Self administration of Parkinson’s medication: a guide for hospital staff
A guide to support senior pharmacists and nurses in developing a self administration policy to improve the delivery of time critical medication.
- Inpatient care and medicines management
- Publications
- Nurse (other)
- Nurse (Parkinson's nurse)
- Pharmacist
About this guide
This guide has been developed by healthcare professionals in the Parkinson’s Excellence Network. It aims to support senior pharmacists and nurses in developing a self administration policy for their hospital to improve the delivery of time critical Parkinson's medication.
Developing a self administration policy is a complex project and we hope these example policies will help to inform discussions in your organisation. It’s important that the policy is ratified in line with your organisation’s safety and quality framework and has an executive sponsor. Once adopted the policy should be reviewed regularly.
Any policy will need to be adapted to your organisation’s procedures and systems with consideration of medicines safety, storage and documentation.
Why self administration?
Patients with Parkinson’s are at risk of significant harm if they don’t get their medication on time, every time. ‘On time’ means within 30 minutes of the patient’s prescribed time. Even short delays can worsen symptoms such as rigidity, pain and tremors, increasing the risk of falls. Delays can also increase the risk of aspiration, cause stress, anxiety and issues with swallowing.
Many people with Parkinson’s can and do take their own medication daily. We believe that people with Parkinson’s who want to manage their medication in hospital should be allowed to, provided they're well enough and have been assessed as safe to do so.
The NICE quality standard for Parkinson’s states that people with Parkinson’s admitted to hospital should be assessed for self administration of medication. Read the NICE quality standard (PDF, 140KB).
The NHS Specialist Pharmacy Service (SPS) says the benefits of self administration schemes include:
- making care more person centred and improved patient satisfaction
- promoting independence and self care in a safe place while reducing the risk of incorrect administration
- improved understanding of a person’s medication, improved adherence with their medication schedules, decreasing the chances of a future medication related admission
- helping people and their care partners to prepare for leaving hospital, aiding decisions about what is needed by the person when they return home.
A Parkinson’s UK survey of people with Parkinson’s found that 48% of people with the condition who are admitted to hospital want to manage and take their own medication.
Patients must be regularly assessed for their suitability to self medicate. Ward staff should also be supported and feel confident to allow patients to self medicate.
On a busy ward, self administration can play a role in freeing up nurses to do other important tasks.
Example self administration policies
This 18 page document sets out the trust's policy and procedures for the self administration of medicines for patients and the roles of hospital staff, including the medicines management team, in delivering this policy. The policy covers 3 levels of administration.
This 25 page document sets out the trust's self administration procedure and the roles of hospital staff in delivering this policy. The policy covers 3 levels of administration.
These self administration policies have been reviewed by a panel of nurses and pharmacists and have been selected as best practice examples. Last reviewed in April 2024.
Basic principles for self administration
Implementing self administration at your hospital doesn’t need to be complicated. The following principles may be helpful to guide your thinking about how to put a safe policy in place for your patients. This will vary for different hospital settings and the context of the patient.
Take a multidisciplinary approach and work with key stakeholders including your medicine safety officer (MSO), pharmacists, and nurses to gain an organisation wide commitment to self administration.
Make sure your policy has an executive sponsor and is ratified at a senior level, in line with your organisation’s safety and quality framework.
Your policy should set out clearly:
How you'll:
- identify patients who are on time critical medications
- check that medications are correct, in date and belong to the patient
- assess patient suitability including a mental capacity assessment
- safely store medications (for example, lockers)
- allow self medication by a family member or carer, where appropriate
- manage self administration and discharging patients.
Who is responsible for:
- the self administrating patient, for example, checking they are medicating safely
- recording that medication has been self administered, how this will be done, and when
- reassessing the patient if their condition changes, and when.
The policy should also state:
- that medication should be taken at the prescribed time
- any reasonable exceptions to this policy
- when the policy will be reviewed.
"My experience of self administration at Norfolk and Norwich Hospital was a positive one. I was on a number of medications both for Parkinson's and other medical conditions which needed to be taken at regular times. My request to self medicate was approved after a discussion with both the hospital pharmacist and nursing staff. We discussed the different medications and timetables, what each was for, and how to take them safely.
"The hospital ensured that my medications were kept in a locked cupboard next to my bed and that I was given my own key. The nursing staff gave me an information sheet showing all the medications and the times to take them as this was critical for Parkinson's and my other medical conditions.
"The nursing staff regularly monitored me during the ward rounds and asked if I was taking my medication and if I had any problems or issues.
"Being able to self administer allowed me to maintain my independence with medicine taking. It also helped to reduce my anxiety and stress regarding taking the Parkinson's medication on time and reduced my dependence on the nursing staff."
Katherine Shaw
Related resources
Visit these pages for further reading on time critical medicines administration: