Outcome 1 Understand legislation, policy and procedures relevant to administration of medication. 1. The current legislation, guideline policies and protocols relevant to the administration of medication are. Medicines Act 1968 & amendments. Categorises how medicines are provided and sold. Misuse of Drugs act 1971 (Controlled Drugs) and amendments.
Health and Safety at Work Act 1974. 5 elements of risk assessment. COSHH. Storage and who has access.
Health and social Care Act 2008. Receipt, storage and administration. Access to Health Records Act 1990. Access to your own records. Data Protection Act 1998. Confidentiality. Hold relevant records for7 years. Hazardous Waste Regulations 2005. Sharps, controlled drugs, unused medication.
Outcome 2 Know about common types of medication and their use 1. Describe common types of medication including their effects and potential side effects. Antibiotic – To treat infection. Can be specific or broad spectrum. Amoxicillin. Penicillin. Oxycycline. Trimethoprim. Common side effects rashes, headaches, anaphylactic shock, GID Gastro intestinal disturbance i.e. sickness. Analgesic – Pain relief: paracetamol Common side effects: long term side effects include liver damage. Anti-histamine – To treat allergies such as hay fever, reaction to insect bites. Piriton. Antacid – To combat excess acid. To calm stomach. Gaviscon. Rennies. Settlers. Peptobismol, omeprazole. Common side effects: GID, dry mouth, insomnia, drowsiness, rash Anti-coagulant – To thin blood and avoid unwanted clotting. Warfarin, Heparin. Common side effects: haemorrhage, hypersensitivity, rash, alopecia jaundice. Psychotropic medicine – To alter state of mind. Loperimide. Risperidone.
Chlorpromazine. Common side effects: rashes, GID, paradoxal effects, extrapymidial side effects rolling of the tongue, drooping of the face, parkinson’s Symptom, Laxative – To soften stool and encourage bowel movements. – Sennocot. Lactulose. Movacol. Common side effects: GID, a tonic bowel Diuretic – To treat water retention and encourage urine flow through kidneys. Frusemide, Bendrofluazide. Common side effects: mild GID, hypotension, electrolyte Anticonvulsant- To control seizure activity for epilepsy. Sodium valproate, Diazepam. Midazolam. Common side effects wait gain and loss, abnormal sensation in limbs GID, rashes, dizziness, amnesia, and headache. Cytotoxic medicines – Cancer treatments. Chemotherapy. Highly toxic. Vincristin Common side effects: hair loss, constipation, low blood counts, abdominal cramps, weight loss, nausea and vomiting, loss of appetite 2. Insulin used in the treatment of Diabetes requires finger prick blood testing for sugar levels.
Warfarin Used to thin blood or prevent unwanted clotting. Fluid Retention. Fluid output measurements. Blood pressure may need to be taken for certain medication that moderates BP or heart function. 3. Describe the common adverse reactions to medication, how each can be recognised and the appropriate actions required. Unexpected adverse reaction can potentially happen from any medication that an individual is taking. Someone can have an adverse reaction to penicillin i.e. anaphylactic shock, the signs for this can be the person has problems swallowing or the lips or face ballooning, a skin rash and the individual may also stop breathing, leading to total system collapse and if not treated with adrenalin death may occur. This is why it is important that all information about an individual’s medical records must be up to date and in their care plans, also in their MAR Chart. You don’t come cross anaphylactic shock often, but you still have to be aware.
Other severe adverse reactions that could include a fever and skin blistering; these usually occur within an hour of the medications being administered. Sometimes adverse reactions can develop over a few weeks, they may cause damage to the kidneys or liver. If adverse reactions are not treated they could be fatal. When individuals experience adverse reactions to medicines my workplace policy is to inform the GP and explaining in detail the adverse reactions, the staff member will then inform the individual/ team. GP advise and guidance will then determine if the medication is to be stopped. If the reactions are so serious then an ambulance should be called my responsibility is that I have duty to continue to observe the individual and monitor their vitals, speaking to them and looking at any changes, so as to ensure that the individual is not deteriorating. All adverse reactions and following advice given, must be recorded in full in the individual’s clinical note and referenced in their daily report also MAR’s chart. 4.
