Medication Administration Class

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Medication Administration Class. Catholic Community Services. Format for Class. Medicines Giving them Proving you gave them Doctors, Nurses and Medicines Core Competencies Skills And (Ahhhh) THE TEST. Protocol for Passing Medications. Medication Class - PowerPoint PPT Presentation

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<ul><li><p> Medication Administration Class</p></li><li><p>Format for ClassMedicinesGiving themProving you gave themDoctors, Nurses and MedicinesCore CompetenciesSkillsAnd (Ahhhh) THE TEST</p></li><li><p>Protocol for Passing MedicationsMedication Class</p><p>Pass test with 75%</p><p>Medication Assignment</p><p>Shadowing</p></li><li><p>Fatal FourAspirationConstipationDehydrationSeizures</p><p>Why do we care?</p></li><li><p>Nursing Outcomes at CCSAspiration</p><p>Constipation</p><p>Dehydration</p><p>Seizures</p><p>Skin Care</p><p>Preventable ER visits</p></li><li><p>Six RightsRight MedicationRight DoseRight manner/routeRight timeRight personRight documentation</p></li><li><p>Right Medication A drug order is written for specific medication</p><p>Double check that youobtained the right drugYour responsibility:ObtainPrepareAdministerthe correct medicationCheck three times themedication containerto the MARRight medication</p></li><li><p>Right Dose Your responsibility it to confirm what dose within the dose range was orderedMake sure that the dose of the medication you are giving matches the MAR orderNever assume what dose of drug will be administeredYou cannot give a different dosage than what is orderedRight dose</p></li><li><p>Right Manner or Route Most drugs have differentroutes for different needsNever assume what form of the drug will be administeredAlways confirm the right route with the MAR orderMost used:PO = oralSL = sublingualRectal = by rectumTopical = on skinRight Manner/Route</p></li><li><p>Right Time Administering dosesToo close together orTo far apartalter the therapeutic effect of the medicationDouble check with MAR when to administer medThe drugsPurpose andPharmacokineticsDetermine how often the medication is administeredYour responsibility is to administer:Stat meds ASAPSingle ordered medications at time orderedStanding ordered meds on timePRN medications when needed</p></li><li><p>Right Person A drug order is written for a specific residentDouble check that you have the right residentYour responsibility is to:ObtainPrepare, andAdministerthe medication to the correct person</p></li><li><p>Right Documentation Right documentation includes correct drug order and a signatureUsing the correct form to record the administration of the med assures that the resident does not receive another dose, preventing overdosing of the resident</p><p>Your responsibility is to document the administration of the med immediately.</p></li><li><p>Five AlwaysPhysician's order for every med/treatmentWash your handsPour medication into cupIdentify and stay with resident until medication is swallowedKeep med storage area locked, clean and orderly</p></li><li><p>Five NeversNever leave meds with client or outNever give a med prescribed for one client to anotherNever give meds prepared by another person.Never use a med that is outdated or from an illegible or unlabeled containerNever give meds if you have questions.</p></li><li><p>Five MustsHave correct MARRead label and compare it with MARGood positionDocumentUnderstand the medicine</p></li><li><p>Storage of MedicationsLocked</p><p>Clean</p><p>Refrigeration</p><p>Separate orals from topicals</p><p>Separate meds for different clients.</p></li><li><p>Preparing MedicationsChanging the form</p><p>Crushing meds</p><p>Measuring liquids</p></li><li><p>PharmacyUse Olsons Pharmacy</p><p>Not all clients use just one pharmacy</p><p>Important to know how each house connects with Olsons</p><p>Use them as a resource</p></li><li><p>Medication Administration RecordForever after known to you as MARPreparation of MARTranscription of ordersSigning backTime limited medicationsDiscontinuing medications</p></li><li><p>DocumentationIf it isnt written down, it did not happen.</p></li><li><p>Charting CodesYR</p></li><li><p>PracticeYou give a medication.Your HM tells you that Jessie needs to have a Dilantin blood test and not to give the 8 AM Dilantin.Adam went home for the weekend.Johnny spit out the medicine you gave him.</p></li><li><p>PRN MedicationsEstablish the need for the medication</p><p>Ensure there is a current order</p><p>Administer the medication</p><p>Sign the back of the MAR</p><p>Follow up within two hours</p></li><li><p>Practice on PRN MedicationsJohnny complains that his head hurts.</p><p>Ronny has a cough</p><p>Mark has a groin rash</p><p>Susie has not pooped in two days.</p></li><li><p>Controlled SubstancesDefinition</p><p>Why they are handled differently</p><p>Examples</p><p>Special Tracking and charting</p></li><li><p>Abbreviations </p></li><li><p>Charting You are telling a story with your charting</p><p>Each house will want you to chart in their way</p></li><li><p>Self Administrated MedsSelf determination is determined through ISP processAt present we have no residents who self-administerPlease see packet for process</p></li><li><p>Different kinds of medicationsVia the mouth!TopicalsSublingualsEye drops/ointmentsEar dropsRectal medsVaginal medsNasal meds</p></li><li><p>PO MedicationsDo not crush unless you have an orderSlower to be absorbedTaste is importantFood can impact the medicineTake with full glass of waterDo not mix in hot drinksShake all liquids before pouring out</p></li><li><p>TopicalsUsually used for