1.1 Identify current legislation, guidelines policies and protocols relevant to the administration of Medication
The Medication Acts 1968
The Misuse of Drugs Act 1971
The Misuse of Drugs (Safe Custody) Regulations 1973
Safe Management of Controlled Drugs Regulations 2006
Health and Social Care Act 2008
Care Quality Commissions’ regulations
Health and Safety at Work Act 1974
Control of Substances Hazardous to Health (COSHH)
Regulations 1999 Hazardous Waste Regulations 2005
Mental Capacity Act 2005
Mental Capacity Act Code of Practice
Nottingham and Nottinghamshire Joint Policy Procedures on the Mental Capacity Act 2010 Company’s Medication Handbook
1.2 Describe common types of medication including their effects and potential side effects General Sales List medicines (GSL) –licensed medications that can be purchased over the counter in shops, supermarkets and pharmacies e.g. Ibuprofen These medications have been assessed as being safe for the general public to obtain without an increased risk of causing any harm. They are limited in their quantities and pack size, and are usually of a weaker strength. They must have all the correct dosage instructions on the packaging along with an information leaflet. Pharmacy medicines (P) – medications that can only be sold in pharmacies. These pharmacies should be registered and supervised by qualified pharmacist. e.g. Paracetamol 100 tablets These medicines can be stronger than the GSL equivalent and can be sold in greater quantities.
The pharmacist and their staff can check that the medicine is suitable for the customer to help prevent side effects and interactions with other drugs. Prescription Only Medicines (POM) – medications that must be prescribed by a qualified medical practitioner and can be dispensed by a pharmacist or doctor.e.g. Ventolin inhaler These medicines will be prescribed for a particular patient at a certain dosage, with specific instructions that must be included on the label by the pharmacist. These drugs must never be used by anyone other than the person named on the label. Controlled Drugs (CD) – Medications that must be prescribed by a qualified medical practitioner and must be stored securely. They must also be recorded when dispensed. E.g. Morphine The Misuse of Drugs Act (1971) gives advice regarding the control of the strongest types of drugs (usually painkillers), which can be subject to abuse and that need special recording and storage.
1.3 Identify medication which demands the measurement of specific physiological measurements Body temperature check – treatment of fever Blood sugar level check – treatment of diabetes, before administering insulin Pulse check – for heart irregularities, such as digoxin
Blood pressure check – after administering medication that is used for lowering blood pressure Regular blood tests – if the individual is taking warfarin
1.4 Describe the common adverse reactions to medication, how each can be recognized and the appropriate action(s) required Common adverse reactions may include diarrhea, skin rashes, sickness, swelling, blistering of the skin, wheezing. They can be recognized by reading the side effects on medication boxes, packets, or contacting a pharmacist. In these cases you should contact doctors or hospital so the person suffering from a side effect can be treated appropriately. 1.5 Explain the different routes of medicine administration
Oral – the most common and convenient route of medicine administration in the forms of tablets, capsules etc. Sublingual – offers quick absorption.
Rectal – unpredictable absorption and not convenient.
Topical – directly into the affected area, such as asthma inhalers. Parenteral – generally it means mainly injections directly into the body through the skin.
1.6 Explain the types, purpose and function of materials and equipment needed for the administration of medication via the different routes Monitored dosage system. Box system typically for tablets or capsules that need to be taken at specific times each day. The box is to organize and provide an easy way of monitoring and individual’s medication. Inhalers – for respiratory problems such as asthma. I t is an effective way of delivering the medication straight into the affected area. Applicators – they contain a suspension of liquid medication for e.g. eye, ear or nose infections. It is important to use a separate applicator for each e.g. eye to avoid cross-contamination. Syringes – it is for injections. Syringes and their needles should only be used once and must be disposed of safely in a box to minimize the risk of infection or injury. They only can be used by trained medical, nursing or care staff. Gloves – they should always be worn when applying creams or ointments to avoid cross-contamination and absorption of the medication into the applier’s skin. Insulin pens
Intravenous devices – e.g. infusions
1.7 Identify the required information from prescriptions / medication administration charts Full name, address and DOB of the patient.
Ensure prescription is dated and is still valid, it is signed by the appropriate prescriber, completed with their registration number and details regarding the address of their practice, it is printed from a computer or written in ink if done by hand, the drug or product is named, complete with strength, dose and quantity.
1.8 Apply standard precautions for infection control
Proper hand wash
Aprons and gowns
Environmental Cleaning and Management of Body Fluids
1.9 Explain the appropriate timing of medication eg check that the individual has not taken any medication recently The Medication Record and the Care Plan should be set up and kept in the individual’s home and should be examined on each occasion for any changes in medication. You should check the MAR sheets to ensure that the medication has not already been administered. You should select the medication required, you must check the name of service user, name and dose of medication on the label with the description in MAR sheets, administer the medication and record the administration of medication by entering your initials in the correct date box. If medication is not taken, you should indicate the reasons.
When medication is prescribed the doctor should state how to take it and at what times. When the prescription is filled at the chemist the directions will be on the label. Sometimes it has to be taken with food, sometimes without, it should be in the morning or evening – it depends on what the medication is and what it is for. In care work you must always check the Medication Records to ensure that the medication has not already been administered. Any entries on the MAR Sheets must be initialed against the date. Alcohol may interfere with the action of many drugs
1.10 Obtain the individuals consent and offer information, support and reassurance throughout, in a manner which encourages their co-operation and which is appropriate to their needs and concerns It is the Prescriber’s responsibility to explain the reasons of a treatment to an individual and the likely effects (including side effects) of any medication prescribed. Every adult must be presumed to have the mental capacity to consent or refuse treatment, including medication, unless they are unable to take in, to understand or to weigh up the information. No medication should be given without their agreement. The individual must have given adequate information about the nature, purpose, risks and alternatives to the proposed medication. A competent adult has the legal right to refuse treatment, even if the refusal will cause harm, or shorten their lives. Where it is considered that refusal to consent to have their medication will place the individual at risk, the refusal should be reported to the service user’s doctor.
