DDA

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Care of the controlled substances

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Learning Outcome

Define controlled substance and the Dangerous Drug Act

Explain the responsibility of the nurse in handling and administration of DD

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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

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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

5

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.

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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

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Two ordinance that control Poisons and Dangerous

Drugs1. 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

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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.

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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

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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

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Methadone Cocaine Cannabis

Medications listed under controlled substances

Opium Morphine Heroin Pethidine

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Handling controlled substances

1. To provide a controlled method for acquisition and dispensing of controlled substances

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Handling controlled substances

2. To maintain appropriate proof of use documentation in a retrievable manner.

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Handling controlled substances

3. To maintain a high level of security in the storage of controlled substances

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Recap

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Nursing responsibilities in

handling controlled substances

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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.

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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

Storage of controlled substances

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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.

Documentation of controlled substances

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A special inventory record is used each time a narcotic is dispensed and provides an accurate ongoing count of drugs used and remaining.

Documentation of controlled substances

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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)

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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

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Documentation of controlled substances

4. Signature of the nurse administering medication

5. Name of drug dosage form

6. Amount given

7. Balance on hand

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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

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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.

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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

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Documentation of controlled substances

In the event of wastage or breakage of controlled substances, it must be documented in the DDA book.

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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

Documentation of controlled substances

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Example of a page from the DD Book

Name of Substance and Dosage: ………………………………….

Date and time

Client’s Name

MRN Name of Doctor

Dose Ordered

Balance

Given by

Witness

Remarks

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Questions?

1. Define controlled substance and dangerous drugs act

2. Explain the responsibility of the nurse in handling and administration of DD

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End of Session