Losing Control - A Way With Words - Reflections (CD)

See Appendix 8 for 3 monthly controlled drug check report. The practitioners administering the controlled drug must verify that the appropriate prescription requirements are in place and independently check appropriate details at the controlled drug cupboard. Checks relate to:. The CD register should be completed with the following details:. Where only part of an ampoule containing a CD is used, the Registered Nurse of Midwife should record the amount administered and the amount discarded.

This should be witnessed by a second Registered Nurse or Midwife who should also sign the record. Both practitioners complete the controlled drug register, signing at the time the drug is removed from the cupboard, verifying the drug and dose - the practitioner administering the drug signs the 'given' column. Details of the amount of drug given and discarded for use of part of an ampoule will be witnessed by both practitioners.

If it is indicated that a controlled drug needs titrated, the dose given and amount discarded will be documented in the register following administration. Any controlled drug discarded is done so in line with Section 8. Packaging is not discarded until the bedside check has been completed.

Both practitioners sign the TPAR alongside the date and time of administration, verifying that the controlled drug has been administered correctly. Two suitably qualified healthcare practitioners one of whom should be a Registered Nurse must be involved in the administration of CDs and both must be present during the whole of the administration procedure.

This is a two step process, step one is the check at the drug cupboard, step two is the check at the patients bedside. Liquids should be rendered secure by use of a self-setting compound such as Pre-Gel or equivalent.

Tablets should be crushed, where possible and capsules should be opened prior to disposal. Used medicated patches may still contain a small quantity of active drug and should therefore be folded in half and disposed of in a pharmaceutical waste bin generally blue lidded.

Controlled drugs which have expired or are no longer required stock or patients own must not be returned to pharmacy. When a patient is discharged to another care facility, e. Where patients are being transferred home with syringe pumps attached it is essential that there is timely transfer of information to the services who will be responsible for ensuring continuity of care, e.

Back to top. Management of Controlled Drugs in wards and departments : Accountability and responsibility The Registered Nurse or Midwife in Charge of a ward or department is responsible for the safe keeping and management of CDs in that area. The Registered Nurse or Midwife in charge may delegate related tasks to another Registered Nurse or Midwife, however legal responsibility remains with the Registered Nurse or Midwife in charge. Management of Controlled Drugs in wards and departments : Requisitioning Controlled Drugs The Registered Nurse or Midwife in charge of a ward or department is responsible for the requisitioning of CDs used in that area.

The responsibility for ordering CDs can be delegated to another Registered Nurse or Midwife, however the legal responsibility remains with the Registered Nurse or Midwife in charge. CD order books must be stored in a locked cupboard. Drug name, form, and strength and ampoule size if more than one available. Total quantity required in dosage unites e. As a matter of good practice and whenever possible, the person ordering the medicine should be different to the person receiving the medicine in to stock, this separation of duties helps create a more thorough audit trail.

Any discrepancy must be reported to the Specialist Pharmacy Technician or Senior Pharmacist in the dispensary immediately. Details of the receipt of the CD must be entered into the Controlled Drug Register: There must be a designated page for each medication, form and strength.

Entries in the Controlled Drug register must be made in ballpoint pen. The stock balance in the register must be checked against the stock in the Controlled Drug Cupboard. This is particularly important for wards and department that are not operational at all times. Management of Controlled Drugs in wards and departments : Record Keeping Entries made in to the CD register should be made in chronological order and in ballpoint pen.

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The lyrics go something like this,". Trying to forget the fact that I hold this burden, you were never mine but I felt certain that I could be the one you've been keeping around. I guess I was the one to think I'm worth it, you new all along id be another person to get back in town?

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Been searching google and using sound hound etc but can't seem to find it. Please I am looking for a song that has the lyrics. Pls who knows the song with the lyric "I'm a prisoner in my head I tried not to listen but the voice is plenty".

Since then, I have so often upgraded my system's components and so many times changed the whole system that these memories are nearly gone now and details once blazingly clear faded slowly away. It may have been helped by my subsequent delightful experiences - I was lucky that my passion for music became passion for high quality music playback, and then a way of life and making a living.

