Self-administration of medicines (SAM)

We support patients to continue to take their own medicines whilst in hospital, as they normally would do at home. This initiative is called self-administration of medicines or 'SAM'. 

There are multiple benefits of self-administering medicines whilst in hospital. These benefits include:

• remaining independent with managing your medicines.
  
  
• learning more about your medicines, how they should be taken and understand any changes to them.
  
  
• supporting you to more easily manage your medicines when you leave hospital.

What does it involve?

A member of the nursing or midwifery team will assess you to make sure you are able to self-administer your medicines safely. They will check:

• the reason for your stay in hospital.
  
  
• if you are currently well enough to self-administer your medicines.
  
  
• how you usually take your medicines at home.
  
  
• if you have any concerns with self-administering your medicines in hospital.

If you choose to take part in the scheme, your nurse will:

• explain the process in more detail. This will include storage arrangements for your medicines and which medicines you will self-administer.
  
  
• give you a key/fob/code to your bedside medicines' locker.
  
  
• give you a Medicines Information Sheet. This lists the medicines you are prescribed and explains when and how to take them. If a dose or a medicine changes, you will be informed, and your Medicines Information Sheet will be updated.
  
  
• order extra medication from the hospital pharmacy if you start to run out.
  
  
• check with you regularly throughout the day that you have taken your medication and they will document it on your health record. It is important we have an accurate record of the medicines you have taken as they may need to be reviewed if you become unwell. 

Do I have to self-administer my medication?

No, this scheme is not compulsory, and it is your choice if you do not feel ready to self-administer your medicines. You can also change your mind and exit the scheme at any point – please tell the nurse or midwife looking after you and they will give you your medicines in hospital. This will not affect your treatment. 

Even if you do not take part in the scheme, you will still receive information about any new medicines.

What happens if I cannot self-administer my medication?

As your needs change during your stay, it may become necessary for the nurse to take over the administration of your medicines for a short time. Wherever possible you will be involved in this decision. Additionally, not all our wards are able to support the scheme and so you may not be able to continue with self-administering if you move to another ward. Again, the nurse will be able to give you your medicines instead.

Storing your medicines whilst in hospital

Medicines, if not used properly, can be dangerous. It will be your responsibility to keep these locked away in your bedside medicines' locker. If any of your medicines require special storage, such as fridge items or controlled drugs, these will not be stored in your bedside medicines' locker - a nurse or midwife will support with administration of these specific medicines.

Some specific medicines do not need to be locked away on adult wards, but staff will inform you if this applies to any of your medicines. Please note, all medicines must be locked away on children's wards.  

Self-administering insulin for patients with diabetes

Insulin and your needles must be locked away when not in use. The 'in-use' insulin pen/cartridge will be kept in your bedside medicines locker for you to access. Any additional unopened insulin will be stored in the fridge on the ward. Please ask the nurse if you need a new pen/cartridge from the fridge. 

Make sure you have a supply of needles and that you put your used needles into a sharps bin. 

If during your hospital stay you are using your own blood glucose meter or the type of glucose monitoring devices where a sensor is attached to your skin (continuous glucose monitor (CGM) or flash monitor), you can continue to monitor your glucose levels but we ask that you let a member of staff monitor your blood glucose at least twice a day with the hospital machine and more frequently if you are acutely unwell or on an intravenous insulin infusion.

Illness can affect blood glucose levels. If your levels are high or low for you, please let a member of staff know. 

We recommend you keep some suitable snacks or ‘hypo’ treatment with you, in case of low blood glucose. Sugary snacks and drinks are available on the ward if you ask a member of staff. Please let staff know if you have had to take any treatment for a high or low blood glucose.

What if I make a mistake?

The nursing team are available to support you. Always ask your nurse if you are unsure about how to take your medicines.

If you forget to take a dose or take a different dose to that written on the Medicines Information Sheet, please tell a member of the nursing or midwifery staff immediately. 

Preparing to go home (discharge)

If you have any questions regarding your medicines, please ask one of the nursing staff, doctors or a member of the pharmacy team.

Do not remove your medicines from their locker when you are going home until a member of staff has checked your medicines and handed over your discharge letter.

Please return your key or fob to your nurse before you go home. If you forget, please return it to the ward as soon as possible.

Your responsibilities if you or your carer self-administers

Here are some tips to help keep yourself and those around you safe.

Do:

• allow a member of nursing or pharmacy staff to check all your medicines and your medicines locker during your stay.
  
  
• check all your medicines and your bedside medicines locker before you go home.
  
  
• return your bedside medicines storage key or fob before you go home.

Tell the doctor, nurse, midwife or member of pharmacy staff:

• if you have new side effects.
  
  
• the dose that you have taken for any medicines where the amount changes (e.g.  insulin) or for medicines that you only take 'when required' (e.g. some pain relief).
  
  
• if the instructions on the medication label do not match the Medicines Information Sheet.
  
  
• if you or your carer have any problems taking or giving your medicines.
  
  
• if you or your carer cannot find your bedside medicines locker key or fob.
  
  
• if you do not have much left of a medicine. Extra medication can be ordered from the hospital pharmacy.
  
  
• if a visitor or another patient tries to take your medicines.

 

Don't:

• do not take more medicine than the dose on the label.
  
  
• do not take any medicine that you are unsure about- ask your nurse.
  
  
• do not store anything apart from your medicines inside your bedside medicines' locker.
  
  
• do not leave your bedside medicines locker unlocked, even for a short time.
  
  
• do not give your bedside medicines locker key or code to another patient, family member or visitor, unless they are your designated carer.
  
  
• do not share your medicines with anyone else, under any circumstances.

 

Further questions

If you have any questions about your medicines whilst you are in hospital, please speak with your nurse, doctor, or pharmacy staff on the ward.

If you have any questions about your medicines once you have been discharged from hospital, you can contact the ward or hospital pharmacy department via switchboard. Alternatively, you can discuss your medicines with your community pharmacist or GP.