Video

Nursing associates administering drugs and IVs

Watch the recording of this webinar and hear how employers are enabling their qualified nursing associate colleagues to administer drugs and IVs.

2 August 2023

Watch the recording of this webinar and hear how employers are enabling their qualified nursing associate colleagues to administer drugs and intravenous (IVs).

This is an opportunity to hear employers share their successes of using the role and the second in our series of webinars celebrating how nursing associates have contributed to the NHS workforce supply.

Speakers

  • Wendy Fowler, Nursing Education Adviser at the Nursing and Midwifery Council, provided an introduction to medicine management guidance and how qualified nursing associate colleagues can scale up to do this.
  • Lyndsay Murden, Lead Nurse at Leeds Teaching Hospitals NHS Trust, discussed how their trust has implemented qualified nursing associates administering drugs and IVs.
  • Julie Bruce-Watt and Maria Smith, job share the role of Head of Professional Education at Gloucestershire Hospitals NHS Foundation Trust shared the work they are doing within their trust to explore the need for nursing associates to do IV administration and how they plan to implement it.

Download a copy of the slides and watch the recording of the webinar below.

Answers to the questions asked as part of the webinar

Wendy's answers

  • The Standards of Proficiency for Registered Nursing Associates (2018) does not include the administration of intravenous drugs as a skill required by nursing associates at point of registration.

  • We don’t regulate post-registration skills training or continuing professional development. You will need to speak with your employer who will be responsible for the provision of appropriate education and training for nursing associates seeking to learn new skills safely and effectively and as part of their agreed scope of practice.

  • The Standards of Proficiency for Registered Nursing Associates (2018) sets out the minimum requirements of what a student nursing associate needs to know and be able to do to register with us. These proficiencies include: the administration of injections using subcutaneous and intramuscular routes and management of injection equipment and any restrictions on this practice will be a local policy decision. 

  • Nursing associate trainees are currently not listed as a qualified healthcare professionals able to supply and administer under a PGD. Any changes to the legal framework for PGDs would need to be made by government. The guidance on PGDs and their current framework can be found on the government website.

  • All nursing associates are required to achieve the knowledge and skills described in our Standards of Proficiency for Registered Nursing Associates (2018), which details the requirements for safe and effective practice for nursing associates at the point of registration. While intravenous drug administration isn’t included in our nursing associate proficiencies, this doesn’t prevent nursing associates from undertaking post registration training in order to develop additional skills, as part of developing their scope of practice and this should be considered when undertaking revalidation every three years.

  • The Standards of Proficiency for registered Nursing Associates (2018) sets out requirements of what a student nursing associate needs to know and be able to practise safely and effectively at point of registration. A student nursing associate must meet all of the proficiencies to be able to register with us. 

    These proficiencies include: the administration of medicines via oral, topical and inhalation routes, administration of enemas and suppositories and injections using subcutaneous and intramuscular routes and management of injection equipment and any changes to restrictions on this practice will be a local policy decision.

  • The requirement for a single or double check is a local policy and it is for employers to decide appropriate governance and risk assessment around this.

  • The Standards of Proficiency for Registered Nursing Associates (2018) does not include the administration of intravenous drugs as a skill required by nursing associates at point of registration, it would be for the university to decide whether to go beyond this.

Lyndsay's answers

  • We would only allow a flush not prescribed when the cannula is inserted. If a flush was needed at any other time then it would need to be prescribed and the practitioner be IV competent.

  • They cannot administer IC controlled drugs or chemotherapy.

  • No, not at the minute.

  • We are just updating this, so I will share once finalised.

  • No.

  • They attend the IV study day at 6 months post qualified and also have a competency booklet to complete.

  • We are discussing this internally at the moment.

  • At the moment there are no issues as we are just defining the RNA role and how this fits in to the ward team.

  • They do IV training at 6 months post qualifying.

  • The administration of medications is a process and this should be followed, there are some elements of assessment and we are currently reviewing this.

Julie and Maria's answers

  • No, we have always had posts for our TNAs who wish to stay with us at the end of their programme.

  • At the moment, it would be any chemo drugs, PGDs and CDs. We are exploring some IV drugs currently.

  • Yes, we are speaking to our partners about our competency review but I anticipate that any further learning will be done within the trust.

  • Yes, they are allocated their own patients but they always work with a RN to allow that oversight and guidance they require as per their Scope of Practice.

  • We applied for HEE funding and have received £8,300 per TNA per year.

  • We recruit 2-3 times a year and we use the apprenticeship standards. For those HCA’s who have completed this apprenticeship, we offer an interview for the TNA programme.

  • Our NAs will be band 4s for the 2 year programme.

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2023 Update

We spoke to Gloucestershire Hospitals NHS Foundation Trust in July 2023, to understand how they have developed their nursing associate recruitment since 2021, and how they are supporting them to administer IVs.  

Gloucestershire Hospitals NHS Foundation Trust continue to work with their local provider, the University of Gloucestershire, to recruit and train nursing associates (NAs). They have expanded the programme to cohorts of around 35 to 40 candidates twice per year. There is huge demand for places, with the January 2023 cohort receiving 115 applicants. They have since opened the programme externally. For external candidates, enthusiasm and a strong understanding of the NA role is vital. The trust now has NAs in most clinical areas across all their acute sites, apart from oncology and maternity. 

NAs continue to move onto the registered nurse degree apprenticeship (RNDA), which they fund internally as the Health Education England (Now NHS England) funding has been paused. They proactively contact all eligible NAs inviting them to express their interest in the RNDA. However, uptake has been lower than expected for several reasons, including candidates independently starting a Nursing BSc, not feeling they have spent enough time in the NA role or conflicting family priorities.  

NAs gave feedback about how not being able to administer IVs is preventing them from offering best patient care. So, the trust is developing IV training for NAs at a considered pace, to ensure they have stayed abreast of legal requirements and good practice across the system.  A six-week trial starts across four clinical areas in July 2023, with results being fed into the Nursing & Midwifery group with the expectation that in due course this can be expanded across the trust. If administration of IV’s introduced, it will be proposed that all new NAs will do IV training with the nursing and midwifery cohorts. For current members of staff there is a discussion ongoing for an opt-in process, with the hope that the positive impact for apprenticeship cohorts will impact on the wider workforce.

To ensure that the NAs have a good theoretical training the trust looked at the current learning materials offered by University of Gloucestershire which showed that the NA apprentices had a basic grounding in IV administering, which they then supplemented with content from their adult nursing training. The NAs are supported in this journey by being on a preceptorship programme with allied health professionals and nurses, which helps break down barriers and builds relationships within a multidisciplinary team.