Medication Administration Class
Format for ClassMedicinesGiving themProving you gave themDoctors, Nurses and MedicinesCore CompetenciesSkillsAnd (Ahhhh) THE TEST
Protocol for Passing MedicationsMedication Class
Pass test with 75%
Why do we care?
Nursing Outcomes at CCSAspiration
Preventable ER visits
Six RightsRight MedicationRight DoseRight manner/routeRight timeRight personRight documentation
Right Medication A drug order is written for specific medication
Double check that youobtained the right drugYour responsibility:ObtainPrepareAdministerthe correct medicationCheck three times themedication containerto the MARRight medication
Right Dose Your responsibility it to confirm what dose within the dose range was orderedMake sure that the dose of the medication you are giving matches the MAR orderNever assume what dose of drug will be administeredYou cannot give a different dosage than what is orderedRight dose
Right Manner or Route Most drugs have differentroutes for different needsNever assume what form of the drug will be administeredAlways confirm the right route with the MAR orderMost used:PO = oralSL = sublingualRectal = by rectumTopical = on skinRight Manner/Route
Right Time Administering dosesToo close together orTo far apartalter the therapeutic effect of the medicationDouble check with MAR when to administer medThe drugsPurpose andPharmacokineticsDetermine how often the medication is administeredYour responsibility is to administer:Stat meds ASAPSingle ordered medications at time orderedStanding ordered meds on timePRN medications when needed
Right Person A drug order is written for a specific residentDouble check that you have the right residentYour responsibility is to:ObtainPrepare, andAdministerthe medication to the correct person
Right Documentation Right documentation includes correct drug order and a signatureUsing the correct form to record the administration of the med assures that the resident does not receive another dose, preventing overdosing of the resident
Your responsibility is to document the administration of the med immediately.
Five AlwaysPhysician's order for every med/treatmentWash your handsPour medication into cupIdentify and stay with resident until medication is swallowedKeep med storage area locked, clean and orderly
Five NeversNever leave meds with client or outNever give a med prescribed for one client to anotherNever give meds prepared by another person.Never use a med that is outdated or from an illegible or unlabeled containerNever give meds if you have questions.
Five MustsHave correct MARRead label and compare it with MARGood positionDocumentUnderstand the medicine
Storage of MedicationsLocked
Separate orals from topicals
Separate meds for different clients.
Preparing MedicationsChanging the form
PharmacyUse Olsons Pharmacy
Not all clients use just one pharmacy
Important to know how each house connects with Olsons
Use them as a resource
Medication Administration RecordForever after known to you as MARPreparation of MARTranscription of ordersSigning backTime limited medicationsDiscontinuing medications
DocumentationIf it isnt written down, it did not happen.
PracticeYou give a medication.Your HM tells you that Jessie needs to have a Dilantin blood test and not to give the 8 AM Dilantin.Adam went home for the weekend.Johnny spit out the medicine you gave him.
PRN MedicationsEstablish the need for the medication
Ensure there is a current order
Administer the medication
Sign the back of the MAR
Follow up within two hours
Practice on PRN MedicationsJohnny complains that his head hurts.
Ronny has a cough
Mark has a groin rash
Susie has not pooped in two days.
Why they are handled differently
Special Tracking and charting
Charting You are telling a story with your charting
Each house will want you to chart in their way
Self Administrated MedsSelf determination is determined through ISP processAt present we have no residents who self-administerPlease see packet for process
Different kinds of medicationsVia the mouth!TopicalsSublingualsEye drops/ointmentsEar dropsRectal medsVaginal medsNasal meds
PO MedicationsDo not crush unless you have an orderSlower to be absorbedTaste is importantFood can impact the medicineTake with full glass of waterDo not mix in hot drinksShake all liquids before pouring out
TopicalsUsually used for skin conditionsAlways use glovesCheck expiration datesPrivacyBe aware of residents tendency to put body parts in their mouthsMake sure you note effectiveness
Under the tongue
Do not offer water right away
Stay with resident until you are sure the medication has been absorbed
Eye Drops/OintmentsUsed to treat infections, inflammation, irritation and lack of moisture
Explain to client
Drops before Ointments
Ear DropsWarm ear drops to body temperatureWash handsWear glovesHave resident lie on side opposite to the ear being treatedHave them stay that way 5-10 minutes
Rectal MedicationsUsed to stimulate bowel movements, relieve pain, relieve vomiting, reduce fevers, stop seizuresWash handsWear glovesPrivacy!!!!Usually kept in refrigeratorDocumentation of this one is important
Vaginal MedicationsDetermine if administration will involve 1 or 2 staff Wash handsWear glovesExplain procedurePrivacy!!!Best time to insert is after shower or bath
Nasal MedicationsWash hands
Spray vs. drops
Work with client
Medication ErrorsDefinition of a medication errorExamplesForgetting to signForgetting a follow upNot giving a suppository when dueWhat happensIntent
Where is the error?
Residents, Living and MedsOur residents have livesSome work or have lives outside our homesThey need their medicationCommunication is the key
Work site responsibilitiesWork site needs a copy of doctors orderAdministered by designated staff personSame rules apply: i.e. MAR, 5 rights
Home responsibilitiesProvide work with necessary informationInform worksite of any changesWhat is the abbreviation for the MAR at home when a resident is at work?
When a client goes homePills in envelopes one type of medication to an envelope
Whole bottles go home
Document on MAR
Never take medicine back
Hospitalized Residents DO NOT TAKE MEDICINES TO HOSPITAL
What is the appropriate documentation?
Disposal of Non-controlled MedicationsMedication that is outdated, recalled, or unused shall either be disposed of in a manner that assures that the medication cannot be retrieved or it will be returned to the providing pharmacy for client credit.
Documentation of this!
Any two staff can do this
Disposal of controlled medicationsMedication that is outdated, recalled, or unused shall either be disposed of in a manner that assures that the medication cannot be retrieved or it will be returned to the providing pharmacy for client credit.Documentation!Of the two staff, one must be an LPN or RN
Disposal DocumentationDateClients nameName of medication and dosageAmount of medication disposedReason for disposalMethod of disposalTwo signatures
What is a medicationMedication means any drug, chemical, compound, suspension or preparation in suitable form for use as a curative or remedial substance taken either internally or externally by any person.
Any medication for our clientsmust be prescribed by a MD
Kinds of medicationsAnticonvulsantsAntipsychoticsAntibioticsAntidepressantsMultivitamin/Minerals/Dietary SupplementsAntidiabeticTopicalsAnalgesicsLaxatives
Timing of MedicationsKnow when to give medicines to gain most benefitNo laxatives within 1 hr of any other medicationIron should not be taken with milkGERD meds hr before mealUse your drug guideAs the doctor
Nurses at CCSNurse patient relationships
When to call
Protocol for paging
Doctors and MedicinesThey have the degreeThey also do the prescribingThey prescribe based on information we provideWe know the resident better than they doIt is in the residents best interest to work closely and respectfully with the physician
Doctors VisitWho decidesHow to prepareWhat to do afterwards
A prescriptionWritten by a doctorParts of a prescriptionClient name first and lastName of drugDosage of drugHow frequent to take it and how longWhat route
Who can take themNurses LPNs or RNsHouse ManagersAssistant House Managers
Getting them on the MAR
Rights regarding medicationsRight to:know what they are gettinghave an explanationrefuse or consentconfidenti