Draft: Controlled Drug ePrescriptions

Policy edited and restructured for improved clarity and consistency. Please let us know if you don't use ePrescribing for controlled drugs and/or if you don't hold any controlled drug pads (not even for emergency use).

Policy

Refer to RNZCGP: ePrescriptions in general practice policy brief for best practice information about ePrescriptions.

To ensure that we satisfy the legislative and safety demands of managing and prescribing controlled drugs we:

• write prescriptions consistent with the Medical Council of New Zealand statement on Good prescribing practice and the information required by the Ministry of Health
• generate ePrescriptions for controlled drugs via the New Zealand ePrescription Service (NZePS)
• ensure all controlled drug prescriptions generated via NZePS meet the legal requirements of an ePrescription.

  Legal requirements of an ePrescription:

  • generated via NZePS
  • contains a unique barcode
  • barcode used at the point of dispensing at the pharmacy.

  Refer to Te Whatu Ora's guidance on Signature Exempt Prescriptions and remote prescribing for detailed information on signature-exempt prescriptions, and the temporary exemption for non-NZePS signature-exempt prescriptions.

All controlled drug ePrescriptions are visible in the patient record in the PMS. Controlled drugs are included in our prescription audits.

See also Prescriptions and Controlled Drug Stock.

Writing a controlled drug prescription using NZePS

Enter the controlled drug prescription details into the Medications tab of the PMS. Send the prescription to the pharmacy via NZePS.

It is not necessary to write "Signature Exempt" on the prescription.

If you experience connection issues with NZePS it may be necessary to restart the PMS.

Controlled drug prescription pads

We maintain a small stock of controlled drug prescription pads for emergency use.

Our controlled drug prescription pads are recorded on a designated page of the controlled drug register and stored in the safe. The person entering the information records the prescription numbers, date of receipt, and their initials.

When a prescription is written using a controlled drug pad, record the patient's name, NHI number, and date on the back of the pad. Add the prescription number to the patient record.

Storing controlled drug prescription pads

When new controlled drug prescription pads arrive at the practice:

1. Secure the package immediately.
2. Check items and quantities are correct.
3. Record the 10 individual serial numbers on the back of the controlled drug prescription pad.
4. Record on the prescription pad page of the controlled drug register:
   • courier track and trace number (or stick in the courier label)
   • date of receipt
   • first and last serial numbers from each pad.
5. Store controlled drug pads in the safe. Place the pads in sequence order with oldest pads on top.

   Consider placing the 'Reminder to Order' note and new order form from the courier bag in the safe after the 7th pad as a reminder to re-order.

6. As each pad is completed, record the finish date in the controlled drug register next to the pad number.

Store completed controlled drug prescription pads for at least four years.

Controlled drug prescription pad audit

Every week, two nurses check:

• controlled drug prescription pads are numbered and recorded on the designated page in the controlled drug register, and all are accounted for.
• used prescriptions are accurately recorded (patient's name and NHI, issue date, and prescriber's details) in the prescription pad register and in the patient's medication list in the PMS.
• completed pad is scanned to the PMS.

If any controlled drug prescription forms or pads are unaccounted for, inform the Nurse Lead and complete an incident form.

Any missing controlled drug prescriptions will be investigated by the Nurse Lead and police notified if necessary.

Controlled drug register

We record all controlled drug transactions in the controlled drug register, a bound book with consecutively numbered pages:

• Record each drug on a separate page.
• Include all required details.

  Details for each transaction in a controlled drug register.

  • Date and type of transaction, e.g. receipt, administration, stock take, or destruction of the medicine.
  • Name and strength of drug.
  • Either:
    • name and address of person drugs were received from
    • name of patient
    • name and address of person supplied
    • description of the transaction, e.g physical stocktake.
  • Either:
    • prescription number
    • order number
    • time of administration/destruction of medicine.
  • Number in.
  • Number out.
  • Remaining balance.
  • Name of authority/prescriber.
  • Received, issued, dispensed, or administered by.
  • Initials/signature of person/s making the entry or checking the balance.

  Source: RNZCGP

• Write clearly with an ink pen.
• Enter the details of each transaction no later than the following business day.
• Correct errors in a margin note or footnote with the date and the person's initials. Do not cross out or erase entries.

Q07

The controlled drug register is kept in a secure place.

Resources

• Ministry of Health: Frequently Asked Questions: Controlled Drugs Prescribing
• HealthPathways: Controlled drugs