skin conditionsAlways use glovesCheck expiration datesPrivacyBe aware of residents tendency to put body parts in their mouthsMake sure you note effectiveness</p></li><li><p>Sublinguals</p><p>Under the tongue</p><p>Do not offer water right away</p><p>Use gloves</p><p>Stay with resident until you are sure the medication has been absorbed</p></li><li><p>Eye Drops/OintmentsUsed to treat infections, inflammation, irritation and lack of moisture</p><p>Wash hands</p><p>Use Gloves</p><p>Explain to client</p><p>Drops before Ointments</p></li><li><p>Ear DropsWarm ear drops to body temperatureWash handsWear glovesHave resident lie on side opposite to the ear being treatedHave them stay that way 5-10 minutes</p></li><li><p>Rectal MedicationsUsed to stimulate bowel movements, relieve pain, relieve vomiting, reduce fevers, stop seizuresWash handsWear glovesPrivacy!!!!Usually kept in refrigeratorDocumentation of this one is important</p></li><li><p>Vaginal MedicationsDetermine if administration will involve 1 or 2 staff Wash handsWear glovesExplain procedurePrivacy!!!Best time to insert is after shower or bath</p></li><li><p>Nasal MedicationsWash hands</p><p>Wear gloves</p><p>Explain procedure</p><p>Spray vs. drops</p><p>Work with client</p></li><li><p>Medication ErrorsDefinition of a medication errorExamplesForgetting to signForgetting a follow upNot giving a suppository when dueWhat happensIntent</p></li><li><p>Where is the error?</p></li><li><p>Residents, Living and MedsOur residents have livesSome work or have lives outside our homesThey need their medicationCommunication is the key</p></li><li><p>Work site responsibilitiesWork site needs a copy of doctors orderAdministered by designated staff personSame rules apply: i.e. MAR, 5 rights</p></li><li><p>Home responsibilitiesProvide work with necessary informationInform worksite of any changesWhat is the abbreviation for the MAR at home when a resident is at work?</p></li><li><p>When a client goes homePills in envelopes one type of medication to an envelope</p><p>Whole bottles go home</p><p>Document on MAR</p><p>Never take medicine back</p></li><li><p>Hospitalized Residents DO NOT TAKE MEDICINES TO HOSPITAL</p><p>What is the appropriate documentation?</p></li><li><p>Disposal of Non-controlled MedicationsMedication that is outdated, recalled, or unused shall either be disposed of in a manner that assures that the medication cannot be retrieved or it will be returned to the providing pharmacy for client credit.</p><p>Documentation of this!</p><p>Any two staff can do this</p></li><li><p>Disposal of controlled medicationsMedication that is outdated, recalled, or unused shall either be disposed of in a manner that assures that the medication cannot be retrieved or it will be returned to the providing pharmacy for client credit.Documentation!Of the two staff, one must be an LPN or RN</p></li><li><p>Disposal DocumentationDateClients nameName of medication and dosageAmount of medication disposedReason for disposalMethod of disposalTwo signatures</p></li><li><p>Practice </p></li><li><p>What is a medicationMedication means any drug, chemical, compound, suspension or preparation in suitable form for use as a curative or remedial substance taken either internally or externally by any person.</p><p>Any medication for our clientsmust be prescribed by a MD</p></li><li><p>Adverse reactionAllergy</p><p>Side effects</p><p>Your part</p></li><li><p>Kinds of medicationsAnticonvulsantsAntipsychoticsAntibioticsAntidepressantsMultivitamin/Minerals/Dietary SupplementsAntidiabeticTopicalsAnalgesicsLaxatives</p></li><li><p>Timing of MedicationsKnow when to give medicines to gain most benefitNo laxatives within 1 hr of any other medicationIron should not be taken with milkGERD meds hr before mealUse your drug guideAs the doctor </p></li><li><p>Nurses at CCSNurse patient relationships</p><p>When to call</p><p>Protocol for paging</p></li><li><p>Doctors and MedicinesThey have the degreeThey also do the prescribingThey prescribe based on information we provideWe know the resident better than they doIt is in the residents best interest to work closely and respectfully with the physician</p></li><li><p>Doctors VisitWho decidesHow to prepareWhat to do afterwards</p></li><li><p>A prescriptionWritten by a doctorParts of a prescriptionClient name first and lastName of drugDosage of drugHow frequent to take it and how longWhat route</p></li><li><p>Telephone orders</p><p>Who can take themNurses LPNs or RNsHouse ManagersAssistant House Managers</p><p>Getting them on the MAR</p></li><li><p>Rights regarding medicationsRight to:know what they are gettinghave an explanationrefuse or consentconfidentiality and privacyappropriate services</p></li><li><p>Medication ResourcesPolicies</p><p>Drug Books</p><p>Drug information sheets</p><p>Pharmacy</p></li><li><p>HandwashingList times to wash hands</p><p>Use plenty of soap</p><p>Lots of friction</p><p>Dry hands with paper towel</p><p>Turn off faucet with paper towel</p></li><li><p>Blood pressureWhy do you have a blood pressureWhat does it representWhat is normalHow to take itWhat to do if it is abnormal</p></li><li><p>Practice </p></li><li><p>RespirationDefinition</p><p>How to count</p><p>What is normal</p><p>What to do if it is abnormal.</p></li><li><p>Practice </p></li><li><p>PulseA pulse is the throbbing of a vessel in response to the heart beating.</p><p>What is normal</p><p>How to count</p><p>What to do if it is abnormal</p></li><li><p>Practice </p></li><li><p>TemperatureJust as a motor is warm from working, our body is warm from its metabolism.