Download Document

Flexlearn
Medication Training
Programme
Flexlearn
Training
• This course provides basic training for care workers to
safely select, prepare and give different types of
medicines
• A senior care worker should always mentor a care
worker until he/she is confident and competent to
administer medicines correctly
Flexlearn
Training
• Basic training does not include the administration of
medicines by specialised techniques including
– Rectal administration
– Insulin administration
– Administration through a Percutaneous Endoscopic
Gastrostomy (PEG)
Flexlearn
Training
• Care workers can only administer medicines by
specialised techniques following an assessment by a
healthcare professional
• The healthcare professional must train the care
worker and be satisfied they are competent to carry
out the task (delegation)
Flexlearn
Session Outline
• Learning outcomes
• Definitions and basic terminology
• Drug formulations
• Legislation
• Policies and procedures
• Risk assessment
• Consent
• Mental Capacity Act (2005)
• Storage and Expiry dates
Flexlearn
Session Outline
• Label interpretation
• Administration
• Medicines administration record (MAR)
• Recording
• Disposal
• Warfarin
• Oxygen
• Homely Remedies
• Mistakes
Flexlearn
Learning outcomes
• Understand the rules and regulations applicable to the
management of medicines in domiciliary care
• Principles and practice on the safe handling of
medicines
• Understand the risks associated with handling
medicines
Flexlearn
Definitions and basic terminology
A drug is :
Something taken into the body that may change or affect one or
more of the bodies functions
A medicine is :
A preparation containing a drug used in the diagnosis, treatment
or prevention of disease
All medicines potentially have side effects:
They are prescribed where the benefit outweighs the risks of side
effects
Flexlearn
Drug Formulations
• Tablets: including slow release (s/r), enteric coated
(e/c), dispersible, sublingual (under the tongue) and
buccal ( between upper lip and gum)
• Capsules
• Liquids
• Suppositories, (local or systemic) enemas
Flexlearn
Drug Formulations
• Injection (into veins, muscles, joints and under
skin)
• Creams, ointments,
• Ear, eye and nasal preparations
• Pessaries, patches, sprays and inhalations
• Transdermal patches and gels
Flexlearn
Legislation: Medicines
• Medicines Act 1968 (MA)
• Misuse of Drugs Act 1971
(MDA)
• Misuse of Drugs
Regulations 2001(MDR)
Flexlearn
Legislation: Medicines Act 1968
• GSL – General Sales List medicine (over the counter medicine)
• P –Pharmacy only medicine (sold under the supervision of a
pharmacist)
• POM – Prescription Only Medicine (supplied on an NHS or
private prescription)
• CD – Controlled Drugs (special requirements apply under the
Misuse of Drugs Act 1971)
Flexlearn
Legislation: Medicines Act 1968
• Anyone can administer a Prescription Only Medicine
(POM) to another person providing it is done in
accordance with the prescriber's instructions.
• Medicines prescribed for a person, are that persons
property, and should not be used by another person.
• Doses of prescribed medicines must not be varied
without the prescriber's consent
Flexlearn
Legislation: Domiciliary Care
• Care Standards Act 2000
• Domiciliary Care Agencies Regulations 2002
• National Minimum Standards (NMS) for
Domiciliary Care Agencies (Standard 10)
Flexlearn
Legislation: Health
• Health and Social Care
Act 2003
• Standards for Better
Health
• Standard C4d
Flexlearn
Policies and Procedures
• Ensure safe and effective use of medicines
• Provide consistency between departments, agencies and
individual members of staff
• Protect staff
• Protect service users/ patients
• Ensure staff are trained and competent to handle medicines
• Provide evidence of compliance with the National Minimum
Standards (CSCI / HCC)
Flexlearn
Policies and Procedures
• UKHCA
• Medication Policy Guidance (2006)
• Other companies
• Integrated Policy on Safe and Secure Handling of Medicines
July 2005
• Procedure for Working with Medication Tasks in the Community
August 2008
Flexlearn
Risk Assessment
A risk assessment specific to medication
related tasks must be completed for every
service user/patient, prior to any member of
staff providing any assistance with
medication. The level of support required
will then be specified in the care plan.
Flexlearn
Risk Assessment
• Self Administration
• Prompt – means to remind
• Assist – means to physically help
• Administer – to physically give medication
• Management – Order, collect and or dispose of
medication.
Always seek to promote the independence of
service users
Flexlearn
Consent
• Valid consent must be obtained and documented for
staff to support services users/patients with their
medication
• Consent must be recorded in the service
users/patients care plan
• Consent must be obtained every time medicines are
administered
• Mental Capacity Act 2005 (MCA)
Flexlearn
Mental Capacity Act (MCA) 2005
Offers protection to service users/patients aged 16 or over who are
unable to make any or some of their own decisions.
