Controlled Drugs Administration and Storage
Controlled drugs (such as opioids) require strict handling: secure storage, double-checking, accurate documentation in the controlled drug register, and witnessed administration.
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What you must know about Controlled Drugs
Controlled drugs must be stored in a locked cupboard within a locked cupboard (double lock).
Two nurses check and witness the administration and wastage of controlled drugs.
Every dose is recorded in the controlled drug register with running balance.
Discrepancies in the register must be reported immediately.
If the dose is unclear or the register does not balance, do NOT administer — verify first.
Wastage of any portion must be witnessed and documented by a second nurse.
NMCN Exam Tips
How this topic appears in the NMCN exam
When a prescription or register is unclear, the FIRST action is to verify — never administer.
Controlled drugs always require a second nurse to witness.
Double-locked storage is the standard for controlled substances.
Documentation and running balance in the CD register are heavily tested.
Practice Question
Test yourself
A nurse is about to administer morphine but notices the controlled drug register balance does not match the stock. What should the nurse do FIRST?
Explanation
A discrepancy in the controlled drug register must be reported and investigated before any further administration. Safety and accountability require that the nurse does not administer until the discrepancy is resolved.
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