Article: Giving oral medicines and supplements to children

The aim of this article is to review the challenges associated with prescribing oral medications to children, especially those who cannot swallow pills, and to provide practical guidance on solutions.    They conclude by discussing an evidence based method for teaching children the important life skill of how to swallow whole pills.

Dersch-Mills, D. & Kaplan, B.  2020. Giving oral medicines and supplements to children.  BMJ.  Published online 5th October, BMJ 2020;371:m3550

Contact the library for a copy or download here

Article: Anticipatory prescribing in community end of life care in the UK and Ireland during the COVID-19 pandemic: an online survey

This is an update to a survey carried out amongst adult hospices, following changes to prescribing guidelines and practice reported during the COVID-10 pandemic.  An online survey was distributed to members of the Association for Palliative Medicine of Great Britain and Ireland.  261 replied were received in April 2020 from clinicians in community, hospice and hospital settings.  A number of changes were noted including route of administration; drugs prescribed; total quantities prescribed; and doses and ranges.  Recommendations for regulatory changes to permit drug repurposing and easier community access were made.

Antunes, B. et al. 2020.  Anticipatory prescribing in community end of life care in the UK and Ireland during the COVID-19 pandemic: an online survey.  BMJ Supportive & Palliative Care, 10 (3) p 343-349.

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Web site: Safety in numbers

Part of the RCN web site, the aim is to provide the practical maths knowledge that staff need in their  day to day work and medicines administration.  Provides lots of information, tips and examples of working out medicines calculations.  Good revision or someone wanting to gain more confidence in this area.
https://www.rcn.org.uk/clinical-topics/safety-in-numbers

Guidance on the use of cannabis-based products for medicinal use in children and young people with epilepsy

This interim guidance has been produced by the British Paediatric Neurology Association (BPNA) prior to the formal guidance by NICE anticipated to be published in October 2019.  It highlights the key questions specialist clinicians should address before considering prescribing cannabis based products along with guidance on appropriate dosage and treatment regimes.

Download guidance here

Guidance: Professional guidance on the administration of medicines in healthcare settings

This guidance provides principles-based guidance to ensure the safe administration of medicines by healthcare professionals.  It was produced following the withdrawal of the Medicines Management Standards by the Nursing & Midwifery Council.

Royal Pharmaceutical Society & Royal College of Nursing, 2019.  Professional guidance on the administration of medicines in healthcare settings. 

Available to download

Article: Understanding the human and system factors involved in medication errors

Nurses, more than any other healthcare professional group are principally involved in medication administration.  This article recognises the complexity of why medication errors occur and considers the many factors involved, including those from an individual and organisational perspective.  It adopts a solution focused approach, based on the evidence underpinning the knowledge of medication errors.

Gluyas, H. 2018. Understanding the human and system factors involved in medication errors.  Nursing Standard, 33 (6) p 50 - 56.

Contact the library  for a copy

New Book: Medicines management at a glance

Written specifically for nurses, the book is divided into three sections, the first introduces key topics within clinical pharmacology and medicines management including, numeracy, pharmacokinetics, routes of administration, and pharmacodynamics. The second and final sections cover the management of medicines for common medical conditions, drug interactions, side effects, and safe and effective prescribing.

Young, S. & Pitcher B. 2016.  Medicines management for nurses at a glance.  Wiley Blackwell.

Contact the library for a loan

Article: Anticipatory prescribing and advance care planning in palliative care for children and young people

This article focuses on the symptom management aspects of the advance care plan, and specifically the challenges faced by prescribers in anticipating the distressing symptoms a child is likely to experience at end of life and prescribing medicines to manage these symptoms.

Tatterton, M. 2018.  Anticipatory prescribing and advance care planning in palliative care for children and young people.  Nurse Prescribing, 16 (5) p 228 - 233

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Article: Barriers to the use of buccal and intranasal fentanyl for breakthrough pain in paediatric palliative care

This letter reports on a survey recently administered to investigate the current off-label prescribing of fentanyl for breakthrough pain in paediatric palliative care in the UK and to ascertain any barriers to use.  The survey was sent to 124 members of the Association of Paediatric Palliative  Medicine (APPM).  The response rate was 44 members (36%).  Respondents were mainly consultants and associate specialist grade clinicians who had worked for over 5 years in this field.  Less than half had prescribed buccal fentanyl and only 4 had prescribed intranasal fentanyl.  The article provides more details of prescribing practice and reasons for the low uptake.

Harrop, E. et al. 2018. Barriers to the use of buccal and intranasal fentanyl for breakthrough pain in paediatric palliative care.  BMJ Supportive & Palliative Care, September 8 (3) p

Book: Numeracy and clinical calculations for nurses

Numeracy and Clinical Calculations for Nurses is a user-friendly introduction to the subject which guides the reader from the basics through to the core calculations required in a healthcare setting.
Using extensive worked examples the author links the mathematics to real-world situations to help the reader understand the subject in the context of their nursing practice.

Davison, N. 2015. Numeracy and clinical calculations for nurses.  Lantern Publishing.

