Legislation: Health and Social Care Act; the Medicines Act and The Misuse of Drugs Act. Guidelines could include the Nursing Midwifery Guidelines for the management of medicine administration – registered nurses have to abide by this set of guidelines and for paid carers, the General Social Care Council’s Code of Conduct will have something which could relate to medication. Policy – for example – consider the Government’s drive to ensure people with dementia are not over medicated – so their policy is currently designed to ‘push’ the professionals responsible for prescribing to bear in mind the effect of drugs on frail elderly people and to consider alternative treatments such as activities and therapies. Other examples of policy might be the Government’s drive to limit the prescribing of antibiotics to reduce the incidence of resistant strains of bacteria. Protocols – a protocol is a procedure and you could outline your company’s procedure (protocol) for disposing of controlled drugs or medication in general.
2- Know about common types of medication and their use.
Antibiotics- The most common side effects of antibiotics affect the digestive system. These occur in around 1 in 10 people. Side effects of antibiotics that affect the digestive system include:
bloating and indigestion
loss of appetite
Ibuprofen- Ibuprofen can cause a number of side effects.
For this reason, take lowest possible dose of ibuprofen for the shortest possible time needed to control your symptoms. Common side effects of ibuprofen include:
nausea (feeling sick)
vomiting (being sick)
diarrhoea (passing loose, watery stools)
abdominal (tummy) pain
Antihistamine- Common side effects of first-generation antihistamines include:
an inability to fully empty the bladder (urinary retention)
Drugs like insulin (blood has to be taken from a pinprick so that glucose can be measured before the insulin can be given); warfarin to thin the blood – again blood levels must be checked regularly; digoxin to slow and steady the heart (pulse should be checked prior to administration and advice taken if the pulse dips below 60 beats per minute) Common adverse reactions might be diarrhoea (some antibiotics for example); skin rashes; nausea – through to serious adverse reactions such as anaphylactic shock (facial swelling, blistering of the skin, wheezing and hives) leading to total system collapse and (if not treated with adrenalin) death. The different routes of medication administration are orally, injection/intravenous, creams, and liquids. 3- Understand procedure and techniques for the administration of medication. The required information from prescriptions and medication administration charts are medication name, the name of the person the mediation is prescribed for, dosage, frequency/PRN and medication strength. 4- Prepare for the administration of medication.
Standard precautions for infection control would be hand washing, ppe for example gloves and aprons etc.
In a structured health care setting, medication would be administered to the patient or resident or client by a nurse, such as an RN or LPN – whoever was assigned to be the med nurse. In other facilities, medication is administered by persons with med cert’s (certification training to administer meds). It’s a very specific, precise duty. Meds are secured in locked rooms, areas, and carts. No one is allowed access except the med nurse or scheduled med cert. (person). Meds have to be administered in the correct dosage, which can only be according to a doctor’s prescription. Dosage cannot be altered unless a doctor alters or updates the Rx. The person administering the meds must observe the person they administer them to and ensure that they took them. Pocketing meds (in the cheek), or refusing meds are handled according to the person’s meds and orders. Sometimes it is marked as declined / refused meds. Sometimes, it is documented that they did not swallow it initially and had to be encouraged, etc. or whatever happened according to the facilities guidelines. Meds are always, and must be, administered and documented accurately when they are administered (contemporaneously). Meds are prescribed to be given sometimes at certain intervals.
If the med is a few minutes late, no one is to assume that it was already administered, and skip it. Likewise, if it is offered a little early and that is appropriate according to the order, the med, or the patient request, etc. and it is not documented correctly and contemporaneously, and a second dose is administered, assuming it is on time, and assuming falsely that it was not recently administered (upon request or whatever the circumstances were), then the patient would have been given an incorrect dosage, more than they were prescribed. You know that with some meds, that could be very a very serious overdose, sometimes terminal. They do try to put many checks and balances in place to prevent as much human error as possible, but it can happen. The consequences are usually pretty severe. A med cert would automatically lose their med certification, and they would be disciplined up to, and including, termination.
With a licensed nurse, I’m not as sure of the procedure, but I’m fairly certain it would definitely include reporting the med error or abuse, suspension without pay, an internal (or perhaps external) investigation, and disciplinary actions up to and including termination. Also, unauthorized access and theft of prescription medications – whether by the assigned med nurse, or an outside party, would automatically involve criminal charges. And of course, criminal charges are always a possibility in the other two scenarios I presented above for med certs and nurses, depending on the laws, the circumstances, and the outcome of the investigations. Like I said, very serious consequences. And it’s not like someone could just take a med and it could go unnoticed. med admin documentation is reviewed / audited at least daily, if not more often, and if someone was suspected of confiscating meds, such as narcotics, the building, in some agencies would go into lock-down and staff could / would be subjected to a search.