1.11 Select, check and prepare correctly the medication according to the medication administration record or medication information leaflet The Medication Record and the Care Plan should be set up and kept in the individual’s home and should be examined on each occasion for any changes in medication. You should check the MAR sheets to ensure that the medication has not already been administered. You should select the medication required; you must check the name of service user, name and dose of medication on the label with the description in MAR sheets, administer the medication and record the administration of medication by entering your initials in the correct date box. If medication is not taken, you should indicate the reasons.
1.12 Select the route for the administration of medication, according to the patient’s plan of care and the drug to be administered, and prepare the site if necessary The medications should be kept in a locked cupboard. After a thorough hand wash you should check the individual’s MAR documentation and if the individual has not taken the medication before so that overdosing or other side effects do not occur. You should also check that the medication is given at the correct time as this is agreed with the prescriber and must be followed for the medication to be effective. You should check the individual’s identity, any allergies, the name of medication, the time to be given, that it has not been given and that it is given with a drink. Then you should ask the individual if he is ready to take medication in a few moments. When they agree you should prepare the medication checking again the details on the MAR and checking the labels of medication boxes. Using a non-touch technique you should pop the medication from the pack into the medication cup and put back the medication box into the cupboard. After every use you should lock the medication cupboard.
1.13 Safely administer the medication:
in line with legislation and local policies
You must be aware of the individual’s care plan.
You must know the therapeutic use of the medication to be administered (including normal dosage, side effects, precautions) You should follow clean procedures to ensure the right individual gets the right medication, in the right dose, by the right route, at the right time. You must check the label of the medication if it is clearly written and not ambiguous. You must be certain of the individual’s identity to whom the medication is to be administered. You must check the expiry date where it is applicable.
You must check if the individual is not allergic to the medication to be administered. You must make a clear, accurate and immediate record of all medications administered. in a way which minimises pain, discomfort and trauma to the individual If the individuals have any questions or concerns about why they need the medication, you should explain them that. You should ask them if they are ready for their medication. You should stay with the individuals while they are taking their medication and another few minutes, ensuring they are right and thank them. You should respect the individuals’ dignity and right to take their medication and supply them with all details they require.
1.14 Describe how to report any immediate problems with the administration You must pay attention to ensure maintaining individuals’ choice, dignity and preferences. Sometimes individuals refuse their medication, this their right to and you cannot legally administer the medication without their consent. However, you should listen to why they are refusing, it can happen as they do not understand why they need to have their medication, or they might have difficulties with swallowing tablets. You should explain them what their medication is for, their effects or inform them how medication is available e.g. in liquid for which they might find easier to swallow.
It they refuse their medication I have to record it on their MAR and inform the line manager who will then contact the individuals’ doctor for advice. It may involve a medication review to see what else can be offered. It might happen that the medication is spoilt (eg. by falling down the floor), or expired, or there is no need for it as medication has been reviewed and modified. You should keep a medication return sheet and storage box where the medication that is to be disposed of is entered in here. These medication should be placed in the medication cupboard securely until the pharmacy collects and signs for it.
1.15 Monitor the individual’s condition throughout, recognise any adverse effects and take the appropriate action without delay You should ask individuals if they are all right and if they are ready for their medication. You should stay with the individuals while they are taking their medication and another few minutes, ensuring they are right. Some medication causes side effects, it is the doctor’s, who prescribed the medication, responsibility to inform the individual about them. As a support worker you should be alert to this possibility and report any concerns to the line manager. An increased temperature may also increase absorption of medications and the individuals should be monitored for side effects and toxicity. In case of any concerns, the individual’s GP should be sought.
1.16 Explain why it may be necessary to confirm that the individual actually takes the medication and does not pass the medication to others You must make sure that the individual is taking their prescribed medication. That is why you must stay with the individual while they are taking them. If the individual passes the medication to others, it may result in other individuals overdosing, taking medication that is not prescribed for them. This can cause them to feel ill, or it can be fatal. If medication is not taken and left out then, others might misuse this, and it is an abuse.
1.17 Maintain the security of medication and related records throughout the process and return them to the correct place for storage All medication should be stored in a secure location in the individual’s home. Details of administration must be recorded on the MAR sheet by Support Worker at the time the medication is administered. Any entry on the MAR sheet must be initialed against the date by the Support Worker. When recording medication administration, initials must be put saying the person has taken each individual medication in the lower box on the MAR sheet and you should put the appropriate code in the top box. There must be a code entry in the top box when the person has had their medication. After every use of medication cupboard you should lock it.
1.18 Describe how to dispose of out of date and part used medications in accordance with legal and organizational requirements It may be necessary to dispose of a Service User’s medication (e.g. if it is expired, or no longer needed – by the Service User’s doctor). In this case you should ask for authority from the line manager to return these medication to the pharmacist. If it is a single dose of medication to be disposed of (e.g. a single tablet is spoilt, dropping on the floor, or the Service User refused to take their medication after it has been removed from the container), it should be returned to the pharmacy in line with procedure and never flushed down the toilet or placed in the domestic waste. You should keep a medication return sheet and storage box where the medication that is to be disposed of is entered in here. These medication should be placed in the medication cupboard securely until the pharmacy collects and signs for it.
I confirm that the evidence listed above is my own work and was carried out under the conditions and context specified in the standards. Candidate’s name Brigitta Dolgos Signature Brigitta Dolgos Date 15.05.2015.