Current legislation, guidelines, policies and protocols relevant to administering medication are:- The Medicines Act 1968 – requires that local pharmacist or dispencing doctor is responsible for supplying medication. The Misuse of Drugs Act 1971 – controls dangerous and harmful drugs, I.e. controlled drugs (CD’s) The Misuse of Drugs and the Misuse of Drugs Regulations 2007 – specifies about handling, record keeping and storing controlled drugs correctly. The Safer Management of Controlled Drugs Regulations 2006 – specifies how controlled drugs are stored, administered and disposed of.
Common types of medication include:-
Medication Effects Side effects
PareacetamolIt is commonly used for the relief of headaches and other minor aches and pains Mild to no side effects. Prolonged daily use increases the risk of upper gastrointestinal complications such as stomach bleedingOmeprazole suppresses gastric acid secretion by specific inhibition of the H+/K+-ATPase in the gastric parietal cell. By acting specifically on the proton pump, omeprazole blocks the final step in acid production, thus reducing gastric acidity headache, diarrhea, abdominal pain, nausea, dizziness, trouble awakening and sleep deprivation Levothyroxine Levothyroxine is approved to treat hypothyroidism and to suppress thyroid hormone release in the management of cancerous thyroid nodules and growth of goiterrs.
Levothyroxine may increase the effect of blood thinners such as warfarin. Therefore, monitoring of blood clotting is necessary, and a decrease in the dose of warfarin may be necessary. AsprinUsed to relive minor aches and pains such as headaches. It can be also used to thin the blood to reduce the possibility of a blood clots, heart attacks and strokes. Aspirin use has been shown to increase the risk of gastrointestinal bleeding2 Medication that demands the measurement of specific psychological measurements includes :Spironolactone – blood pressure Furosemide- blood pressure
Digoxin – blood pressure
Warfarin – INR blood test
Common side effects to medication include:
Side effects How can be recognised Actions required
Weight gain Visual and my weighing Diet control
Constipation Not being able to pass a bowel motion LaxitivesDrowsiness Person being very sleepy Rest until drowsiness wears off Rashes Visual appearance on the skin Stop medication and consult GP Vomiting Person is vomiting Consult GP
DiahorreaPerson having loose bowlesSeek advice from GP
Swelling Swelling of limbs face ectStop medication and consult GP Breathing difficulties Person finding in difficult to breath Ring 999 4
Different routes of medicine administration:
Oral – tablets, capsules, liquids etc. These are swallowed by the person. Sublingually – tablets or liquids are administered under the tongue for speed of absorption. Inhalation administration – this is breathed in through the nose or mouth so its delivered straight into where it is most needed i.e. the lungs. Intramuscular (IM) injection administration – injected into large muscles onto the body e.g. legs, bottom. Can only be performed by a trained doctor or nurse.Intravenous (IV) injection administration – administered directly into the veins so it is rapidly absorbed into the body.Subcutaneous injection – medicine is injected directly under the skin, most common type of medicine injected in this way is insulin.
Instillation administration – these can be a suspension or liquid and can be administered in a number of ways via ear nose or eyes. Rectal Administration – these are usually suppositories and are absorbed into the body quickly by this route. Vaginal administration – only really used to treat conditions in the vagina such as thrush Topical application administration – creams, ointments and gels are applied to the skin. Transdermal patch – this is applied the skin for slow absorption into the body.
Explain the types, function and purpose of equipment and materials used when administering medication.
Type Purpose and function
Gloves They protect the skin and stops cross contamination
Aprons They protect cloth and create a barrier which helps prevent cross contamination Sharps bin This is used for the safe disposal of needles etc.
Needles These are available in an array of sizes so they are specific to the function and resident using them. They are used to inject insulin into diabetics Syringe These are available in different sizes and are used to obtain the correct amount on medication. Medication pots These are used to safely transport and hold the medication before being administered to the resident. Monitored dosage system (MDS) This is system pharmacists use to dispense medicines and must be used with accordance to the MAR record. inhalers You can also compliance aids such as Aerochambers to aid to inhale the medicine correctly.
The required information on prescriptions and medications charts include:
The name or names and address of the patient or patients.
The name and quantity of the drug or device prescribed and the directions for use. The date of issue.
Either rubber stamped, typed, or printed by hand or typeset, the name, address, and telephone number of the prescriber, his or her license classification, and his or her federal registry number, if a controlled substance is prescribed.
The time the medication should be administered.
