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  • Administering Medications In Home Support

    First Edition

  • The Elizabeth M. Boggs Center on Developmental Disabilities

    University of Medicine & Dentistry of New Jersey • Robert Wood Johnson Medical School 2002 2

    ADMINISTERING MEDICATIONS - A GUIDE FOR IN HOME SUPPORTS

    Acknowledgments This guide was developed from a much more extensive training module, Administering Medications, which is used in preservice training for all residential staff working with people with developmental disabilities. It has been developed and produced with financial support of the New Jersey Division of Developmental Disabilities. Its goal is to provide some basic information on medications for respite care workers, personal assistants, and others who work directly for people with developmental disabilities and their families.

    This guide cannot be substituted for The Boggs Center and Division of Developmental Disabilities preservice Medication Training. Review of the material in the guide will not satisfy New Jersey Office of Licensing and Inspections requirements for certification. Families and consumers who want their personal assistants or direct support workers to get more extensive medication training should contact a local provider agency.

    Thanks to the following for their work on this Guide:

    Bill Gaventa Training Network Coordinator

    Robyn Risley Coordinator of Communications

    Mimi Lencovich Epilepsy Foundation of New Jersey

    Donna Toth Lead Trainer, Arc of Bergen/Passaic

    335 George Street • P.O. Box 2688 • New Brunswick, New Jersey 08903-2688 Voice (732) 235-9300 • TDD (732) 235-9328 • Fax (732) 235-9330

    . Copyright 2002 The Elizabeth M. Boggs Center on Developmental Disabilities. All rights reserved.

  • The Elizabeth M. Boggs Center on Developmental Disabilities

    University of Medicine & Dentistry of New Jersey • Robert Wood Johnson Medical School 2002 3

    ADMINISTERING MEDICATIONS - A GUIDE FOR IN HOME SUPPORTS

    Table of Contents ADMINISTERING MEDICATIONS -

    A GUIDE FOR IN HOME SUPPORTS

    Chapters 1 Medications and Related Issues ................................................. 5

    2 Categories and Effects of Medications ..................................... 15

    3 Observing and Reporting .......................................................... 23

    4 Documentation .......................................................................... 31

    5 Administering Medications ........................................................ 43

    This guide and manual for use by in home personal assistants and respite workers was adapted from The Boggs Center training manual used by agencies for direct support staff in group home and other residential settings. This guide cannot be substituted for The Boggs Center Preservice Medication Training. Review of this will not satisfy the New Jersey Office of Licensing requirements for Medication Certification and therefore no certificate will be awarded.

    Families, respite workers, and personal assistants who want more extensive training can contact coordinating agencies to participate in the agency based training on medication administration.

    The suggestions and guidelines in this manual should be checked by both families and in home support workers to make sure they conform to the specific directions and instruction developed by families for use in their own homes.

    Families may wish to attach specific instructions on medications and medical emergencies to this manual, and/or highlight particular sections which apply to their son, daughter, or relative.

    In home workers must also check with their coordinating agency for any specific requirements and reporting procedures.

    Any suggestions for changes in this guide should be sent to:

    The Boggs Center on Developmental Disabilities UMDNJ P.O. Box 2688 New Brunswick, NJ 08903

  • The Elizabeth M. Boggs Center on Developmental Disabilities

    University of Medicine & Dentistry of New Jersey • Robert Wood Johnson Medical School 2002 4

    ADMINISTERING MEDICATIONS - A GUIDE FOR IN HOME SUPPORTS

  • The Elizabeth M. Boggs Center on Developmental Disabilities

    University of Medicine & Dentistry of New Jersey • Robert Wood Johnson Medical School 2002 5

    ADMINISTERING MEDICATIONS - A GUIDE FOR IN HOME SUPPORTS

    Chapter 1 MEDICATIONS

    AND RELATED ISSUES

    Objectives

    This guide will help direct support workers do the following:

    1. understand why specific procedures for administering medications are necessary;

    2. understand the use of medication to alter behavior;

    3. view medication administration as an opportunity for learning.

    Introduction

    Among the many duties of a provider of direct support, the administration of medications requires specific understanding of the need for attention to detail for the safety of the individual. It is most important that staff apply themselves diligently in acquiring a basic knowledge of medications, their use or abuse, correct dosage, methods of administration, signs of overdosage, and adverse reactions which may arise in the treatment of various conditions.

    The attitude of the staff towards the use of medications is an important factor. Ideally, the body functions best when given adequate food, rest, relaxation, and freedom from undue emotional stress. However, because of challenges of a physical or emotional nature, it is necessary at times to utilize medications to produce a more stable condition.

    The staff person who combines diligent and intelligent observation with moral integrity and plain common sense in their administration of medications will make lasting contributions.

  • The Elizabeth M. Boggs Center on Developmental Disabilities

    University of Medicine & Dentistry of New Jersey • Robert Wood Johnson Medical School 2002 6

    ADMINISTERING MEDICATIONS - A GUIDE FOR IN HOME SUPPORTS

    Why Have a Medication Guide? Almost all adults in our society are familiar with doctors and pharmacists, and have used a variety of medications. However, there are some important reasons for the training offered in this module:

    1. Many of the individuals you teach will need prescribed medications which you may not be familiar with and which are potentially dangerous.

    2. A service system can not always use typical, everyday procedures. For example, most parents administer medications without using formal rules and regulations. However, when a program, such as the one you work in, assumes responsibility for the support and protection of the individuals they serve, it is required by law to make special efforts to protect their safety. Serious medication errors are often made even in relatively uncomplicated family settings. Given the complexity of services (many different staff, people with developmental disabilities, and staff turnover, etc.), you can see that a systematic set of rules and regulations is necessary to ensure that appropriate procedures are carried out on a consistent basis. You need to be thoroughly familiar with those rules and procedures.

    3. In addition to protecting the health and well-being of the people you teach, your knowledge of appropriate medication procedures will serve to protect you and your agency from errors which could have serious legal consequences.

    The Medication Cycle

    Safe Administration As you see in the diagram, safe medication administration can be looked at as a cycle which proceeds from observation, to reporting changes, to administering and documenting, and back to observing.

  • The Elizabeth M. Boggs Center on Developmental Disabilities

    University of Medicine & Dentistry of New Jersey • Robert Wood Johnson Medical School 2002 7

    ADMINISTERING MEDICATIONS - A GUIDE FOR IN HOME SUPPORTS

    Medications Must be Used Correctly Aspirin, penicillin, vitamins, phenobarbital, dilantin . . . when used cautiously and correctly, these chemicals, or medications, can have a number of desirable effects. When used incorrectly or carelessly, these same chemicals can result in many undesirable and potentially dangerous effects.

    You Will Have Several Roles As an individual’s support worker, you may be required to help him/her use necessary medications safely. Depending on your specific job, you will function in some or all of the following ways:

    • observe individuals with developmental disabilities for changes in physical symptoms and/or behavioral signs.

    • report any changes to the right person at the right time by the right means.

    • record medication information on appropriate forms

    • actually supervise the administration of medications.

    Consumer involvement and participation are important, no matter how much support is required.

    All Functions Are Necessary It is important to understand that safe medication administration involves all of these job functions, and that it is much more than simply handing out medications.

    • Individuals with developmental disabilities usually first go to a doctor because someone has reported a change in physical symptoms or behavioral signs. An individual with developmental disabilities may not receive needed medical attention unless you conscientiously observe him or her and report any significant changes.

    • Reporting must be both in written and verbal form according to agency and family policy.

    • A person with developmental disabilities may receive the wrong amount of a medication or the wrong medication u