Drugs & Poisons Controls in Victoria

Common questions

This page answers common questions about changes to provisions for management of medicines administration in residential aged care.

What are the changes?

There are two changes, as set out in New arrangements for management of the administration of medicines in residential aged care – overview:

• The wording of Section 36F of the Drugs Poisons and Controlled Substances Act 1981 has been changed to refer to the Nursing and Midwifery Board of Australia instead of the Nurses Board of Victoria
• The former 'Code for Guidance – Management of the Administration of Medications to High Care Residents in an Aged Care Facility' (The Code) has been repealed.

Registered Nurses will continue to be responsible for managing the administration of medicines to high care residents, including making delegation and supervision decisions in accordance with professional practice guidelines and ensuring that appropriate supervision and monitoring arrangements are put in place and followed.

When did these changes come into effect?

The legislative amendments came into effect on 1 July 2010. The former 'Code for Guidance – Management of the Administration of Medications to High Care Residents in an Aged Care Facility' (The Code) was repealed by the Nurses Board of Victoria with effect from 31 May 2010.

What medications are covered by this legislation?

The legislation applies to all medications for which a prescription is required, namely Schedule 4, 8 and 9 medicines, where they have been prescribed by a medical practitioner (or other authorised prescriber) and dispensed by a pharmacist (or the prescriber).

These are medicines that most adults outside of a residential aged care service would usually administer themselves. For all ‘high care’ aged care residents, a Registered Nurse must manage the administration of these medicines.

The residential aged care service should have quality and safety systems and protocols in place to assure quality and safety in administration of all medicines including over-the-counter and complementary medicines.

Who can administer medicines to ‘high care’ residents?

Registered Nurses are required to manage the administration of medicines to ‘high care’ aged care residents. Administration may be delegated to someone appropriately qualified to administer medicines. This means that nurses will use their professional judgement about whether to administer the medicines themselves or whether to delegate the administration to someone with appropriate qualifications.

Can personal care workers administer medicines to high care residents?

Personal care workers with appropriate medication administration training may be competent to administer medicines with appropriate supervision arrangements as determined by the managing Registered Nurse. If a nurse judges that a personal care worker is not appropriately qualified to administer to a ‘high care’ resident they would administer the medicines themselves.

Why can’t an enrolled nurse (Registered Nurse Division 2) manage the administration of medication?

Enrolled Nurses may administer medicines under the direction of a Registered Nurse. However, the legislation does not allow them to manage the administration of medication.

Can an enrolled nurse supervise the work of another worker who is administering medication?

Yes, the Registered Nurse who is managing the administration of medication to residents could delegate the routine supervision of other workers to an Enrolled Nurse, within the medication management plan that they have determined.

What are the minimum supervision requirements?

The legislation does not prescribe any particular supervision arrangement. Decisions about the supervision of delegated tasks within the medication administration process must be made by the nurse managing the process, in accordance with professional guidelines for supervision and delegation.

The Nursing and Midwifery Board of Australia (the body that has been responsible for professional standards for nurses since 1 July 2010) is considering adoption of the document Delegation and Supervision for Nurses and Midwives, developed by the Australian Nursing and Midwifery Council and adopted by the nursing profession after considerable consultation. The Nursing and Midwifery Board of Australia has sought feedback on its proposal to adopt that and other documents.

The document will be available on the Nursing and Midwifery Board of Australia website

Who will be held accountable if a nurse delegates a medication administration task to a non-nurse and something goes wrong?

As in all other aspects of nursing professional activity, a nurse is accountable for their professional decisions and actions. A nurse must demonstrate that delegation decisions have been properly made in accordance with professional practice guidelines and that appropriate supervision and monitoring arrangements have been put in place and followed. The worker to whom a task is delegated is also held accountable to the extent of their training and for following the systems and procedures required.