PEGCO, Inc.
386-756-4266
ASSISTED LIVING/ HOME HEALTH
Medication Management
Presented By Bill Stacy RN
AGENDA
I. Introduction
II. Medication Labels & Health Care Orders
III. Medication Management
a. Self Administration
b. Assistance with Self Administration
c. Medication Administration
IV. Storage & Disposal of Medications
V. Common Medication Classifications & Side Effects
VI. Medication Administration Documentation Exercises
VII. Skills Demonstration Exercises
VIII. Questions & Answers
IX. Evaluations
X. Certificates
OBJECTIVES
Upon completion of the training program caregivers will be able to demonstrate the ability to:
1. Understand a prescription label.
2. Provide assistance or administer oral medications
3. Provide assistance or administer topical forms of medication including ophthalmic, optic and nasal forms.
4. Measure liquid medications, break scored tablets & crush tablets as directed by prescription order.
5. Recognize the general side effects of medication classes and how to report adverse reactions.
6. Recognize the need to seek clarification for “as needed” prescription orders.
7. Develop an understanding of the types of questions to as a health care provider regarding a patient’s medication.
8. Recognize a medication order which requires judgment and advise the patient, patient’s health care provider, or supervisor of the unlicensed caregiver’s inability to assist or administer of such orders.
9. Complete a medication observation or administration record.
10. Retrieve and store medications.
429.256 Assistance with self-administration of medication.
For the purposes of this section, the term:
(a) "Informed consent" means advising the resident, or the resident's surrogate, guardian, or attorney in fact, that an assisted living facility is not required to have a licensed nurse on staff, that the resident may be receiving assistance with self-administration of medication from an unlicensed person, and that such assistance, if provided by an unlicensed person, will or will not be overseen by a licensed nurse.
(b) "Unlicensed person" means an individual not currently licensed to practice nursing or medicine who is employed by or under contract to an assisted living facility and who has received training with respect to assisting with the self-administration of medication in an assisted living facility as provided under s. 429.52 prior to providing such assistance as described in this section.
(2) Residents who are capable of self-administering their own medications without assistance shall be encouraged and allowed to do so. However, an unlicensed person may, consistent with a dispensed prescription's label or the package directions of an over-the-counter medication, assist a resident whose condition is medically stable with the self-administration of routine, regularly scheduled medications that are intended to be self-administered. Assistance with self-medication by an unlicensed person may occur only upon a documented request by, and the written informed consent of, a resident or the resident's surrogate, guardian, or attorney in fact. For the purposes of this section, self-administered medications include both legend and over-the-counter oral dosage forms, topical dosage forms and topical ophthalmic, otic, and nasal dosage forms including solutions, suspensions, sprays, and inhalers.
(3) Assistance with self-administration of medication includes:
(a) Taking the medication, in its previously dispensed, properly labeled container, from where it is stored, and bringing it to the resident.
(b) In the presence of the resident, reading the label, opening the container, removing a prescribed amount of medication from the container, and closing the container.
(c) Placing an oral dosage in the resident's hand or placing the dosage in another container and helping the resident by lifting the container to his or her mouth.
(d) Applying topical medications.
(e) Returning the medication container to proper storage.
(f) Keeping a record of when a resident receives assistance with self-administration under this section.
ASSISTANCE WITH MEDICATION DOES NOT INCLUDE:
1. Mixing, compounding, converting or calculating medication dosages
2. Preparing or giving injections
3. Administration of medications through intermittent positive pressure breathing machines or a nebulizer WITHOUT ADDITIONAL TRAINING
4. Administration of medications through a tube inserted in the body.
5. Parenteral preparations (medications which are not taken by mouth or applied topically such as IV Medications)
6. Irrigations or dedribing agents, suck as for the treatment of pressure sores.
7. Rectal, urethral, or vaginal preparations (such as Suppositories)
8. “As needed” or PRN medications where the orders are unclear or require judgment on the part of the caregiver
9. Any medication which requires judgment or discretion
on the part of the unlicensed caregiver
COMMON PRESCRIPTION SYMBOLS
|
ac before meals ad lib As desired ad right ear as left ear au both ears bid twice a day gtt drop hs bedtime or hour of sleep od right eye os left eye ou both eye |
po by mouth tid three times a day pc after meals prn as needed q3h every three hours qd every day qid four times a day
|
Example of a properly written prescription for PRN medication
McMahon Pharmacy
200 Main Street, Boca Raton, Fl.
Ph. 561-555-8787 Fax. 561-555-8686
RX# 5564 Dr. Johnson, DO
Mabel Poole 3/15/05
A. Why is patient taking this medication? ______________________________
B. How often is this medication taken? ________________________________
C. When do you call the doctor if the medication is ineffective? _____________
D. What is the expiration date of this medication? _______________________
Example of a prescription for PRN medication that would require CLARIFICATION
McMahon Pharmacy
200 Main Street, Boca Raton, Fl.
Ph. 561-555-8787 Fax. 561-555-8686
RX# 5599 Dr. Johnson, DO
Unlicensed caregivers MAY take clarification orders over the phone
A. Why is patient taking this medication? ______________________________
B. How often is this medication taken? ________________________________
C. When do you call the doctor if the medication is ineffective? _____________
D. What is the expiration date of this medication? _______________________
5 RIGHTS OF MEDICATION MANAGEMENT
· RIGHT RESIDENT
· RIGHT MEDICATION
· RIGHT DOSE
· RIGHT TIME
· RIGHT ROUTE
FOLLOWING THESE RULES WILL GREATLY DECREASE RISK OF MEDICATION ERRORS!
SIDE EFFECT IS DEFINED AS:
THE BODY’S REACTION TO A MEDICATION THAT IS DIFFERENT FROM THAT WHICH WAS INTENDED BY THE HEALTHCARE PROVIDER