2 Dda

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Learning outcome
Define controlled substance and the Dangerous Drug Act (DDA) Explain the responsibility of the nurse in handling and administration of DD
Poison
Substance on which ingestion, inhalation, absorption, application, injection or development within the body, relatively small amount, may cause structural damage or functional disturbance
Drug
Any substance that when taken into living organism may modify one or more of its function All dangerous drugs are categorized as poison but not all poisons are dangerous drugs
Controlled substances
Includes opium and its active derivatives, such as heroin and morphine; coca leaf and its derivatives principally cocaine; hallucinogenic drugs, lysergic acid diethylamide (LSD) and other substances producing similar effects; whether natural or synthetic, with the physiological effects of a narcotic drug
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Controlled substances
These drugs must be safeguarded from unauthorized persons Delivered to nursing units in stock supply Nurses are responsible for an accurate accounting of their use
Two ordinance that control Poisons and Dangerous Drugs
1. Poison Ordinance 1952 2. Dangerous Drug Act (DDA) 1952
Poison Ordinance
Law that controls all type of drug use for internal and external use
DDA 1952
An act to make further and better provision for the regulating of importation, exportation, manufacture, sale and use of opium and of certain other dangerous drugs and substances to make special provision relating to the jurisdiction of courts in respect of offences thereunder and their trial, and the purpose connected therewith
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DDA
Ordinance that controls any abuse and selling of drugs, which may cause addiction Control the distribution and use of all depressants and stimulant drugs of abuse or potential abuse
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DDA
1. 2. 3. 4. 5. 6. MOH has the authority to control poisonous drugs or dangerous drugs from the following aspects: Manufacture Supply Distribution Dispensing Storage Sale
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Medications listed under controlled substances

Opium Morphine Heroin Pethidine Methadone Cocaine Cannabis
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Handling controlled substances

1. To provide a controlled method for acquisition and dispensing of controlled substance
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2. To maintain appropriate proof of use: Documentation in a retrievable manner
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3. To maintain a high level of security in the storage of controlled substances
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Nursing responsibilities in handling controlled substances
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Storage of controlled substances

Dispensed to the ward using the stock supply or floor stock Controlled substances must be stored under a double lock system
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Storage of controlled substances

The nurse in charge of medication during the shift is responsible to keep the key and to hand over the key to the next nurse on duty at the end of her shift The nurse on duty must ensure that the DD cupboard is locked at all times
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Documentation of controlled substances

The nurse must check narcotic supplies at the change of shifts The nurse completing the shift does the narcotic count with the nurse beginning the next shift Both nurses sign the DD accountability sheet to indicate that the count is correct
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A special inventory record is used each time a narcotic is dispensed and provides an accurate ongoing count of drugs used and remaining
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All usage of controlled substances will be documented appropriately on the controlled substances documentation sheet or DDA book
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DDA book consists of these following information: 1. Date 2. Name of client and RN 3. Name of Dr ordering the controlled substance 4. Signature of the nurse administering the medication 5. Name of drug dosage form 6. Amount given 32 7. Balance on hand

In the event of an inaccurate count: Report immediately Remain on duty and search for missing narcotics Sign list as incorrect Fill out incident report and sign with one witness
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These special precautions are used to help control drug abuse
Drug abuse : inappropriate intake of a substance either periodically or continually
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If one part of a pre-measured dose of drug is given, a second nurse witnesses disposal of the unused portion and documents such on the DDA book In some hospitals the empty ampule is required to be returned to the pharmacy
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In the event of wastage or breakage of controlled substances, it must be documented in the DDA book
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The nurse must state: 1. The date of event 2. Reason for wastage e.g. Accidentally broken, expired or return to pharmacy 3. Amount wasted 4. Signature of the nurse wasting the substance 5. Signature of witness
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Two ordinance that control Poisons and Dangerous Drugs

1. Poison Ordinance 1952 2. Dangerous Drug Act (DDA) 1952

Medications listed under controlled substances

Handling controlled substances

Handling controlled substances

Handling controlled substances

Nursing responsibilities in handling controlled substances

Storage of controlled substances

Storage of controlled substances

Documentation of controlled substances

Documentation of controlled substances

Documentation of controlled substances

Documentation of controlled substances

Documentation of controlled substances

Documentation of controlled substances

Documentation of controlled substances

Documentation of controlled substances

Documentation of controlled substances

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