Creams, patches, inhalers, eye drops and time-critical formulations

Medicines are not only tablets. Care staff may support creams, ointments, patches, inhalers, eye drops, ear drops, liquids, sprays, thickened fluids, rescue medicines, insulin (under delegated arrangements), or medicines given by visiting nurses.

Different formulations require different checks. The route affects how a medicine works and its risks. Staff must only support routes and use devices for which they have been trained and assessed as competent.

Practical formulation checks

• Creams and ointments: record which product was applied, when, where and how much if specified, and who applied it.
• Emollients: consider fire risk where product builds up on clothing, bedding or dressings and follow the risk assessment.
• Patches: apply to the correct site, rotate sites, remove old patches, record the location and check patches remain in place.
• Heat and patches: fever, hot baths, heat pads and electric blankets can increase absorption for some patches.
• Inhalers: check the person has the correct inhaler and spacer, and support the technique required by the care plan.
• Eye drops: check which eye, the spacing between drops, expiry after opening and whether refrigerated storage is needed.
• Liquids: use the correct measuring device, such as an oral syringe for small doses, and avoid household spoons.
• Rescue medicines: know where emergency medicines are stored, who may give them and when urgent help is needed.

Specialist routes and delegation

The route is part of the prescription. Tablets, patches, drops, inhalers, creams and liquids each need the right technique and record.