CBRF Medication Administration Training

1. CBRF Medication Administration Training Developed by: University of Wisconsin Oshkosh CCDET Approved by: Wisconsin Department of Health Services Division of Quality Assurance Bureau of Assisted Living March 1, 2014 www.uwosh.edu/ccdet

2. Training Topics • Resident Rights • Legal Responsibilities • Facility Policies and Procedures • Delegated Procedures • Medication Management • Medical Terms and Abbreviations • Medication Packaging, Labeling and Storage • Types of Medications • Medication Administration www.uwosh.edu/ccdet

3. SECTION I: INTRODUCTION TO MEDICATION ADMINISTRATION • Under certain conditions • After successful completion of this training course CBRF resident assistants (RAs) may administer medication to residents: www.uwosh.edu/ccdet

4. Role of the Caregiver • Approximately 800,000 drug-related injuries occur in U.S. long-term care facilities every year • Errors occur at many levels • Most are preventable www.uwosh.edu/ccdet

5. Honoring Resident Rights Residents have the RIGHT to: • Receive medication as prescribed • Refuse medication • Participate in planning • Refuse care and treatment • Make decisions www.uwosh.edu/ccdet

6. Med Administration Differences • Staff-administered with supervision • Staff-administered without supervision • Self-administered by resident Ways that medication can be administered: Activity: Residents’ Rights and Medication Administration www.uwosh.edu/ccdet

7. Legal Issues • CBRFs and staff regulated by Wisconsin law • Division of Quality Assurance roles • Dept. of Safety and Professional Service roles • CBRF legal requirements www.uwosh.edu/ccdet

8. Nurse Delegation Allows RNs to: • Delegate tasks • Provide direction and assistance • Observe and monitor • Evaluate www.uwosh.edu/ccdet

9. Medication Administration Procedures www.uwosh.edu/ccdet

10. Training and Supervision Related to Delegated Tasks Conditions that must be met: • You must be trained • Perform nurse delegated-tasks that are EXACTLY the same as your training Activity: Delegated Tasks www.uwosh.edu/ccdet

11. 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 www.uwosh.edu/ccdet

12. Dosage Forms www.uwosh.edu/ccdet

13. Purposes and Effects-Medication Terminology • Drug indication • Drug effect or action • Side effect • Drug allergies • Specific administration information www.uwosh.edu/ccdet

14. Factors that Impact Drug Effectiveness • Age • Drug interactions • Fluids • Renal function • Gender Activity: Drug Effects www.uwosh.edu/ccdet

15. Classes of Commonly Used Drugs www.uwosh.edu/ccdet

16. More Drug Classes Activity: Using the Drug Classification Reference Tool www.uwosh.edu/ccdet

17. Medical Abbreviations • Error-prone • Easy to misinterpret • Ask if you’re not sure • PRN Medications Activity: Understanding Abbreviations • Do Not Use List www.uwosh.edu/ccdet

18. Generic vs. Trade Name Drugs • Generic = New drug name • Trade = Brand name • Medications: Look Alike/Sound Alike Activity: Look Alike/Sound Alike Medications www.uwosh.edu/ccdet

19. Pain Management • Causes of Pain • Pain Management Scales • Numeric Pain Assessment Tool • Wong-Baker Faces Pain Rating Scale • Checklist of Non-Verbal Indicators • Facility Policy www.uwosh.edu/ccdet

20. Pain Management Medication Acetaminophen • Mild pain Non-steroidal anti-inflammatories (NSAIDs) • Mild to moderate pain Opioids • Severe and chronic pain www.uwosh.edu/ccdet

21. Controlled Substances • Millions of Americans use prescription drugs for non-medical reasons. • “Diversion” means using a drug for another purpose or person www.uwosh.edu/ccdet

22. Federal Controlled Substances Act www.uwosh.edu/ccdet

23. Commonly Abused Prescription Medications • Opioids – pain • CNS Depressants – anxiety and sleep disorders • Stimulants -sleep disorders and ADHD www.uwosh.edu/ccdet

24. 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 www.uwosh.edu/ccdet

25. Reporting Drug Diversion Wisconsin’s Caregiver Law: • Abuse or neglect • Misappropriation of property Criminal Charges and Penalties: • Caregiver misconduct • Criminal violation • Permanent record www.uwosh.edu/ccdet

26. SECTION III: MEDICATION MANAGEMENT Medication Administration System CBRF Policies and Procedures should cover: • Administrative records • Orders • Packaging requirements • Labeling www.uwosh.edu/ccdet

27. Medication Administrative Records The MAR is a written record of each resident’s medication regimen including: • Prescription drugs • Over-the-counter medications • Dietary supplements www.uwosh.edu/ccdet

28. 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. • Transcription of Orders www.uwosh.edu/ccdet

29. Medication Packaging and Labeling Requirements • Unit Dose Packaging • Medication Samples • Labeling Requirements • Medication Transfers • Expiration Dates Activity: Review of Medication Packaging and Labeling www.uwosh.edu/ccdet

30. Medication Procedures and Documentation • Required Documentation • Special Requirements for PRN Psychotropic Medication • Other Reporting and Documentation www.uwosh.edu/ccdet

31. Medication Errors Causes of Medication Errors • Wrong medication • Wrong dose • Wrong time/omission • Wrong route • Wrong technique Activity: Recognizing Medication Errors Ways to Prevent Errors www.uwosh.edu/ccdet

32. Medication Storage • Staff- vs. Self-Administered • Refrigeration • Chemicals • Internal/External Separation • Controlled Substances • Record/Auditing www.uwosh.edu/ccdet

33. Destruction & Disposal of Medication • Medications go with resident upon discharge • CBRF must have policy for disposing other types of medication • Witnessing and/or signing a medication destruction form is a big responsibility Activity: Med Storage & Disposal www.uwosh.edu/ccdet

34. CBRF Review and Monitoring Responsibilities CBRF Responsibilities: • Medication regimen review • Medication review for scheduled psychotropic medication • Annual review requirements • Other monitoring to assure oversight www.uwosh.edu/ccdet

35. SECTION IV: MEDICATION ADMINISTRATION • Follow requirements • Know which meds you may or may not administer • Completing this course vs. nurse delegation • Understand medications • Understand ordering, packaging, labeling, etc. • Use all resources available to you www.uwosh.edu/ccdet

36. The Six Rights of Medication Administration: • Right Individual • Right Drug • Right Dose • Right Time • Right Route • Right Documentation www.uwosh.edu/ccdet

37. 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 www.uwosh.edu/ccdet

38. Routes and Procedures Demonstration Oral Medications Oral Inhalers Eye/Ophthalmic Drops Eye Ointment Ear Drops Nasal Medications Transdermal Medication Patches Topical Medications www.uwosh.edu/ccdet

39. Using the Medication Administration Record Activity: Review the record www.uwosh.edu/ccdet

40. Medication Administration Process Steps • Unlock the cabinet/cart • Observe 5 medication rights • Check 3 times • Practice hand hygiene • Put on gloves • Inform the resident • Be respectful www.uwosh.edu/ccdet

41. More Medication Administration Process Steps • Administer meds • Allow the resident to assist • Observe the resident • Remove gloves • Repeat hand hygiene • Document required information Activity: Administering Medications Activity: Understanding the Medication Process www.uwosh.edu/ccdet

42. 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 www.uwosh.edu/ccdet