A PDF version of this Standard can be downloaded here.
Introduction
Physiotherapists administering prescription medicine is a delegation of care, which carries risks and responsibilities for both the authorised prescriber who is delegating and the physiotherapist who is administering. Although most instances of physiotherapists administering medicines occur within hospital settings for example with nebuliser administration, other instances may include team sports physiotherapists or physiotherapists working in inter-professional settings.
Physiotherapists are frequently asked about medication by their patients. Specific information on this topic can be found in the ‘Physiotherapists adminstrating prescription medicines standard’.
New Zealand law
Prescription medicine can only be administered to a person either:
(a) in accordance with a prescription given by an authorised prescriber, designated prescriber or delegated prescriber; or
(b) in accordance with a ‘standing order’.
Medicines Act 1981, s 3(c) (i)(ii)
‘A standing order is a written instruction issued by a medical practitioner [doctor] or dentist. It authorises a specified person or class of people (e.g. paramedics, registered nurses) who do not have prescribing rights to administer and/or supply specified medicines and some controlled drugs. The intention is for standing orders to be used to improve patients’ timely access to medicines. It is an offence to fail to meet the requirements of the Medicines (Standing Order) Regulations. The Ministry of Health may, from time to time, audit any standing order.’
Ministry of Health, 2012
Physiotherapists administering medicines must comply with the Medicines Act 1981. They must be experienced physiotherapists with appropriate pharmacology training for their area of practice. Physiotherapists administering medicines via injection must have appropriate, relevant and recognised education and training for their area of practice and ensure they have professional support and mentoring structures in place in order to meet their professional and ethical obligations.
Physiotherapists are included as a ‘specific person or class of people’ in the Medicines (Standing Order)
Regulations 2002, s4(2). As persons engaged in the delivery of a health service, physiotherapists are currently authorised to administer and/or supply medicines under standing orders.
NZ Government Medicines Regulations (Standing orders) 2002
Physiotherapists, working in accordance with their scope of practice under the Health Practitioners Competence Assurance Act 2003 (HPCAA), need to ensure their patients receive safe and appropriate evidence-informed treatment.
1. Prescription medicine administration
1.1. Physiotherapists administering medicine understand that public safety is paramount. If there is any doubt or concern regarding any part of the medicine administration, they must seek help and advice from a suitably qualified colleague.
1.2. Physiotherapists administering medicine in accordance with a prescription given by an authorised prescriber, designated prescriber, or delegated prescriber must:
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- ensure that instructions from the prescriber are clear and unambiguous
- ensure that you are able to communicate with the prescriber if necessary
- keep comprehensive, up-to-date, accurate, and legible documentation of care given
- debrief with the prescriber on a regular basis and on completion of the prescription
1.3. Physiotherapists administering medicine in accordance with a prescription given by an authorised prescriber, designated prescriber, or delegated prescriber must:
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- not deviate from the prescription
- ensure that administration via injection is only undertaken by physiotherapists who have completed appropriate, relevant and recognised education and training for their area of practice
2. Standing order medicine administration
2.1. Physiotherapists administering medicine via standing orders must:
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- make sure of their legal obligations by thoroughly understanding the regulations and guidelines
- ensure that instructions from the prescriber are clear and unambiguous
- not deviate from the standing order
- ensure that you are able to communicate with the prescriber at all times
- keep up-to-date, accurate, and legible documentation of care given
- debrief with the prescriber on a regular basis and on completion of the standing order
- maintain appropriate competencies, as determined by the prescribing doctor, and be aware of their limitations.
3. Nicotine replacement therapy
The Ministry of Health has developed an online certification for the prescription of Nicotine Replacement Therapy (NRT) by health professionals. If a physiotherapist intends to prescribe NRT, they must undergo the ABC smoking cessation training module available on the Quitline website.
Related resources
Anderson L. (2011). Physiotherapists administering medications under instruction. British Journal of Sports Medicine Online.
Anderson L. (2010). Travelling light – sports physiotherapists administering medications in the absence of a doctor. New Zealand Journal
of Sports Medicine, 37 (2), 38-42.
New Zealand Legislation Medicines (Standing Order) Regulations 2002
New Zealand Legislation Medicines Act 1981
Ministry of Health Standing Order Guidelines