•
Five principles within the MCA
1. Own decisions
2. Supported
3. Unwise decisions
4. Best interest
5. Rights and freedom
Flexlearn
What you should know about your service
users/patients medicines
• Name (generic/brand)
• What its for
• When it should be taken
• Criteria for using ‘when required’ medication
• Need to avoid foods, drinks or other medicines
Flexlearn
What you should know about your service
users/patients medicines
• How long it should be taken for
• When it will run out
• Common side effects
• Expiry date
• Special storage instructions
Flexlearn
Storage of Medicines
Factors affecting the
stability of medicines:
• Temperature
• Humidity
• Light
Flexlearn
Expiry Dates
• Check when prompting assisting or administering
medicines
• Liquid medicines expire more quickly than solid
preparations especially antibiotics
• Eye preparations must be discarded 28 days after
opening
• Out of date medicines should be returned to the
supplying pharmacy for disposal
Flexlearn
Label Interpretation
Must include
• Name of the service user/patient
• Name and address of the supplying pharmacy or dispensing doctor
• Date of dispensing and quantity dispensed
• Name of the medicine and strength where appropriate
• ‘’Keep out of the reach of children’’
• Directions for use
• ‘‘For external use only’’ if appropriate
• Additional cautionary labels where necessary
Flexlearn
Adminstration
• Wash and dry hands
• Check for consent to administer
• Select medication checking the
label against the MAR
medication
• Check MAR relates to the service
• Ensure dose, route, person,
medication and time are correct
user/patient
• Check MAR for allergies and to
• If all checks are satisfactory then
administer the medication.
confirm that medication has not
already been given,
• Check for any special instructions
• Check medicine has been taken
• Record clearly on MAR
Flexlearn
Medicines Adminstration Record (MAR)
This must include the following information:
• Service users/patients details (name, address, date of
birth)
• Allergies
• Medication (name, form and strength)
• Dosage instructions
Flexlearn
Recording
Medicines are the property of the service user/patient
for whom they are prescribed. Therefore staff must
account for:
• Medicines received (if applicable)
• Medicines administered (if applicable)
• Medicines disposed of (if applicable)
Staff have a duty of care to report and record any concerns
or queries with medicines to their manager
Flexlearn
Disposal
• Medication should be returned to the issuing pharmacy ideally by
the service user/patient or their representative
• Staff can be nominated with permission from the service
user/patient
• Staff returning medication for disposal must record the service
users/patients name, details of medication returned and the date
• The pharmacist should be requested to sign a receipt for the
returned medication
Flexlearn
Warfarin
• Can be administered by staff
• Must be recorded in care plan, profile and MAR
• Register with hospital for safe haven faxing (appendix
6)
• Inform anticoagulant clinic of the need to administer
warfarin to named service users/patients (appendix 7)
Flexlearn
Warfarin
• Must be aware of
–Dose
–Test date
• Recommend keeping a warfarin register
• Administer as instructed by the
anticoagulant clinic unless otherwise
instructed
Flexlearn
Warfarin
• Anticoagulant clinic will inform organisation by fax of
test results usually by 5pm on day of test
• Results of blood samples received after 5pm will be
faxed the next day
• Rarely will inform verbally of dose change
• If results not available by 4pm attempt to contact clinic
Flexlearn
Oxygen
• Must undertake an oxygen risk
assessment (appendix 9)
• Staff need to know
–Flow rate
–Duration and frequency
–Who supplies the equipment
Flexlearn
Oxygen
• Record administration on MAR
• Always follow safe handling procedures
– Away from heat
– Store as instructed
– No smoking or naked lights
– Free from oil/grease (careful with hand creams)
– Open cylinders slowly
Flexlearn
Homely Remedies
• Service users/patients may obtain homely remedies (HR’s) at
their own discretion.
• If service users/patients request staff to administer HR’s this
must be done in accordance with the care plan
• Administration must be recorded appropriately
• Check that HR’s can be taken with prescribed medicines.
Flexlearn
Mistakes…don’t panic!
• Observe the service user/patient for any immediate problems which may require
contacting NHS Direct (see care plan) or the Emergency Services.
• Notify your line manager immediately who will seek advice from the prescriber, or
appropriate health care professional.
• Record details of the error in the daily log/ daily record and document action
taken
• Record details on the MAR
• Complete the appropriate incident form.
REMEMBER TO REPORT THE NEAR MISSES
Flexlearn
What happens next?
• Complete workbook and
deliver allocated power
point training sessions
(trainers)
• Complete workbook and
practice competency
checklist (care workers)
Flexlearn
Questions
• Any questions?