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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?