Preparation for Medication Administration

1. CMT Training #2 The Center for Life Enrichment Resource: MTTP Student Manual Preparation for Medication Administration

2. There are “Four (4) Basic Rules” that must be followed when giving medication to an individual in a DD community-based agency such as TCLE • Unlicensed Assistant Personnel (UAP) may administer medications ONLY after the successful completion of the MTTP and certification by the Maryland Board of Nursing (MBON) as a Medication Technician (CMT) • Only RN case managers/delegating nurses (RN CM/DN) may delegate the administration of medications to CMTs who are staff of or under contract with the DD community based program • All medications must have a current Health Care Provider (HCP) order and a pharmacy label to be administered • All “over-the-counter” medications must have a current HCP order and a pharmacy label to be administered 4 Basic Rules

3. As a CMT, you will be responsible for ensuring that individuals take their medications safely • Administering medications safely requires following the Medication Administration Process/Cycle: • Observing the individual for changes in physical condition and/or changes in behavior • Reporting these observations to the RN CM/DN and supervisor in an appropriate time frame • Assisting the individual in a visit to the HCP and communicating and obtaining all necessary information (May apply to CMTs providing ISS/CSLA support) • Communicating with the pharmacist and obtaining the prescribed medication (i.e. new orders/refills) (May apply to CMTs providing ISS/CSLA support) • Storing the medication safely • Administering medications correctly • Ensuring medications are taken • Recording information promptly, correctly and on correct forms Staff Responsibilities in Administering Medications

4. The MAR is a form used for documenting that medications have been administered as ordered • Specific information must be recorded on the MAR when a new medication is received from the pharmacy and when a medication is administered: • The individual’s name, sex, & birth date • The name of the agency • The month and year of the record • Pertinent diagnoses • Any allergies the individual may have; “none known” should be written if none exists • The individual’s diet as ordered by the HCP (Health Care Professional) • The individual’s primary physician • The name of the delegating Registered Nurse responsible for follow-up and monitoring Medication Administration Record (MAR)

5. If there is a current MAR for the individual (meaning that other medications are already being given this month), and a new medication is ordered, then a new MAR does not have to be started • The following information about the new medication can be added to the current MAR: • Name of the medication • Prescribed dose of the medication • Route of the administration • Times (frequency) of administration • Start date is the most recent date on the signed HCP order • The HCP must write a Discontinue Order for all medications/treatments. If applicable, this discontinued date is to be documented in the D/C column of the MAR • Draw a horizontal line and arrow up to the exact date and time(s) the medication is to start Adding a Medication to a Current MAR

6. The MAR is a legal document! • All information must be documented in blue or black ink • Do not erase! • Do not use whiteout! Remember,

7. Compare the HCP order, the Pharmacy Label, & MAR • Make sure all 3 match! “3 Way Check”

8. All medications must be stored in the original containers in which they were dispensed by the pharmacist • The pharmacy label should never be altered • All medications must be grouped by the individual and stored centrally in a locked cabinet (area) • The storage area must be locked when not in use • The key to the locked medicine cabinet (area) or access to a lock combination should only be available to those individuals authorized to administer medications • Refrigerated medications must also be kept in a locked storage container in the refrigerator Medication Storage

9. At times you may be responsible for disposing of medications. This may occur when: • The medication is discontinued before all of it is used • The individual has refused to take the medication after it has been poured • The medication is dropped on the floor or becomes contaminated in some other way • The medication has expired • The RN CM/DN will dispose of any Schedule II/Controlled Substances according to agency policy Disposing of Medications

10. Any Questions?