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Learning outcome

Define controlled substance and theDangerous Drug Act (DDA)

Explain the responsibility of the nurse inhandling and administration of DD

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Poison

Substance on which ingestion, inhalation,absorption, application, injection ordevelopment within the body, relatively

small amount, may cause structuraldamage or functional disturbance

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Drug

Any substance that when taken into livingorganism may modify one or more of itsfunction

All dangerous drugs are categorized aspoison but not all poisons are dangerousdrugs

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Controlled substances

Includes opium and its active derivatives,such as heroin and morphine; coca leaf andits derivatives principally cocaine;

hallucinogenic drugs, lysergic aciddiethylamide (LSD) and other substancesproducing similar effects; whether natural

or synthetic, with the physiological effectsof a narcotic drug

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Controlled substances

These drugs must be safeguarded fromunauthorized persons

Delivered to nursing units in stock supply

Nurses are responsible for an accurateaccounting of their use

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Two ordinance that controlPoisons and Dangerous Drugs

1. Poison Ordinance 1952

2. Dangerous Drug Act (DDA) 1952

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Poison Ordinance

Law that controls all type of drug use forinternal and external use

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DDA 1952

An act to make further and better provisionfor the regulating of importation,exportation, manufacture, sale and use of

opium and of certain other dangerousdrugs and substances to make specialprovision relating to the jurisdiction of

courts in respect of offences thereunderand their trial, and the purpose connectedtherewith

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DDA

Ordinance that controls any abuse andselling of drugs, which may cause addiction

Control the distribution and use of alldepressants and stimulant drugs of abuseor potential abuse

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DDA

MOH has the authority to controlpoisonous drugs or dangerous drugsfrom the following aspects:

1. Manufacture2. Supply

3. Distribution

4. Dispensing5. Storage

6. Sale

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Medications listed under controlledsubstances

Opium

Morphine

Heroin Pethidine

Methadone

Cocaine Cannabis

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Handling controlled substances

1. To provide a controlled method foracquisition and dispensing of controlledsubstance

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Handling controlled substances

2. To maintain appropriate proof of use:

Documentation in a retrievable manner

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Nursing responsibilities inhandling controlled substances

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Storage of controlled substances

Dispensed to the ward using the stocksupply or floor stock

Controlled substances must be storedunder a double lock system

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Storage of controlled substances

The nurse in charge of medication duringthe shift is responsible to keep the key andto hand over the key to the next nurse on

duty at the end of her shift

The nurse on duty must ensure that theDD cupboardis locked at all times

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Documentation of controlledsubstances

The nurse must check narcotic supplies atthe change of shifts

The nurse completing the shift does thenarcotic count with the nurse beginningthe next shift

Both nurses sign the DD accountabilitysheet to indicate that the count is correct

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Documentation of controlledsubstances

A special inventory record is used eachtime a narcotic is dispensed and providesan accurate ongoing count of drugs usedand remaining

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Documentation of controlledsubstances

All usage of controlled substances will be

documented appropriately on thecontrolled substances documentation sheetor DDA book

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Documentation of controlledsubstances

DDA book consists of these followinginformation:

1. Date

2. Name of client and RN3. Name of Dr ordering the controlled

substance4. Signature of the nurse administering the

medication5. Name of drug dosage form6. Amount given

7. Balance on hand

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Documentation of controlledsubstances

In the event of an inaccurate count:

Report immediately

Remain on duty and search for missingnarcotics

Sign list as incorrect

Fill out incident report and sign with onewitness

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Documentation of controlledsubstances

These special precautions are used to helpcontrol drug abuse

Drug abuse : inappropriate intake of asubstance either periodically or continually

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Documentation of controlledsubstances

If one part of a pre-measured dose of drugis given, a second nurse witnessesdisposal of the unused portion anddocuments such on the DDA book

In some hospitals the empty ampule isrequired to be returned to the pharmacy

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Documentation of controlledsubstances

In the event of wastage or breakage ofcontrolled substances, it must bedocumented in the DDA book

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Documentation of controlledsubstances

The nurse must state:

1. The date of event

2. Reason for wastage e.g. Accidentallybroken, expired or return to pharmacy

3. Amount wasted

4. Signature of the nurse wasting thesubstance

5. Signature of witness

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