The use of standing orders in the community for the administration of prescription medicines is generally discouraged. However, where standing orders are required in special circumstances, service providers should have policies and procedures in place for their use.
Standing orders provide a legal written instruction for the administration of medicines by an authorised person in situations where a prompt response using a standard procedure will improve consumer care and where a medicine is part of this procedure. A standing order is NOT a ‘when required prescription’ (PRN) for an individual consumer.
Where standing orders are required, for example in rural and remote areas and some immunisation programs, service providers should develop policies and procedures describing the development, authorisation, use and routine monitoring of the standing order. They must be in accordance with Australian, state and territory legislation and policy, and promote the quality use of medicines.
The decision to use a standing order is a clinical judgement and should be applied following an individual assessment in specific circumstances for an individual consumer.
All standing orders should be linked to a service provider’s policies and procedures that are relevant to standing orders. All protocols for the use of standing orders should require that the order:
- is condition specific;
- is supported by or linked to appropriate clinical assessments;
- is clearly written, with the name of the medicine, dosage, route and frequency;
- identifies precisely which patients are to receive the medication;
- clearly states under which circumstances those patients are to be given the medicine, and conditions which are to preclude its administration;
- notes any special observations or care which may be required prior to, or subsequent to the administration;
- is not only signed, but the name of the authorised prescriber is legible;
- is clearly dated;
- is time limited and subject to regular review, that is, the service provider has set a period for review of this type of order where there is no legal time limit;
- is current (within that date);
- identifies who, either by name or by qualification (eg RNs), may administer the medicine;
- is supported by appropriate education or training for authorised persons using them.