PROTOCOL FOR THE ADMINISTRATION OF HYDROXOCOBALAMIN TO ADULTS BY

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Protocol for the Administration of Hydroxocobalamin to adults




Protocol for the Administration of Hydroxocobalamin to adults


by Health Care Assistants (HCA)


Purpose of Protocol


To enable suitably trained Health Care Assistants working for ………………….. SURGERY who have undertaken relevant training (as outlined below), to administer hydroxocobalamin as a duty delegated by the General Practitioner (GP employer) or registered nurse (Trust employee).


Characteristics of staff

Staff group (s)

Health Care Assistants


Additional Requirements

Training and competence in the correct procedure of administering medication via intramuscular injection.

Completion of a validated course on Basic Life Support and Treatment of Anaphylaxis.

Knowledge of ……………………. Surgery policy on management Anaphylaxis in the Community.

Other relevant training (as outlined below)


Continuing Training Requirement

Annual updates in Basic Life Support and in the treatment of Anaphylaxis.

Demonstration of competence in relation to this medication within the PDP and appraisal process.



Clinical Condition

Clinical Condition to be treated

Pernicious or other macrocytic anaemias


Criteria for inclusion

Any adult (i.e. any person aged 16 years or over) who has received initial treatment following diagnosis and now requires maintenance doses.


Criteria for exclusion

Patients with an unconfirmed diagnosis of pernicious or other macrocytic anaemia.

Recently diagnosed patients who are receiving the initial loading doses

Any person less than 16 years of age.


Circumstances for further advice/action

Consent not given

Excluded patients: refer to GP

Suspected hypersensitivity reactions: refer to GP

Pregnancy and breastfeeding: refer to GP

Recommended treatment, route and legal status

Hydroxocobalamin by intramuscular injection into the deltoid muscle

Prescription Only Medicine (POM)

Dosage

1mg in 1ml

Storage

At or below 25oC and protected from light

Frequency of administration and maximum dosage

Normally 1mg every 3 months

Follow-up & advice


Side effects & their management

Local side effects: injection site pain

Systemic side effects: nausea, headache, dizziness, fever, rash & pruritis

Rare side effects: cardiac arrythmias – contact GP, anaphylaxis – see protocol for treatment of anaphylaxis for appropriate management.

Special considerations/Concurrent medication

Response to Hydroxocobalamin reduced by Chloramphenicol. Discuss with GP

Clinical Aspects


The following will be required:

  1. Patient specific directions – written by the General Practitioner or other authorised prescriber

  2. Patient identification - required prior to the administration of medication (confirmed by the patient declaring his or her name, date of birth and home address).

  3. Consent – informed consent must be obtained from the patient.

  4. Record keeping – The following should be recorded in the patients notes, either according to the GP practice system, or within the district nursing documentation drug administration records

    • Name of drug, dose route and site of administration

    • Date administered

    • Batch No and expiry date

  5. Signature of person administering

  6. Patient assessed as not appropriate for injection and any alternative action taken

  7. If the patient has declined injection and any alternative action taken

  8. Any reaction should be recorded in the clinical record


Adverse reactions

Health Care Assistants must ensure the availability of an Anaphylaxis shock pack containing Adrenaline 1:1000.


If a general adverse reaction does occur:



If anaphylactic reaction occurs


Relevant training


  1. The Health Care Assistants will attend a training session covering the following aspects of the administration of hydroxocobalamin


  1. The Health Care Assistant will have successfully completed a relevant qualification. This could be NVQ3 or an accredited course from an academic institution. They should have completed a course in Basic Life Support.


  1. The Health Care Assistant will undergo a period of supervised practice and assessment and will be directly observed administering intramuscular injections by the general practitioner or the practice nurse mentor (GP employee) providing this duty has been delegated in writing by the general practitioner or by a registered nurse.



Assessment of competence


Assessment of competence will be undertaken following the period of supervised practice as outlined above. In the GP Practice, this will be undertaken by the practice nurse/GP providing that this duty has been delegated in writing) in order to comply with the specific requirements of the company providing medical indemnity. If employed by the ……………………………. TRUST, assessment of competence will be undertaken by an occupationally competent registered nurse.



Competence will be assessed by direct observation of the HCA’s ability to:


The Health Care Assistant will also be assessed (via oral questioning) on issues relating to the therapeutics of hydroxocobalamin.



Significant Events

Any significant event which occurs during or as the result of administration of medication must be reported to the Practice Manager/General Practitioner (GP employee) or Registered Nurse/Manager (Trust employee), and the incident reported via the PCT significant event reporting framework.


Audit: Health Care Assistants will be expected to participate in audit in relation to patient outcomes and the development of this role.


Health Care Assistants must be familiar with the following documents:




Review:

It is the responsibility of the lead of the staff group (s) to whom this protocol applied to ensure the review process takes place.


This protocol becomes valid on ……………………………………. and becomes due for review on ……………………………………………….. ..






Protocol for Hydroxocobalamin


Agreement for general practice Health Care Assistants


This protocol is to be read, agreed and signed by all Health Care Professionals it applies to:


Practice: ________________________________



Staff Name: __________________________________



Designation: __________________________________



Signature: __________________________________



Date: __________________________________



Approved by __________________________________

Lead GP:


Date: __________________________________




The Health Care Professionals should retain a copy of the document after signing and the original retained in their personal file.





(ORGANIZATION NAME) LANGUAGE ACCESS PLAN & PROTOCOL I
(RISERVATO ALL’UFFICIO URBANISTICA) (TIMBRO PROTOCOLLO COMUNALE) (SPAZIO PER LA
(TRANSLATION) (2003) LI ZI NO 57 THE PROTOCOL DEPARTMENT


Tags: administration of, of administration, hydroxocobalamin, adults, administration, protocol