CBRF Medication Administration Training

Developed by:University of Wisconsin Oshkosh

Approved by:Wisconsin Department of Health Services

Division of Quality Assurance Bureau of Assisted Living

Training Topics

Resident Rights Legal and Ethical Responsibilities Facility Policies and Procedures Delegated Procedures Medication Management Medical Terms and Abbreviations Medication Packaging, Labeling and

Storage Types of Medications Medication Administration

SECTION I: INTRODUCTION TO MEDICATION ADMINISTRATION

Under certain conditionsAfter successful completion of this

training course

Resident assistants (RAs) may administer medication to residents:

Role of the Caregiver

Approximately 800,000 drug-related injuries occur in long-term care every year

Errors occur at many levels - from prescription to administration

Most are preventable

Honoring Resident Rights

Residents have the RIGHT to: Receive medication as prescribed Refuse medication Participate in planning Refuse care and treatment Make decisions

Med Administration Differences

Staff administered with supervision Staff administered without supervision Self administered

Activity: Residents’ Rights and Medication Administration

Ways that medication can be administered:

Legal and Ethical Issues

Legal Responsibilities – Permitted by the law

Ethical Responsibilities – Nursing Code of Ethics

Activity: Code of Ethics for Caregivers

Allows RNs to: Delegate tasks Provide direction and assistance Observe and monitor Evaluate

Nurse Practice Act

Delegated and Supervised by RN

Description

Injection Using a needle

Rectal or VaginalInto the rectum or

vagina

NebulizerInhaled as a vapor from a machine

Stoma Through a stoma

Enternal “Feeding” tube

Medication Administration Procedures

Training and Supervision Related to Delegated Tasks

Conditions that must be met: You must be trained You are only permitted to perform nurse

delegated-tasks that are EXACTLY the same as your training

Activity: Delegated Tasks

SECTION II: THE FACTS ABOUT MEDICATIONS

This section covers:Types and forms of medications Factors that can affect medications Classes of medicationsPain management systems

Dosage Forms

Forms You May Administer when Delegated by an RN

Injectables Douches

Suppositories Enemas

Forms You May Administer After Completing this Training

Tablets (or pills) Aerosols or inhalers

Capsules Transdermal patches

Liquids Drops

Powders Ointments/salves/sprays

Medication Terminology

Drug indication Drug effect or actionSide effectDrug allergiesSpecific administration

information

Factors that Impact Drug Effectiveness

Age Drug interactions Fluids Renal function Gender

Activity: Drug Effects

Classes of Commonly Used Drugs

Analgesic Antifungal

Antibiotic Antiparkinson

Anticoagulant Antipsychotic

Antidepressant Cardiovascular

Antidiabetic Cholesterol

More Drug Classes

Cognitive Enhancers

Respiratory

Gastrointestinal

Sedative

Ophthalmic HypnoticOsteoporosis Thyroid

Activity: Using the Drug Classification Reference Tool

Medical Abbreviations

PRN Medications Means “as needed”

Stat Medications Means “immediately”

Activity: Understanding Abbreviations

Be Careful About Drug Names

Generic vs. Trade Name DrugsAcetaminophen vs. TylenolMedications: Look Alike/Sound Alike

Zantac ↔ XanaxZestril ↔ Zyprexa

Activity: Look Alike/Sound Alike Medications

Pain Management

Causes of PainPain Management Scales

Numeric Rating SystemWong-Baker Faces Pain Rating Scale

Pain Management Medication

Acetaminophen Mild pain

Non-steroidal anti-inflammatories (NSAIDs)

Mild to moderate pain

Opiods Severe and chronic pain

Controlled Substances

Over 6 million people “divert” medicationsNot restricted to any:Socio-economic classCultureGeographic location Profession

Federal Controlled Substances Act

Schedule I High potential for abuse – no accepted medical use

Schedule II High potential for abuse – an accepted medical use

Schedule III Lower potential for abuse than I or II

Schedule IV Lower potential for abuse than III

Schedule V Lower potential for abuse than IV

Knowing Your Responsibilities

Report suspicions of drug diversion to a supervisor

Store, administer and dispose of controlled substances appropriately

It is your ethical responsibility to ensure the safety and well-being of residents

Commonly Abused Prescription Medications

Opiods – pain

CNS Depressants – anxiety and sleep disorders

Stimulants -sleep disorders and ADHD

Increasing Awareness: What Caregivers Can Do

Watch for red flags of drug abuse or medication diversion

Don’t enable the abuser

Activity: Developing Best Practices

Activity: Applying Best Practices

Reporting Drug Diversion by Caregivers

Wisconsin’s Caregiver Law:Abuse or neglect Misappropriation of property

Criminal Charges and Penalties:Caregiver misconductCriminal violationPermanent record

SECTION III: MEDICATION MANAGEMENT

Administrative records Orders Packaging requirements Labeling

Medication Administration System

CBRF Policies and Procedures should cover:

Medication Administrative Records

The MAR is a written record of each resident’s medication regimen – it tells when the resident is taking:Prescription drugs Over-the-counter medicationsDietary supplements

Medication Orders

DHS 83 requires a physician’s or practitioner’s order in each resident’s chart or record for all prescription or over-the-counter medications.

Medication Packaging and Labeling Requirements

Unit doses are required when no supervision

Permanent labels Medications may not be shared

Activity: Review of Medication Packaging and Labeling

Medication Procedures and Documentation Name of the med-dosage, date and

time of administration Treatments Effects or side effects The need for PRN meds Refusal by the resident to take meds Omissions of meds Medication errors Drug reactions

Medication Errors

Causes of Medication ErrorsWrong medicationWrong doseWrong time/omissionWrong routeWrong technique

Activity: Recognizing Medication Errors

Medication Storageand Disposal

DHS 83 requires that medications are secured in accordance with laws and regulations to prevent access by unauthorized persons

Activity: Medication Storage and Disposal

CBRF Review and Monitoring Responsibilities

The CBRF’s Responsibilities: Medication regimen review Medication review for scheduled

psychotropic medication Annual review requirements Other monitoring to assure oversight

SECTION IV: MEDICATION ADMINISTRATION

The Six Rights of Medication Administration:

1.Right Individual 2.Right Drug3.Right Dose4.Right Time5.Right Route6.Right Documentation

Standard Precautions

Ways of doing your work to lower the chance of spreading diseaseHand hygieneProtective equipmentCare of the environmentSafe injection practices

Routes and Procedures Demonstration

You must demonstrate ALL EIGHT procedures before the training can continue

1.Oral Medications2.Oral Inhalers3.Eye/Ophthalmic Drops4.Eye Ointment5.Ear Drops6.Nasal Medications7.Transdermal Medication Patches8.Topical Medications

Using the Medication Administration Record

You must demonstrate the ability to read and understand the medication administration record

Time and day Special instructions

Medication name PRN orders

Route Documentation

Medication Administration Process StepsUnlock the cabinet/cartObserve medication rightsCheck 3 timesPractice hand hygienePut on gloves Inform the resident Be respectfulObserve the resident

More Medication Administration Process Steps Administer meds Allow the resident to assist Assure ingestion Remove gloves Repeat hand hygiene Document required information

Activity: Administering Medications

Activity: Understanding the Medication Process

Training Topics Review Resident Rights Legal and Ethical Responsibilities Facility Policies and Procedures Delegated Procedures Medication Management Medical Terms and Abbreviations Medication Packaging, Labeling and Storage Types of Medications Medication Administration