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Medication Administration Training for Paraprofessional Staff
Purpose and Objectives Purpose: To teach direct care staff basic knowledge for safe and accurate medication administration. Objectives: Staff will understand: 1. 2. 3. 4. Common medical abbreviations. The “six rights” of medication administration. Correct administration procedures for oral, inhaled, eye, ear, nose and emergency medications. Appropriate actions to be taken if a medication is not taken/given either by refusal or omission.
Common Abbreviations prn – as needed po – by mouth ac – before meals pc – after meals BID – twice a day TID – three times a day QID – four times a day QOD – every other day q – every qd - everyday q2h – every 2 hours c – with s – without a - before p – after n/v – nausea and vomiting npo – nothing by mouth gtts – drops mg – milligram ml – milliliter oz – ounce Tbsp – tablespoon (15ml) tsp – teaspoon (5ml)
“6 Rights” of Medication Administration 1. 2. 3. 4. 5. 6. Right Right Right Right Right Right CONSUMER MEDICATION DOSE TIME ROUTE DOCUMENTATION
Medication Guidelines Consumers will be given medication when the medication is prescribed by a healthcare practitioner and the consumer or parent/guardian completes a medication permission form. Over-the-counter medications also require a medication permission form.
Role of the Paraprofessional Staff Verify authorization forms are properly completed. Assure medication is properly labeled and matches the information provided on the authorization form. Maintain medication in a locked place, inaccessible to other consumers. Maintain medication administration records.
Responsibilities When Administering Medication Know the agency’s policy and regulations. Follow medication administration guidelines. Know the “6 Rights” of medication administration. Make certain the consumer receives his/her medication since serious consequences would occur if a dose is missed. Notify the parent/guardian or physician immediately if medication error occurs.
Medication Log Complete a medication administration record (MAR) form for each consumer receiving medication. Each medication should listed on a separate line. When administering medication, document time and your initials IMMEDIATELY AFTER giving the medication. If documentation is not completed, other staff could think the medication has not been given. If the consumer refuses to take the medication, make a notation in comments area, which must be dated.
Reporting Medication Errors If you believe a medication error has occurred, notify the parent/guardian immediately. Errors may include, but are not limited to, giving the wrong medicine, wrong consumer, wrong dosage, wrong time, or wrong route. Notify parents, physician and supervisor (the assigned QP) immediately and complete an incident report. Monitor consumer / follow physician instructions.
Non-Prescription Medications If a healthcare practitioner feels it is necessary for a consumer to take non-prescription over-the-counter (OTC) medication, then s/he and the parent/guardian must complete a medication permission form. Parent/guardian will provide the day program with an unopened container of the OTC medication. Personnel will administer the medication following the
Review - Safe Medication Administration Guidelines 1. Know and follow the “6 rights” of medication administration. 2. Document medication administration immediately after giving the medication. 3. Report any medication errors immediately. 4. If you have any questions about the medication, STOP, do not give the medication and follow up with the parent/guardian or healthcare provider. 5. Medication must be kept in a locked cabinet/drawer. 6. If a consumer vomits within 1 hour after receiving medication, notify the parent/guardian so proper action can be taken. 7. It is generally accepted that medication should be administered within 1 hour before or after the scheduled dose is due.
Route-Specific Medication Procedures Oral (tablets, capsules, liquids) 1. 2. 3. 4. 5. 6. 7. 8. 9. Wash your hands!!! Verify consumer’s identity. Review the medication order. Retrieve the appropriate medication container, make sure the label matches the consumer and the physician’s order. Pour the correct dosage into the cap of the bottle or medication cup without touching the medication. Double check the medication, dosage, route, time and consumer then pour the medication into the consumer’s hand. Provide water or if the consumer has a special method to taking the medication (i.e. in applesauce), it should be noted on the medication log. Liquid medication should be held at eye level when measuring dosage. Observe consumer swallowing the medication. Document the medication administration on the medication log. Return the medication container to its locked storage place.
Oral Medications continued Tablets/Capsules – Only break tablets that are scored. Do not open any capsules or break/crush any tablets unless the physician specifically orders it. Extended release tablets should never be cut or crushed. Liquids – When measuring liquid medication, use a medication cup, syringe or medication measuring spoon. Do not use a household teaspoon or tablespoon to measure liquid medication.
Inhalers Follow the Asthma Action Plan for orders for inhalers. Indications for rescue inhaler use are: Difficult, shallow rapid breathing Longer time exhaling than inhaling, whistling or wheezing noise with breathing. Unable to speak more than 1-2 words without taking a breath. Coughing continuously Flaring nostrils Neck/chest muscles pull in (retract) with breathing Cyanotic (turning blue) Consumer states that his/her chest feels tight or complains of difficulty breathing. Call parent/guardian if no improvement after inhaler use.
Inhalers Wash hands and wear gloves. Follow the “5 rights” of medication administration. Shake inhaler, attach inhaler to spacer if provided. Ask consumer to breath out, place mouthpiece in mouth with lips sealed around it or cover mouth and nose with mask. Depress canister to release medication as consumer breathes in slowly. Ask consumer to hold breathe for 10 seconds and breathe out slowly through pursed lips. Wait at least 1 minute before administering another puff, if prescribed. Remove gloves and wash hands. Document.
Ear Drops (Otic Medications) Wash hands, wear gloves, follow the “5 rights” of medication administration. Have the consumer lay on the cot in the sidelying position with the appropriate ear facing upward. Gently grasp the pinna of the ear and pull it upward and backward to straighten the ear canal. Insert the prescribed number of drops along the side of the ear canal. Do not allow the dropper tip to touch the ear. Have the consumer remain in the sidelying position for 3-5 minutes to ensure absorption of medication. Only insert cotton in the opening of the ear canal if prescribed by the physician. Remove gloves and wash hands. Document.
Eye Drops (Ophthalmic Medications) Wash hands, wear gloves, follow the “5 rights” of medication administration. Instruct consumer to tilt head back and look up to the ceiling. Pull the lower lid down and administer the prescribed number of drops, one at a time, in the pocket created by pulling down the lower lid. Do not touch any part of the eye with the tip of the eye dropper. Do not allow consumer to rub eyes. Blotting with a tissue is okay. Remove gloves and wash hands. Document.
Topical Medications Wash hands, wear gloves, and follow the “5 rights” of medication administration. Wash area if directed. Apply a thin layer of medication as directed using a tongue blade, cotton swab or gloved finger. Cover area if directed. Remove gloves and wash hands. Document.
Medication Administration Test Congratulations, you have almost completed your annual medication administration training. Now you will take a short quiz to test your knowledge.