Understanding Patient Group Direction

Keywords: 1. Patient Group Direction 2. Patient groups 3. Prescribing treatment 4. Written instruction 5. Supply of medicinal drugs

The Patient Group Direction (PGD) is referred to the written instruction that allows sale, administration or supply of medicine to patient groups who may not be identified individually before presenting them to the treatment process (SPS, 2016). The mentioned concept of PGD which informs patients may not be identified individually is not to be interpreted as must not be determined (NHS, 2019). The use of PGD is not considered as any proper form of prescribing treatment to the patient. The administration or supply of medicinal drugs under the PGD is not able to be delegated (Bussey and French, 2017). The PGD is not to be considered as long-term means of supporting clinical condition for the patient.

Bussey, A. and French, K., 2017. A pan-London approach to patient group directions in sexual health services: from aspiration to reality. J Fam Plann Reprod Health Care, 43(2), pp.154-156.

Keywords: 1. Assessment and prescription 2. Care management 3. Pre-determined patients group 4. Administering specific medicines 5. Patient Group Direction

The purpose of Patient Group Direction (PGD) in care management is that it acts as a legal framework which allows few of the registered healthcare professionals for supplying or administering specific medicines to any pre-determined patients group. This is done by the registered health professionals without making the patients' avail assessment and prescription from a doctor or nurses who are regarded as the main prescriber of treatment for patients (GOV, 2017; NHS, 2019; Kaufman, 2015). Moreover, the purpose was also to increase the platform for wider range of health professional to show their skill for delivering care to patient in need.

Kaufman, G., 2015. Use of patient group directions in medicines management. Primary Health Care, 25(2).pp.12-32.

Keywords: 1. Intense side-effects 2. Fits the criteria 3. Patient Group Directions 4. Supply of PGDs 5. Assessment

The assessment, as well as evaluation, is essential for supplying and administration of Patient Group Directions (PGDs) so that proper medications are provided to the patients which do not lead them to develop any infection or intense side-effects that may negatively affect their health. In addition, the evaluation of supply of PGDs is significant so that it can be determined that if the patient who is included in the process properly fits the criteria being mentioned for PGDs (Christensen, 2015; NHS, 2019; SP6, 2017).

Christensen, M., 2015. Patient group directions: The application and integration of knowledge in advancing nursing practice. Journal of Nursing Education and Practice, 5(2), pp.103-109.

Keywords: 1. Production and expiry date 2. Details of all medications 3. Medication errors 4. Patient Group Direction 5. wrong administration

The drug errors which may occur during administration and supply of Patient Group Direction (PGD) include delivery of expired medication, wrong medication that does not fit the patient condition, wrong administration of medication and others (NHS, 2019). The risk management strategies to avoid medication error in PGD include:

The production and expiry date of medication before supply or administration to patients under PGD are to be checked to avoid medication error (NICE, 2017). This is because it would help to avoid supply or administering expired medication which is able to adversely affect the health of individuals.

The details of all medications to provided for patients under PGD criteria such as strength, name, dose, quantity, mode of administration and others are to be properly documented (NICE, 2017). This is because it would avoid the risk of wrong administration technique error as well as understand the amount of dosage being prescribed to the patients, in turn, resolving dosage form error where the patients are provided medicine that is of different dose instead of what is being prescribed.

In order to avoid medication errors, the details of the patients such as age, allergies, previous health complications, previous impact of medications being provided and the way the patients are meeting the criteria mention for PGD (GOV, 2017). This is because it would help to analyse the exact type of medication to be provided along with the mode through which the medication is to be transferred so that error which creates negative health condition of the patients can be avoided.

Keywords: 1. Patient Group Direction 2. Patient-specific direction 3. Requires time 4. Adversely affects 5. Health assessment

The advantage of using Patient Group Direction (PGD) over patient specific direction is that it reduces time and delay in treatment. This is evident as in patient-specific direction the patient requires time for making appointments with the health practitioners and the health practitioners takes time for assessment and analysis of the individual’s health condition based on which medication are then only prescribed that is often seen to be longer process (NHS, 2019). In addition, the benefit of using PGD is that it delivers effective patient care in pre-defined clinical condition without show comprises towards patient safety (Price et al. 2012). The disadvantage of using Patient Group Direction (PGD) over patient specific direction is that it creates medication error which in some cases adversely affects the patient’s health. This is because in this case the health assessment of the patients is not done and the medication provided may not be effective for proper treatment of the disease (NICE, 2017).

Price, O., Baker, J., Paton, C. and Barnes, T., 2012. Patient Group Directions: a safe and effective practice?. British Journal of Nursing, 21(1), pp.26-31.

Keywords: 1. Update and reauthorize 2. Review of PGDs 3. Changes in legislation, 4. upgradation 5. Reauthorise

The process of reviewing and updating PGD includes:

Establishment and management of structured work program that are to be dedicated to review, update and reauthorise the PGD (SPS, 2016)

Ensuring that a proper lead author who is supported by local multidisciplinary team has the role and responsibility to review and update the PGDs (NICE, 2017)

During review of PGDs, proper literature search is required to be organised to determine new evidence based on which PGD’s validity and reliability can be assured

Identifying the expiry date of individual PGD for each patient to ensure safety (NICE, 2017)

During upgradation of any PGD, it is to be made sure other related to documents are accordingly updated (NICE, 2017)

Determine changes in legislation, drug safety patterns, changes in local formula and others while reviewing PGD (NHS, 2019)

Keywords: 1. Agreement and documentation 2. Extensive researchers 3. Education requirement 4. Accountability 5. Patient Group Direction

The accountability fits into the professional practice regarding Patient Group Direction (PGD) as they include proper agreement and documentation of patient reference, develop declaration of any conflicting interest, establish proper medical documentation and make effective decision based on the criteria mentioned for PGD. These actions help the professional to avoid error in care in turn showing effective accountability in the practice of PGD (NICE, 2017). The education requirement for PGD include individuals who are qualified healthcare professionals such as nurses, pharmacists and others who have knowledge regarding the way care and support are to be provided to individuals for any disease (NHS, 2019). Thus, it makes PGD fit for professional practice as it does not include referring medication and care support to patient in an inappropriate manner by any random individual who does not have any information of knowledge regarding healthcare. The competence and evidence-based practice fit surrounding professional and legal framework for PGDs because proper training to professionals regarding the way to supply and administer PGD, as well as extensive researchers, are made by professionals who are administering PGD to ensure safe care to the patients (SPS, 2016).

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