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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
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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
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SECTION I: INTRODUCTION TO MEDICATION ADMINISTRATION
Resident assistants (RAs) may administer medication to residents: Under certain conditions After successful completion of this training course
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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
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Honoring Resident Rights
Residents have the RIGHT to: Receive medication as prescribed Refuse medication Participate in planning Refuse care and treatment Make decisions
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Med Administration Differences
Ways that medication can be administered: Staff administered with supervision Staff administered without supervision Self administered Activity: Residents’ Rights and Medication Administration
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Legal and Ethical Issues
Legal Responsibilities – Permitted by the law Ethical Responsibilities – Nursing Code of Ethics Activity: Code of Ethics for Caregivers
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Nurse Practice Act Allows RNs to: Delegate tasks
Provide direction and assistance Observe and monitor Evaluate
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Delegated and Supervised by RN
Medication Administration Procedures Delegated and Supervised by RN Description Injection Using a needle Rectal or Vaginal Into the rectum or vagina Nebulizer Inhaled as a vapor from a machine Stoma Through a stoma Enternal “Feeding” tube
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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
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SECTION II: THE FACTS ABOUT MEDICATIONS
This section covers: Types and forms of medications Factors that can affect medications Classes of medications Pain management systems
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Dosage Forms Forms You May Administer After Completing this Training
Tablets (or pills) Aerosols or inhalers Capsules Transdermal patches Liquids Drops Powders Ointments/salves/sprays Forms You May Administer when Delegated by an RN Injectables Douches Suppositories Enemas
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Medication Terminology
Drug indication Drug effect or action Side effect Drug allergies Specific administration information
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Factors that Impact Drug Effectiveness
Age Drug interactions Fluids Renal function Gender Activity: Drug Effects
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Classes of Commonly Used Drugs
Analgesic Antifungal Antibiotic Antiparkinson Anticoagulant Antipsychotic Antidepressant Cardiovascular Antidiabetic Cholesterol
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More Drug Classes Cognitive Enhancers Respiratory Gastrointestinal Sedative Ophthalmic Hypnotic Osteoporosis Thyroid Activity: Using the Drug Classification Reference Tool
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Medical Abbreviations
PRN Medications Means “as needed” Stat Medications Means “immediately” Activity: Understanding Abbreviations
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Be Careful About Drug Names
Generic vs. Trade Name Drugs Acetaminophen vs. Tylenol Medications: Look Alike/Sound Alike Zantac ↔ Xanax Zestril ↔ Zyprexa Activity: Look Alike/Sound Alike Medications
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Pain Management Causes of Pain Pain Management Scales
Numeric Rating System Wong-Baker Faces Pain Rating Scale
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Pain Management Medication
Acetaminophen Mild pain Non-steroidal anti-inflammatories (NSAIDs) Mild to moderate pain Opiods Severe and chronic pain
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Controlled Substances
Over 6 million people “divert” medications Not restricted to any: Socio-economic class Culture Geographic location Profession
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Federal Controlled Substances Act
Schedule I High potential for abuse – no accepted medical use Schedule II 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
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Knowing Your Responsibilities
It is your ethical responsibility to ensure the safety and well-being of residents Report suspicions of drug diversion to a supervisor Store, administer and dispose of controlled substances appropriately
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Commonly Abused Prescription Medications
Opiods – pain CNS Depressants – anxiety and sleep disorders Stimulants -sleep disorders and ADHD
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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
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Reporting Drug Diversion by Caregivers
Wisconsin’s Caregiver Law: Abuse or neglect Misappropriation of property Criminal Charges and Penalties: Caregiver misconduct Criminal violation Permanent record
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SECTION III: MEDICATION MANAGEMENT
Medication Administration System CBRF Policies and Procedures should cover: Administrative records Orders Packaging requirements Labeling
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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 medications Dietary supplements
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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.
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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
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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
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Medication Errors Wrong medication Wrong dose Wrong time/omission
Causes of Medication Errors Wrong medication Wrong dose Wrong time/omission Wrong route Wrong technique Activity: Recognizing Medication Errors
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Medication Storage and 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
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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
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SECTION IV: MEDICATION ADMINISTRATION
The Six Rights of Medication Administration: Right Individual Right Drug Right Dose Right Time Right Route Right Documentation
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Standard Precautions Ways of doing your work to lower the chance of spreading disease Hand hygiene Protective equipment Care of the environment Safe injection practices
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Routes and Procedures Demonstration
You must demonstrate ALL EIGHT procedures before the training can continue Oral Medications Oral Inhalers Eye/Ophthalmic Drops Eye Ointment Ear Drops Nasal Medications Transdermal Medication Patches Topical Medications
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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
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Medication Administration Process Steps
Unlock the cabinet/cart Observe medication rights Check 3 times Practice hand hygiene Put on gloves Inform the resident Be respectful Observe the resident
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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
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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
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