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
Dec 22, 2015
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