy: Des nt have any cntraindicatins t that remedy. Are nt already taking the remedy as prescribed medicatin. Only thse cnditins stated in the plicy may be treated and may nly be treated using the specified prducts and dses. Administratin f a hmely remedy shuld nt cntinue mre than 48 hurs befre cnsulting the resident s GP. Inclusin If the hmely remedy is required fr regular treatment, a prescriptin shuld be prvided. This plicy is restricted t thse residents: Wh have agreed t their use. Fr thse residents wh lack capacity wh have made a Lasting Pwer f Attrney, an agreement shuld be made with the appinted Attrney(s). If n attrney has been appinted, then a best interests meeting with the next f kin and/r resident s GP is needed. 2
Agreement Explain t resident and/r family that the hme has a hmely remedy plicy (fr new residents this is part f admissin prcess). This cnversatin shuld include the need fr the staff t knw if any medicatin is purchased by r n behalf f the resident as safety, strage and recrding issues wuld then need t be discussed. Once agreement is gained by the resident and/r family, ensure a recrd f the agreement is dcumented in the resident s medicatin file. N.B. There is n requirement fr a GP give written authrisatin fr the administratin f a hmely remedy unless it is utside the scpe f this plicy. Administratin: If a resident displays symptms f indigestin, mild pain r cnstipatin infrm the senir carer n duty. Senir carer assesses the resident and checks in cnjunctin with hmely remedy treatment chart ( see appendix 2): The general cnditin f the resident n ptentially serius symptms What if anything the resident has previusly used fr these symptms The medicine is nt cntra-indicated r interact with ther prescribed medicines r with a pre-existing cnditin ( if unsure cntact insert name f pharmacist fr advice) The resident is nt allergic r intlerant t the medicine r any ingredient. The resident is nt already taking prescribed medicine cntaining the same drug(if unsure cntact insert name f pharmacist fr advice) Obtain and dcument verbal cnsent frm the resident wh is aware that the medicine is nt prescribed. Once assessment cmpleted and decisin is made t administer the senir carer will: Fllw the directins n the medicine cntainer and prduct infrmatin. Recrd administratin n the reverse f the resident s MAR chart stating: Name f medicatin given dse given time given date given 3
wh administered by reasn fr administratin Regularly mnitr the resident t assess their respnse t the medicatin and t be aware f any side effects r adverse reactins. Refer t the GP: If symptms d nt imprve r side effects/adverse reactins are nted. If resident s cnditin deterirates If symptms persist fr mre than 48 hurs. If symptms f diarrhea present Ensure that ther members f staff n duty are aware f when the last dse f a hmely remedy was given t mnitr effectiveness and avid verdsing. This is particularly imprtant at staff handver. If the resident wishes t self-medicate ensure that a risk assessment has been cmpleted and recrded. Review: The GP shuld be infrmed f the administratin f a hmely remedy at their next visit, and als infrmed f frequent usage f a remedy. The hmely remedies used in this hme are purchased frm insert name f pharmacy. Strage and recrd keeping: Upn receipt fill in the hmely remedy recrd chart (see appendix 3) this is t ensure that an audit trail f administratin is recrded. Ensure the hmely remedies are stred in the secure medicatin area in the cupbard marked hmely remedies, and are nt stred with prescribed medicatin. Ensure the hmely remedies are stred in their riginal packaging tgether with any infrmatin supplied with the prduct abut the medicine use (i.e. patient infrmatin leaflet) Once a liquid is pened ensure the date is marked n the bttle t ensure that it isn t used past its shelf life. A mnthly check must be carried ut t: Check balances; any discrepancies t be reprted t the manager as sn as pssible. Check expiry dates; date expired stck shuld be dispsed f in line with the care hme s plicy n the dispsal f medicatin. Check dates n pened liquids 4
I can cnfirm that I have undertaken and successfully cmpleted the hmely remedy training prvided by insert name f care hme. I am able t administer hmely remedies in accrdance with this plicy Name f staff member Signature Date Name f manager Signature Date 5
