W.04.03 Prisoner self-administration of medication

Self-administration of medication is a health process which is approved by health staff and managed according to the health [Self-Administration of Medication] procedure. This procedure is for prisoners with a demonstrated ability to self-manage chronic conditions, who are a low security risk and/or nearing the end of their prison term.

This enables prisoners to take an active role in their healthcare and be responsible for taking their own medication prescribed for their medical condition, instead of receiving it via the daily medication rounds.

It is important to note that not all prisoners will be able to self-administer their medication, and not all medications are included in this process.

W.04.03.01 Overview of health staff role

  1. The Health Centre Manager (HCM) or delegated Registered Nurse (RN) is responsible for ensuring that self-administration of medication by prisoners is planned and supervised to minimise the risk of harm to the person or any other person.
  2. Health staff manage the self-administration of medication process and are responsible for:
    1. Identifying candidates.
    2. Completing risk assessments to determine a prisoner’s suitability for self-administration of medication.
    3. Providing guidance for prisoners that are assessed as suitable.
    4. Undertaking monitoring and regular reviews of prisoners who are self-administering their medication.
  3. Health staff will enter into IOMS the appropriate alerts to ensure custody are aware of prisoners who:
    1. will be holding medication according to this procedure, and
    2. the amount of medication they can hold.

W.04.03.02 Role of custodial staff

  1. Custodial staff contribute to the health risk assessment process for self-administration of medication and are able to:
    1. report any concerns regarding potential for stand over behaviours, medication diversion and risks to the cell mate or others in the unit.
    2. consider situations when cell mates may be holding larger volumes of medication at any one time.
  2. To mitigate risks associated with the self-administration process in the prison, unit staff conduct business as usual activities of:
    1. supporting the timely administration of medication via medication rounds whilst ensuring the safety of all concerned.
    2. cell checks (daily).
    3. cell and facility searches (as required).
    4. prisoner searches (as required or on reasonable grounds).
    5. observations of prisoners undertaken in the unit.
  3. Any concerns regarding self-administration of medication raised by staff who have conducted these activities are to be escalated (refer [W.04.03 Escalation process] below).
  4. The general manager custodial is responsible for implementing a site plan for cell searches.
  5. Custodial staff immediately advise health staff when a prisoner who is self-administering medication in their unit, is scheduled for transfer to another prison.

W.04.03.03 Escalation process

  1. If custodial staff have concerns regarding any aspect of the self-administration process these are to be reported as soon as possible to a principal custodial officer (PCO) for escalation or escalated directly to a member of the health team.
IssueAction
Custody staff are concerned about a person who may be on a self-administration of medication contract.

Health staff are to be notified of any concerns that are related to medication as soon as possible.

If custody feel the concerns have not been heard, they are to notify the PCO who will discuss with the Health Centre Manager.

When there is no agreement, the General Manager Custodial and Health Centre Manager will provide a decision.

Custody staff are concerned that medication is being hoarded, diverted, or traded.
Custody staff have observed behaviour that may indicate an overdose or is behaviour not typical for a person.
Custody staff observe a person who takes medication from someone and either consumes it or holds on to it.

Refer to health staff if present or contact health team immediately to identify the medication taken and the risks with taking something that is not prescribed to a person.

For example, during a medication round a cellmate snatches medication from the nurse or cellmate. A risk assessment should be completed to determine if attempts to retrieve the medication is required depending on the risk to the person.