Contact the Library  for a loan

Article: Avoiding errors when administering injectable phenytoin to a child in status epilepticus

Errors often occur in the prescribing, preparing, administering and monitoring of intravenous phenytoin.  In 2016 an alert was issued by NHS Improvements.  Although not commonly given, this article explores why adverse events occur when it is used with the aim to ensure a safer and effective care environment when administered.

Douglass, C. 2018.  Avoiding errors when administering injectable phenytoin to a child in status epilepticus.  Nursing Children and Young People, 30 (1) p 35 - 38.

For a copy of the article please fill out the online request form

Article: Off-label drug use without evidence makes for a difficult decision-making process: a case study

The off-label use of drugs in the UK is relatively common in palliative care, in part because a drug's original marketing authorisation hasn't allowed for new routes and emerging novel indications for use.  This case study explains the difficulties faced in complying with the wishes of a dying patient admitted to an adult hospice.

Freshwater, E., et al. 2017. Off-label drug use without evidence makes for a difficult decision-making process: a case study.  European Journal of Palliative Care. 24 (6) p 274-276.

For a copy of the article please fill out the online request form

Article: Undertaking drug calculations for intravenous medicines and infusions

Drug calculations for intravenous (IV) medicines and infusions are more complex than those for oral medicines.  This article aims to enable nurses to review and enhance their competences in drug calculations for IV medicines.  It provides methods for undertaking IV drug calculations, using case studies to demonstrate these methods.

Brindley, J. 2018.   Undertaking drug calculations for intravenous medicines and infusions.  Nursing Standard, 32 (20) p 55 - 59.

Request the article via the online form

Book: Intravenous therapy administration: a practical guide

This practical book offers step-by-step guidance in how to administer intravenous fluids and medicines. It is written to be equally helpful for staff either practicing intravenous therapy and wish to refresh or update their knowledge or for staff learning the skill for the first time. Each chapter contains intended learning outcomes, clinical points for practice, and activities.

Brooks, N. 2017.  Intravenous therapy administration: a practical guide. M & K Allen.

Available for loan from the library

Article: Undertaking drug calculations for oral medicines and suppositories

The article aims to assist nurses in identifying their competence in undertaking drug calculations and includes how to minimise the risks of medication errors, converting units of measurement, and the formula used for calculating tablets and liquid medicines.  A drug calculations quiz is included with 10 multiple choice questions which relate to the article.

Brindley, J. 2017. Undertaking drug calculations for oral medicines and suppositories.  Nursing Standard, October, 32 (7)  56-62

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RCN Competences: an education and training competence framework for administering medicines intravenously to children and young people.

This revised and updated guidance describes theoretical and practical competences for the education and training of staff administering intravenous medicines to children and young people.

RCN Competences:  an education and training competence framework for administering medicines intravenously to children and young people.  December 2017.

Available to download

Article: Drugs for opioid induced constipation

This article is part of a series of articles reviewing areas of practice, covering new drugs and old drugs with important new indications or concerns. It provides an overview of constipation resulting from use of opioids including treatments available and effectiveness. It also considers safety of the options, how the different treatments are taken and cost effectiveness.

Boland J, Boland E, 2017. Drugs for opioid induced constipation. The British Medical Journal, September, 358 p 326-329

To request this article complete the online form

[Article] Undertaking safe medicine administration with children part 2: essential numeracy

This article addresses essential numeracy and calculation skills that have been identified as an important risk factor associated with medication errors in children.

Pentin, G. et al. 2016.  Undertaking safe medicine administration with children part 2: essential numeracy.  Nursing Children and Young People, 28 (7) p 37 - 42.

To request a copy, click here fill in form and return to library.

[Article] Codeine in paediatrics: pharmacology, prescribing and controversies

Codeine is a drug that until recently was widely used in children.  It was endorsed by the WHO as the 2nd step on the analgesic ladder for cancer pain.  Recently it's safety and efficacy have been called into question.  This article discusses the pharmacology underpinning it's action in children, how this relates to prescribing as well as the practical issues and the most recent regulatory framework surrounding it's use.

Andrzejowski, P. & Carroll.  2016.  Codeine in paediatrics: pharmacology, prescribing and controversies.  Archives of Disea51se in Childhood. 101 p 148 - 150
To request a copy, fill out this form and return to the library

[Article] Analysis of drug interactions at the end of life

As death approaches, patients are at their most frail, but an increasing symptom burden often necessitates  an increase in medications.  This study used case notes from 266 adult patients referred to specialist palliative care.  The study found that the mean number of medications prescribed was 10.8 with 72% of patients at risk of one or more drug interaction.  The authors conclude some drug interactions may be recognised as an acceptable risk, but more research is required to improve recognition of potential drug interactions and the rates of morbidity or associated mortality associated with this. Greater use of computerised prescribing software and closer liaison with clincal pharmacists is recommended.

Morgan, N. A., Rowett, D. & Currow, D. 2015.  Analysis of drug interactions at the end of life.  BMJ Supportive and Palliative Care.  5 (3) p 281-286.

To request a copy, click here fill in form and return to library.