Nurse Initiated Medicines are simple over-the-counter medicines which can be used for some ailments in care recipients of aged care facilities. These ailments generally include pain, constipation and reflux. In order to administer these medicines they must be selected from a list which is determined by a Medication Advisory Committee at the aged care facility and signed by a doctor, thereby allowing their use.
But the real question is – are nurse initiated medicines harmless and able to be given to all care recipients? The one word answer to that question is No. An example of this is a commonly used antacid used to treat an upset stomach, heartburn, and acid indigestion, called Mylanta®.
Q. If Mylanta® is listed on a nurse initiated medicines list and a care recipient has asked for some to be administered due to stomach discomfort, how long should you wait if the care recipient has recently taken other oral medication? We’ll have more on the answer to that question at the end of this article.
What do I need to know?
Nurse Initiated Medicines include some scheduled medicines which as with all scheduled medication are governed by state legislation. In addition, Nurse Initiated Medicines are also covered by guidelines, namely Guiding Principle 5 in the publication Guiding Principles for Medication Management in Residential Aged Care Facilities 2012.
Equally as important is Guiding Principle 14 which states that “The Residential Aged Care Facility should use ongoing quality improvement activities such as staff education and training and ongoing competency assessment, developed in consultation with the Medication Advisory Committee, to support appropriate medicines administration.”
Administering Nurse Initiated Medicines
Nurse initiated medicines are intended for a single dose, or for a very short course, until the care recipient’s medical practitioner can evaluate the ailment further.
Before administering a Nurse Initiated Medicine, you must determine the following:
- That the care recipient has not already been prescribed the medication
- That the medicine is not contraindicated with other medication that they are taking
- The expected effects of the medicine
- Any known allergies or previous reactions to medicines experienced by the care recipient
Finally, as with all medication administration you must record the outcome in the care recipient’s progress notes once the medicine has been given.
Now, back to the Mylanta® question…
A. In relation to administering other oral medication, Mylanta® should not be given for at least 2 hours after administering other medicines. This is due to how Mylanta® interacts and binds with other medications which can cause a reduction in the amount of that medication being absorbed, resulting in reduced therapeutic effect (this and additional information can be found in the Australian Medicines Handbook 2016).