For more than twenty years I have been professionally involved in audio. First, I worked in professional audio as a sound engineer in a theater, at concerts and in the recording studio, and then I became involved in home or audiophile audio. During all this time, I have auditioned and reviewed so many products used for sound reproduction that I lost count long ago.

However, I do not think of myself as a jaded journalist who is insensitive to what he is doing. For me, these two things are inseparable. When it comes to equipment for a long time already experiencing but not so big surprises, revelations, glare, as at the beginning.

Until recently In recent times I have had a couple of mystical experiences that provided a solid framework for my thinking about what is possible in the audio world. The third, actually the earliest chronologically, were my experiences with the Studer A The source that was presented by Raveen sells for over a hundred and fifty thousand US dollars, including a rack and necessary cables.

The only thing that matters are the sound and build quality, brand, finish and customer service. The dCS sounded insanely good. It was the best sounding digital system I ever heard. The experience was so strong that it redefined my understanding of the capabilities of such a limited format as the Compact Disc. That's right, I said CD. Yet it was the CD that sounded so spectacular that all of us present during the audition were truly shocked. We listened to a lot of audio files only to agree that it's still not the kind of technology that could compete head-to-head with the CD.

Even Raveen confirmed that. The difference was clear and large, not to the audio files advantage. This may change sometime in the future, but not just yet. We did not listen to SACDs. It is a proven format backed by many years of development, which has finally matured to become the high-end.

And it has its own problems. There have been, however, several players that provided satisfying enough SACD playback to shake my seemingly firm belief. One of them was the Mark Levinson No. It offered superb build quality and exceptionally smooth sonics that did not turn the sound of SACDs into a warm mush, nor made them into super-precise and perfectly focused hi-res PCM recordings.

Built with precision typical of this manufacturer yet maintaining a healthy engineering sense, it offered a sound that I found interesting not only for its own sake, but also because of how it built up on everything that the company achieved previously.

The first product in this series was the C preamplifier, but it was the two-piece player and the A monoblocks that brought a noticeable change in the paradigm of thinking about sound. All these changes were then consistently introduced to less expensive products. The DP is the latest example of them. Maybe that's why it is so mercilessly heavy.

Mechanical design is just as important for the Accuphase engineers as electrical design. No money is spared here, although high structure stability and vibration control is not the result of some sophisticated hi-tech methods but rather reliable techniques that have been tried and tested in turntable design.

Instead, as I was told some time ago by Mr. Jim S. Saito, current Chairman of the Board, the company focused on the laborious and expensive process of component selection. As he said, it yields better results than using better quality components with wider parameter variation.

It is no coincidence I have mentioned a turntable. Its mechanical design is extremely sophisticated. The most important part of it is the platter and its air bearing. It seems to me that similar conclusions to those reached by Mr. Masaomi Suzuki. He is an engineer employed by Accuphase for the sole purpose of developing company's digital branch. He joined Accuphase in The company's management immediately realized that the new digital audio format would change the world forever.

The importance of digital source for the company product lineup is demonstrated by the fact that Mr. Suzuki is currently the head of Accuphase's design department. If we look more closely at the player under review, we will see many analogies between the DP and top end turntables. I have already mentioned its heavy, rigid, multi-layer enclosure. Add to that a complex power supply. The most important to me, however, is the drive, which is equivalent of the platter and tonearm with cartridge in a turntable.

Accuphase belongs to the elite club of companies that manufacture their drives in-house. While a trained eye will detect the characteristic blue optics, known from Sony designs, everything else is the work of Accuphase engineers. The company literature focuses on this design aspect and describes it this way:. The digital section is of course equally important. Here, too, Accuphase presents something unique for this company, dedicated to the best possible DSD decoding. As we read in the company literature, the 1-bit DSD signal is first upsampled by the factor of two, from 2.

Then the timing of the 1-bit signal is shifted progressively in increments of nanoseconds.

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