In order to ensure I follow standards to prevent infection control I must make sure that I wash mu hands before and after each resident. You should always wear gloves if you run the risk of handling them inadvertently if they are cytotoxic. Medicines should always be stored in a clean and tidy environment.
All medication a resident takes will be recorded on the MDS chart and all staff trained in administering medication will know how to record and understand the MAR charts. If resident B requests some pain relief you should always refer to the MDS chart to see what type of pain relief medication they are taking. It will also state how often they can have the medication and by what route the medication should be given. When preparing medication you should always refer to the MDS chart as it will tell you the exact time that the resident had their last pain relief. If it is ok to give the resident the medication then you should prepare the medication and then take it straight to the person. You should then immediately record the transaction onto the MDS chart either by signing it to say that the medicine has been taken or recording the reason for non-administration. This is done be a code described on the MDS chart.
You have to obtain the residents consent before administering them their medication. They must know what the medication they are taking and have the right to refuse medication. The resident may ask what their medication is for and I must give them this information. If a resident is not capable of making an informed choice i.e. the resident has got a mental illness and it is essential that that resident has their medication then it may have to be administered covertly (hidden or disguised in food) this must only be done after discussion with a doctor.
All medication for each individual resident will be stored in MDS and are clearly labelled so selecting to correct medication is easier. After selecting all the correct medication with accordance to the MDS chart you should then check you have the correct type and dosage against the MDS chart. If any medicines have to be prepared for example having 10mls of lactulose you should ensue you prepare the correct amount them double check the amount against the MDS chart.
There are different routes for administering medication. You should always read the label of medication to ensure that are administering it in in the correct way. If you are giving insulin to a resident it is important to alternate sites of injection, so you must look in their insulin record book to see which site was used for the last injection. You must also make sure that the site is clean before you inject.
You must ensure that you give the correct medication at the correct dose by the correct route at the correct time with agreed support. You must always use the medication system in place at the home and make sure that medication is given as stated on the MDS charts. My doing this you will stay in line with legislation and the homes policies.
There may be immediate problems when administering medication which have to be resolved and reported such as: Missed medication – the medication may have been missed as the resident was asleep, or because they go out regular social events. If they miss their medication on a regular occasion that you should talk to their GP or pharmacist to see if their medication regime can be changed so it is more suited therefore they do not miss medications. Spilt medication – this may occasionally happen you may knock over a resident dispersible aspirin, if this happens you should give them the last dose from the MDS blister pack and record to say why this is missing. A person decides not to take prescribed medication – you must find out why the person is choosing not to take their medication.
You can explain the side effects if the person does not take their medication but you cannot force then to take it. You must inform their GP of their wishes not to take the medication. Wrong medication used – mistakes can happen in social care especially if poor systems are in place. If a medication error has been made you must follow the correct procedures. You must seek advice from a doctor to make sure the medication that has been given in error does not react with any other medication that the resident is taking. You must them fill out an incident report. Adverse reaction – these may occur when a resident takes any medicine. They may have been taking the medication for a short or long time before that reaction happens. It is important to document the reaction when it occurs and inform the doctor. All of the above must be reported to the senior member on shift and also recorded in their care notes.
When administering medication you must monitor the resident throughout so you can observe if any adverse reaction are taking place. If any adverse reactions are taking place you must take the appropriate action depending on the type of reaction. This must then also be recorded in their care notes and their doctor will also have to be informed.
It is necessary to confirm that the resident has taken their medication and does not pass it on to others as the medication if taken by another resident may be harmful to them. The resident if they have mental health issues may not realise that the medication is only for them to take and may believe them to be sweets. You must also ensure they take them so that you can sign the MDS chart or else you cannot correctly sing the chart as you are signing to say they have took the medication. You should only leave medication with a resident if a risk assessment has been carried out.
All medication must be stored in a locked dry room. The room must not be above 25°ᶜ to ensure that they are stored within their product licences and their stability is maintained. The MDS chart must also be stored in a locked cupboard as all information about a resident medication is confidential. The drugs trolley’s whilst in use must be kept in good vision in order to maintain security. After each medication round the trolleys must be locked up in the locked cupboard at the senior member on shift should hold the keys to this room in order to maintain security.
Any out-of-date and part used medication must be sent back in the correct way in accordance to your MDS. All medication must be counted and recorded on the medication returns record. You have to record which resident’s medication it is, what strength, the amount being returned and the reason for disposal. Two members of staff have to sign and count the medication being returned, the pharmacist then collects the medication and will return the receipt that the homes keeps to record that the medication has been returned.