National Health (Residential Medication Chart) Amendment Determination 2012 (No. 1) (No. PB 59 of 2012)

EXPLANATORY STATEMENT

National Health Act 1953

National Health (Residential Medication Chart) Amendment Determination 2012 (No.1)

Authority

Subsection 93A (2) of the National Health Act 1953 (the Act) provides that the Minister may determine the pharmaceutical benefits or classes of pharmaceutical benefits that may be supplied to a prescribed institution under section 93A of the Act, and the conditions under which those benefits may be supplied under that section of the Act.

Purpose

The purpose of this Instrument, made under section 93A (2) of the Act, is to amend the National Health (Residential Medication Chart) Determination 2012 (the Determination), which determines the pharmaceutical benefits that may be supplied under section 93A of the Act to a prescribed institution which is a residential care service within the meaning of the Aged Care Act 1997 and the conditions which must be met in order for that supply to occur.

This Instrument provides minor changes to clarify important safety elements of the residential medication chart. This Instrument makes changes to the sections for regularly administered pharmaceutical benefits, insulin, short-term medicines and variable dose pharmaceutical benefits that are part of the standard field information requirements for a residential medication chart in the Determination.

In practice, residential care services did not start to use a residential medication chart for supply of pharmaceutical benefits on 1 July 2012, and widespread prescribing and supply from a residential medication chart will also involve any necessary adjustments to state and territory law.  Therefore transitional arrangements are not required in relation to these amendments.

A provision by provision description of this Instrument is set out in the Attachment.

Consultation

Broad consultation has been undertaken throughout the development of the Supply and PBS claiming from a medication chart in residential aged care facilities initiative.  A public written consultation process was undertaken in 2011.  Responses were received from a broad cross section of stakeholders within key industry groups including prescribers, pharmacists, aged care and consumers.  The responses provided both positive and constructive feedback that was used in finalising policy parameters for the initiatives.  The Department has continued to engage with stakeholder groups as individual issues are identified.  In particular, throughout the development of Residential Medication Chart the Australian Commission on Safety and Quality and Healthcare established an expert reference group made up of key industry representatives.  This group was integral to the development of the implementation model for this initiative.

In addition, the Department has also undertaken direct consultation with the Department of Human Services and has also engaged and consulted with State and Territory Departments of Health to seek their input and support for the initiatives.

These amendments are the result of direct consultation with the Australian Commission on Safety and Quality in Health Care; and the recent outcomes of human factors analysis undertaken as part of the design process for the National Residential Medication Chart.

This Instrument commences on the day after it is registered.

This Instrument is a legislative instrument for the purposes of the Legislative Instruments Act 2003.

ATTACHMENT

PROVISION BY PROVISION DESCRIPTION OF THE NATIONAL HEALTH (RESIDENTIAL MEDICATION CHART) AMENDMENT DETERMINATION 2012 (No. 1)

1                         Name of Instrument

This section provides that the name of the Instrument is the National Health (Residential Medication Chart) Amendment Determination 2012 (No. 1) and that the instrument may also be known as PB 59 of 2012.

2                         Commencement

This section provides that the Instrument commences on the day after it is registered.

3                         Amendments to National Health (Residential Medication Chart) Determination 2012

This section provides that this Instrument amends the National Health (Residential Medication Chart) Determination 2012 (the Determination). 

Schedule 1  Amendments

[1] Paragraph 2.08(1)(j)

Item 1 amends paragraph 2.08(1)(j) of the Determination to clarify that the position of the box in relation to the list of months is not required to be fixed next to the heading for that section of the residential medication chart.

[2] Paragraph 2.09(1)(d)

Item 2 amends paragraph 2.09(1)(d) of the Determination to clarify that the area for insulin administration is not required to be immediately below the area for blood glucose level (BGL) recording.  However, provision for BGL recording and for insulin administration must be provided for in a part of the residential medication chart that relates only to insulin, as per paragraphs 2.13 (3) and (4) of the Determination.

[3] Subparagraph 2.09(1)(e)(ii)

Item 3 amends subparagraph 2.09(1)(e)(ii) of the Determination to ensure that the residential medication chart is consistent with the safety principles and safe use of medicines principles determined by the Australian Commission on Safety and Quality in Health Care. The use of ‘u’ or ‘U’ as an abbreviation for ‘units’ is considered to be a dangerous abbreviation for the communication of the dose, and is not to be used. This change is intended to optimise the safety of residents.

[4] Section 2.11

Item 4 amends section 2.11 of the Determination to clarify the format of the short-term medicines section of the residential medication chart, in accordance with the outcomes of human factor testing. Medicines to be recorded in this area of the residential medication chart are those medicines that the prescriber determines should be administered short term, for example, an antibiotic. These medicines are not intended to have a variable dose, nor have the facility for the person administering the medicine to indicate variable times of day for administration. Rather the prescriber will indicate the dose and frequency of administration, in the same way as for the resident’s regular medicines. The requirement for the ‘ongoing’ field in paragraph 2.11(a) of the Determination, which links with paragraph 2.08(1)(e) of the Determination, is removed, to prevent confusion, as it is not best practice to write orders for ongoing medicines in the short term medicine section.   

[5] Subparagraph 2.12(1)(e)(i)

Item 5 amends subparagraph 2.12(1)(e)(i) of the Determination to clarify that the person administering the variable dose medicine may not identify with the title ‘nurse’. This would allow for local differences. The administration of medicines in a residential aged care facility is to be performed in accordance with the relevant legislation and accreditation standards, which exist in addition to the residential medication chart and its requirements. 

[6] Subparagraph 2.13(4)

Item 6 amends subsection 2.13(4) of the Determination to clarify that the area for insulin administration is not required to be immediately next to the area for blood glucose level (BGL) recording. However, provision for BGL recording and for insulin administration must be provided for in a part of the residential medication chart that relates only to insulin, as per paragraph 2.13 (3). The BGL recordings must be visible when recording the administration of insulin.