Outcome 3 Understand procedures and techniques for the administration of medication. 1. Explain the different types, purpose and function of both materials and equipment that may be needed for the administration of medication via different routes. Type; Syringe
To administer medication such as insulin into the blood stream. The function;
Enables subcutaneous/ intermuscular administration in correct and measured dosage into the blood stream. Type; Spacer
To add to an inhaler
To enable correct dosage of inhaled medication when patient is not able to use the inhaler on its own Type; Medication pot
To contain medication when being dispensed with non-touch technique The function;
To enable people to take medication cleanly and safely without contamination and in some cases to promote active participation and inclusion/independence 2. What information must be included on a prescription?
Doctor’s name and signature
Date of issue
Patient’s name and address
Patient’s date of birth
Name and dosage of medication
Quantity and form of medication. e.g. 30 tablets
Strength of medication
How many times a day
Duration of treatment
Method and route of administration
Outcome 4 Be able to prepare for the administration of medication 1. wash your hands gather your equipment required i.e. medication pots, spoons, water, gloves, mar sheets, aseptic wipes aseptic equipment if required establish who the medication is for ensure the environment is suitable for the safe administration of medication sharp box if required
2. Establish on the mar sheet that no medication has been given recently and that it is time to give medication as per mar sheet instructions. To ensure the spacing between medication is appropriate and as per guidance. Ensure dosage is spaced evenly as per therapeutic range and ensure therapeutic range is achieved. 3. Consent is through implied consent or objective consent and if consent is not achieved then it will have to go best interested decision. All s/u that I support will have a risk assessment in place that identifies individual’s capacity issues. Furthermore individual s/u have a PDP that specifies how an individual receives their medication.
This will say the process if the s/u declines to receive their medication. If the s/u declines to take their medication then it is my responsibility to insure I have within the best of my abilities attempted to explain and divulge the information that is within the realms of the individuals understanding. This is to develop a knowledge and therefore capacity to make informed decisions. If unsuccessful then I’m to contact the GP to seek advice and refer for a best interest decision. Any issues around consent must be recorded and be communicated to the individuals who are significant in the administration of medication to that person. 4.
Outcome 5 Be able to administer and monitor individual’s medication 5.3 I always pay attention to ensuring I maintain individuals’ dignity, choices and preferences. Sometimes individuals refuse their medication, this is their right to as I cannot legally and according to our medication policy administer their medication without their consent. I listen to why they are refusing sometimes because they can’t understand why they need to have their medication, other times because they can’t swallow tablets. I explain what their medication is for and their eﬀects and also give them information about how medication is available in liquid form which they would ﬁnd easier to swallow. If the client refuses their medication I have to record it on their MAR and in their support plan and client notes and get advice from the GP or 111 then inform my Manager. This may involve a medication review to see what else can be oﬀered.
Sometimes when individuals leave the home or stop taking their medication because it is not agreeing with them then the home is left with out-of-date and part-used medications. Under the care home standards, the hazardous waste regulations and the medication policy it is a requirement for all medications to be disposed of safely. At work we have a medication returns book where the medication that is to be disposed of is entered in here, then packaged up and placed in the medication cupboard securely until the pharmacy collect this this usually happens when the new medication is delivered these are signed for and recorded.
5.5 To make sure that the individual is taking their prescribed medication and that their condition does not deteriorate. It is our workplace policy to check that medication is taken by the individual. If the individual passes it to others, this could result in other individuals overdosing, taking medication that is not prescribed for them, and this can cause them to feel ill or can be fatal. If medications not taken and left out then others might misuse this too which is abuse and neglect. If I was working in mental health settings I would also be aware of Individuals distributing certain medication that has a value.
5.7How do you dispose of out of date or part used medication ensuring that you comply with legal and organisational requirements? All unused or out of date medication should be disposed of via the pharmacy, placed in clear individual bags clearly labelled with details of the medication, dose, name of s/u and stored in an appropriate manner i.e. locked box in a locked room. Record must be kept in the s/u notes and also a returns book. Records should be signed by person initiating the disposal if these returns are collected, or by the person taking medication for disposal if taken to pharmacy. Records must be signed by the pharmacist or their representative on receipt of the medication. Medication should not be put down the toilet or drain or put into household waste.