</p><p>Normal Temperature USUALLY 98.6 orally may be different for different residents </p><p>A fever is an elevation of the body temperature above normal</p><p>Differences between oral, axillary, and rectal</p><p>When should you be concerned?</p></li><li><p>Practice </p></li><li><p>PainDefined by the residentWill be manifested differently by different residentsCan lead to other symptoms/behaviors which are not desirableWhat to do first if you suspect someone is in painWhen should you be concerned</p><p>Thank you for coming today. This part of your orientation, right? I am hoping this will be a little more concrete, although hearing about pay and benefits is good, right?</p><p>My name is Patricia Auerbach. I am one of the RNs who work with the Paragon Program. I have worked with Walker Home for about 2 years now. I have worked the Battlecreek and Bain Homes. I have also been on call for all the homes.</p><p>The other note you need to know about me and this class is that I am a nurse. And, surprise, surprise, I use nursing language. At any time you dont understand something, PLEASE ASK! We also will be talking about bodies and body functions. I am a nurse and a mother. Not much phases me. I hope I will not offend any of you with my openness.</p><p>The purpose of today's class is to provide you with information about safety giving medication to our residents. There is lots of information today. I hope to not overwhelm you. It is a lot of information. However, the learning process is broken up so if something isnt crystal clear today, you have several other times to make sure you are safe and ask questions.</p><p>I LOVE questions. I am a very interactive person. I dont do well just talking. So you are a definite part of today.</p><p>We will talk about:MedicinesHow to give themDocumentation proving you gave themHow do the CCS nurses fit inHow do doctors fit inCore competencies around medicationCertain skills you need such as:How to take a temperatureHow to take a blood pressureHow to assess painAnd yes there is a test. However it is my goal that you all pass it. The goal here is to be knowledgeable about medications and giving them.</p><p>Bathrooms</p><p>Break</p><p>Any questions yet?There are certain things you need to do in order to be considered safe and competent to give medications to our residents.You need to successfully complete this class with a 75% on the test.You need to complete the medication assignment within 2 weeks of today. That assignment is given to the RN for your home. She or he will review it for completeness and accuracy. If there are any additions needed, she will either talk with you or your manager. This is a learning process. Once the medication assignment is approved, you will shadow another experienced employee during 2-3 medication passes.Then someone will shadow you passing medications.When you, your manager/supervisor and the RN are all confident you know what you are doing, you are done with the process!These are four major health issues that are more common in people with developmental disabilities. They cause illness and can cause death. Our residents are dependent upon us for their health care and safety.</p><p>Aspiration, dehydration and constipation may be fairly invisible until they become serious. Seizures can happen very suddenly and place their at risk.</p><p>Aspiration is inhaling food, fluid, medications or secretions into the lungs. You will see a shortness of breath and low grade fever. </p><p>Constipation is a decrease or no passing of stool. The resident also can have a very difficult time having a bowel movement and/or the feces are hard or dry.The symptoms you see is a decrease or no bowel movements.</p><p>Dehydration is when our residents having a significantly lower body fluid content. This is dangerous to multiple systems. It can come about because many of our residents are dependent upon us for their fluids.</p><p>Seizures take all forms. Another word for this is convulsion. There are multiple effects of seizures not to mention problems with their breathing and/or injuries as a result.Outcomes at CCS are added benefits our residents receive as a result of us being in their lives.</p><p>Nursing Services have the following outcomes. Four of them you will recognize and now understand their importance!</p><p>Aspiration We want our residents to not have any aspiration.Constipation We want our residents to poop regularly and easily.Dehydration This just doesnt happenSeizures these either dont happen or at a level that doesnt compromise their health.</p><p>Skin care their skin is healthy and what we call intact no breaks.</p><p>Preventable ER visits - The six rights in giving medication ensure that the resident receives the right medication in the right dose in the right route at the right time and that medication is documented correctly as given.It is important that you give the right medication. It needs to be the residents medication. Check at least three times. The right dose is important. It is your responsibility to know that what you are giving is what is ordered for the resident. Never assume the dosage. Never assume what works for you works for the resident. You have to give what is ordered. Once again, check the MAR very carefully.Making sure that you are giving the medication right is important. Once again, check the MAR. Confirm that the route is right. This may seem obvious but never assume. </p><p>Crucial abbreviations:PO SLRectalTopicalTiming is crucial for medications. The therapeutic effect of the medication is heavily dependent upon when it is given and what it is given with. The drug book can b...</p></li></ul>

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