Drug administration records should clearly state which drugs you are administering in secret and when. This is especially important for people with varying capacity. In England and Wales, hidden drug management legislation is the Mental Capacity Act 20055 and the Mental Health Act 1983.3 in Scotland. relevant statutes are the Adults with Incapacity (Scotland) Act 20006 and the Mental Health (Care and Treatment) Act 2003;7 in Northern Ireland the applicable law is the Mental Capacity Act (Northern Ireland) 2016.8 The latest guideline of Nice 108 on decision-making and intellectual capacity gives a good overview, how to apply applicable legislation.9 Once a decision has been made on the complete administration of the drugs, a pharmacist should be advised on the suitability of each drug to be administered undercover. Pharmacists should refer to the Product Characteristics Summary (CPR) for the drug or drug in question and other appropriate sources of supply (see “Additional Resources for Drug Crushing”). Therefore, hidden medications can only be administered in the best interests of a patient who lacks mental capacity and refuses to take such medications. a regular review plan for the need for continued undercover drug administration. Undercover drug administration should only be used in exceptional cases if such a product is deemed necessary under the Mental Capacity Act 2005. However, once a decision has been made regarding the undercover administration of a particular drug (after assessing the resident`s ability to make a decision on their medications and a best-interest meeting), it is also important to review and plan how the drug can be administered undercover, if it is certain to do so and to ensure that the need for continuous undercover administration is regularly verified (capacity may vary over time). Medications should only be administered undercover after a best-interest meeting.
If the situation is urgent, it is acceptable for a less formal discussion between caregivers, prescribers and family or lawyers to make an urgent decision. However, a formal meeting should be agreed as soon as possible. They should regularly reassess the need for continuous covert management. Be sure: [16] Smyth J. NEWT rules for administering medications to patients with edge feeding tubes or swallowing problems. Betsi Cadwaladr University Local Health Board (East). Available at: www.newtguidelines.com (called in June 2016) Coverage drugs have many medical and ethical aspects.