Medication rules in Belgium¶
The medication circuit of WideCare — treatments, pillboxes, the round — asks a few questions that each country answers. In Belgium, the answers come from federal law and install themselves with the Belgian pack and the medication circuit.
The CNK code¶
The CNK Code is the national code of a medicine package, the one a Belgian pharmacy finds a medicine by.
It appears on the medicine record, after the strength, in the catalogue list and in its search, with the With CNK filter.
The BCFI URL sits next to the SmPC and the leaflet, in the Official Documents tab.
The stock product made from a medicine carries its CNK as internal reference.
The CNK is filled in from SAM: see The SAM medication database.
Who may give what¶
Giving a medicine is a nursing act (royal decree of 18 June 1990). A nurse or a physician gives everything. A care assistant gives, under a nurse’s delegation, the medicines a nurse or a pharmacist prepared (royal decree of 12 January 2006 as amended on 27 February 2019):
by mouth (sublingual and inhalation included), rectally, as eye or ear drops, on the skin;
under the skin only for a medicine ticked SC Injection Open to Care Assistants in the catalogue (fractionated heparin);
never a narcotic (a medicine marked Controlled Substance);
never a dose prepared at the moment (Prepared at the Moment on the treatment: a syrup measured, a powder dissolved) — it is a preparation, so a nurse’s.
On the employee’s record, Medication Acts says which list a care assistant follows:
Prepared medicines, every route of the list of 2019 (150 h) — the default;
Help with the oral intake only (list of 2006) — by mouth only.
When a care assistant may not give a dose, the care app shows the reason in place of the buttons (A nurse gives it: a narcotic is never given by a care assistant, for instance), and WideCare refuses the record, even sent later from the phone.
With the pillboxes tracked
When Track the pillboxes is on, a care assistant gives only a dose that was prepared and checked without an issue. See Pillboxes and the pharmacy’s sachets.
The pharmacy’s sachets (PMI)¶
The individual preparation of medication (PMI) is the pharmacist’s act: the pharmacy prepares the medicines in a sachet per resident and per moment (royal decree of 24 September 2012, FAMHP guideline of October 2013).
Fourteen days from the delivery¶
The sachets are used within fourteen days of the delivery (art. 6). The delivery’s Use By date is computed so: when the last day falls on a weekend or on one of the ten legal public holidays, it moves to the next working day. The care app shows the same date when the sachets are received.
Past that date, the delivery shows a red banner, its doses still to give are blocked, and the Past the Use-By Date filter finds it. A nurse prepares the doses again, or a new delivery takes them; the old sachets go back to the pharmacy and are listed on the return slip.
What stays with the house¶
The pharmacy’s sachets leave out what the guideline keeps out of them (2.1): a split tablet — written as ½ tablet, 1/2, half, or as a part of a tablet such as 0.5 tablet — stays the house’s to prepare. The treatment says so under Out of the Sachets Because. What goes back to the pharmacy is never given again (annex 2.6).