INDIGESTION/HEARTBURN discmfrt r burning pain in the central chest regin. When this burning rises up twards the thrat it is referred t as Heartburn. If pain mild see belw. In cases f acute r severe pain refer immediately Lifestyle Advice Eat small, regular meals Chew fd well Avid bending r stping after meals Reduce r stp smking, alchl, caffeine Avid spicy fds Avid clthing that is tight arund the waist Directins fr use: Dse: 10 20 ml after meals and at bedtime Max ttal use in 24 hurs 80mls in divided dses (4 dses f 20ml) Shake well befre use Hmely Remedy t be used: PEPTAC Cnsider Is the resident taking any medicatin that may cause indigestin? Is the resident taking any medicatin that carries a warning t avid antacids r indigestin remedies? When t refer If there is any dubt that the symptms are caused by indigestin? If there is increased shrtness f breath, excessive sweating, if the pain radiates dwn the arm r the resident is generally unwell CONTACT NHS DIRECT 111 OR 999 Cautins Shuld nt be used in patients wh are severely debilitated r suffering frm kidney failure. Antacids inhibit the absrptin f tetracyclines and vitamins and shuld nt be given at the same time leave at least TWO hurs between dses This prduct cntains a high level f sdium salt and is nt recmmended where a lw sdium diet has been recmmended fr a patient. Leave gap f 2-3hrs hurs between administratin f Peptac and ther ral drugs. Medicines that cmmnly cause Indigestin Anti- inflammatry medicines e.g. aspirin, ibuprfen, diclfenac, naprxen Oral crticsterids e.g. prednislne 12
CONSTIPATION initial changes in bwel habit shuld be reprted t the GP. Bwel charts shuld be kept in care plans fr mnitring purpses. Cnstipatin in the elderly is ften due t insufficient fluid intake Hmely Remedy t be used: BISACODYLTABLETS 5MG large glasses f fluid shuld be avided; little and ften is mre effective Lifestyle Advice Cnstipatin can be due t insufficient fluids water little and ften mre effective than large glasses f water Increase dietary fibre, try prune juice Increase mbility if pssible Directins fr use: Dse: 1-2 tablets befre bedtime Maximum dse in 24hurs: 2 tablets Cnsider Is resident taking any medicatin which culd cause cnstipatin? Is cnstipatin recurrent? When t refer Any initial changes in bwel habit Cautins Antacids shuld nt be given ne hur after taking the tablets. Medicines that cmmnly Indigestin remedies cntaining Aluminium cause cnstipatin Antidiarrheals e.g. lperamide Antihistamines e.g. chlrphenamine, prmethazine Antipsychtics e.g risperidne, prmazine Cugh suppressants e.g. cdeine and phlcdine Diuretics e.g. bendrflumethiazide, fursemide Irn and Calcium Supplements Pain killers cntaining piates e.g. cdeine, dihydrcdeine, mrphine, tramadl Sme antidepressants e.g. amitriptyline, dsulepin, imipramine Sme drugs used t treat Parkinsn s e.g.levdpa 7
MILD PAIN, E.G. HEADACHE, GENERAL MUSCLE ACHES AND PAINS, TOOTHACHE FEVER (ABOVE 37.5C) Hmely Remedy t be used: Paracetaml 500mg tablets/250mg/5ml liquid Lifestyle Advice Cmmunicatin f pain is nt just verbal 8 lk fr facial signs, sighing, graning, calling ut, aggressin and withdrawal which is ut f character. Directins fr use: Dse: 1-2 tablets up t FOUR times a day ( MAX 2 tablets every 4-6 hurs and 8 tablets in 24 hurs) Liquid 250mg/5ml DOSE: 10ml 20ml up t FOUR times a day (MAX 20ml every 4-6 hurs and 80ml in 24 hurs) Cnsider Has the resident been given any medicatin cntaining paracetaml in last 24 hurs? Cnsider giving ONE tablet r 10ml liquid if weight <39 Kg If using liquid in diabetic resident ensure it is SUGAR FREE When t refer Resident has liver impairment, suspected liver impairment Headache is as a result f an injury/trauma Resident has a previus histry f self-pisning with paracetaml Resident has a histry f alchl abuse Resident has a rash, vmiting, is intlerant t light r has a temperature that des nt respnd t first dse f paracetaml Cautins Anticagulants warfarin dsage may need adjustment if paracetaml is taken regularly at maximum dses Carbamazepine may accelerate the rate at which paracetaml is metablised by the bdy Clestyramine reduces the absrptin f paracetaml Metclpramide / Dmperidne increase the rate at which paracetaml is absrbed by the bdy. Many medicines cntain paracetaml if in dubt check with the pharmacist Medicines that cntain Paracetaml paracetaml C-cdaml C-dydraml Over the cunter cugh and cld remedies
Appendix 3 - Hmely Remedies Recrd f Receipt and Administratin fr Insert name f Care Hme T recrd when hmely remedies are btained and administered. Insert name f hmely remedy including Strength Frm (i.e. paracetaml tablets 500mg) Date Time Pharmacy Obtained Frm Batch N/Expiry Date Amunt Received Amunt Administered Balance In Stck Resident Receiving Medicatin Name Of Carer Signature Of Carer 9