CBRF Medication Administration Training

1. 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

2. 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

3. SECTION I: INTRODUCTION TO MEDICATION ADMINISTRATION • Under certain conditions • After successful completion of this training course Resident assistants (RAs) may administer medication to residents:

4. 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

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

6. Med Administration Differences • Staff administered with supervision • Staff administered without supervision • Self administered Ways that medication can be administered: Activity: Residents’ Rights and Medication Administration

7. Legal and Ethical Issues • Legal Responsibilities – Permitted by the law • Ethical Responsibilities – Nursing Code of Ethics Activity: Code of Ethics for Caregivers

8. Nurse Practice Act Allows RNs to: • Delegate tasks • Provide direction and assistance • Observe and monitor • Evaluate

9. Medication Administration Procedures

10. 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

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

12. Dosage Forms

13. Medication Terminology • Drug indication • Drug effect or action • Side effect • Drug allergies • Specific administration information

14. Factors that Impact Drug Effectiveness • Age • Drug interactions • Fluids • Renal function • Gender Activity: Drug Effects

15. Classes of Commonly Used Drugs

16. More Drug Classes Activity: Using the Drug Classification Reference Tool

17. Medical Abbreviations PRN Medications • Means “as needed” Stat Medications • Means “immediately” Activity: Understanding Abbreviations

18. 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

19. Pain Management • Causes of Pain • Pain Management Scales • Numeric Rating System • Wong-Baker Faces Pain Rating Scale

20. Pain Management Medication Acetaminophen • Mild pain Non-steroidal anti-inflammatories (NSAIDs) • Mild to moderate pain Opiods • Severe and chronic pain

21. Controlled Substances Over 6 million people “divert” medications Not restricted to any: • Socio-economic class • Culture • Geographic location • Profession

22. Federal Controlled Substances Act

23. 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

24. Commonly Abused Prescription Medications • Opiods – pain • CNS Depressants – anxiety and sleep disorders • Stimulants -sleep disorders and ADHD

25. 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

26. 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

27. SECTION III: MEDICATION MANAGEMENT • Administrative records • Orders • Packaging requirements • Labeling Medication Administration System CBRF Policies and Procedures should cover:

28. 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

29. 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.

30. 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

31. 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

32. Medication Errors Causes of Medication Errors • Wrong medication • Wrong dose • Wrong time/omission • Wrong route • Wrong technique Activity: Recognizing Medication Errors

33. 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

34. 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

35. SECTION IV: MEDICATION ADMINISTRATION The Six Rights of Medication Administration: • Right Individual • Right Drug • Right Dose • Right Time • Right Route • Right Documentation

36. 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

37. 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

38. Using the Medication Administration Record You must demonstrate the ability to read and understand the medication administration record

39. 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

40. 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

41. 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