Regional Template for Syringe Pump Prescription, Administration and Monitoring Record

In 2009, a multidisciplinary sub group of the NICaN Pharmacy Group produced templates for syringe driver prescription and adminstration. These templates were part of a best practice circular re syringe driver prescription and administration issued in June 2009.  These templates have been reviewed as many trusts have or are implementing new syringe pumps calibrated in volume per unit time in response to National Patient Safety Agency  Rapid Response Report: Safer Ambulatory Syringe Drivers. The orginal templates were for syringe drivers calilbrated in distance travelled. The subgroup has revised these for syringe pumps calibrated in volume per unit time. Following consultation and piloting, the revised templates are now complete.

o       Prescription and administration of medicines via subcutaneous CME/McKinley T34 syringe pump

o       Continuation record for prescription and administration of medicines via subcutaneous CME/McKinley T34 syringe pump in primary care
 
o       Prescription and subcutaneous administration of medicines for breakthrough symptoms in primary care.
 
The DHSSPSS is to commend these templates to the HSC as best practice guidance. Support available for the implementation of these charts has also been produced. This includes explanatory notes and a training package with speaker’s notes and slides. 
 
  •  Click here to view Prescription and administrations of medicines via subcutaneous CME/McKinley T34 syringe pump with volume template
  • Click here to view Prescription and administration of medicines via subcutaneous CME/McKinley T34 syringe pump without volume template
  • Click here to view Continuation record for prescription and administration of medicines via subcutaneous CME/McKinley T34 syringe pump in primary care template
  • Click here to view Prescription and administration record of subcutaneous medicines for breakthrough symptoms in primary care template
  • Click here to view Explanatory notes
  • Click here to view training slides and speakers notes for primary care without volume
  • Clickhere to view training slides and speakers notes for primary care with volume
  • Click here to view training slides and speakers notes for secondary care without volume
  • Click here to view training slides and speakers notes for secondary care with volume