Report of the Joint Sub-Committee on the Control of Dangerous Drugs and Poisons in Hospitals.

  • Great Britain. Joint Sub-Committee on the Control of Dangerous Drugs and Poisons in Hospitals.
Date:
1958
Catalogue details

Licence: Public Domain Mark

Credit: Report of the Joint Sub-Committee on the Control of Dangerous Drugs and Poisons in Hospitals. Source: Wellcome Collection.

    20/36 (page 12)
    52. We have seen draft specifications prepared by the British Standards Insti- tution for a standard poisons cupboard, with an inner locked compartment for Dangerous Drugs. This cupboard seems to us well adapted to its purpose. 53. Custody of Drugs. Arrangements should be made for the storage of patients’ valuables and other articles needing to be kept under lock and key which do not invotve placing them in the drug cupboard even as a temporary measure in emergency. 54. We would also draw attention to the fact that no department should have a Dangerous Drugs cupboard unless there is an authorised possessor, who would normally be a nurse, personally responsible for the Dangerous Drugs in the cupboard. We have in mind especially radiological and psychiatric Departments. 55. Limitation of ward stocks. We believe that there is a tendency among ward sisters to accumulate too wide a range of drugs and medicines. The result is that cupboards are overcrowded with bottles the purpose of which is forgotten, that drugs may be used which are inert and that losses may pass for a very long time unnoticed. The intention no doubt is to be prepared for any eventuality, but this is in our view misguided: the advantages gained are not worth the dangers. We have been told of serious results in two successive cases in the same hospital where ward sisters produced from their stock in emergency a drug which should only be dispensed for immediate use because of its short active life and proved in fact in both cases to have deteriorated. Also, certain drugs such as paraldehyde become dangerous. Supplies again get inflated because some house officers as they come and go tend to order a drug of their own particular choice, then they move on, and the drug remains unused on the shelf. (See paragraph 29). 56. The ‘‘stock bottle’? and multi-dose container. The misuse of injectable Dangerous Drugs is rendered very much more difficult when the drugs are dispensed in single-dose containers. We should have liked to recommend that multi-dose containers for Dangerous Drugs should be banned altogether, save for a few exceptional cases, but we decided in the end that it would be difficult for the Minister to insist on this, since the change might involve an appreciable increase in the time, trouble and expense of making up drugs in certain hospitals where a single “‘stock bottle’ had to be replaced by a considerable number of ampoules with various strengths and combinations of the drug. We believe, however, that if the medical staff will co-operate the extra work involved need not be large: we were told of one hospital with a very big consumption of morphine where since the “stock bottle’? has been abolished nothing but 4-srain and 4-grain ampoules have been supplied for stock, without apparently causing any difficulty. We know of many hospitals of all types where single- dose containers have Jong been the rule and we hope that other hospitals will before long follow their example. 57. We consider it important that the different types of medicaments and their various methods of administration should be distinguished by means of con- tainers and labels. We accordingly make the following recommendations and to ensure uniformity we think that they should be adopted by all hospitals.