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HSC 3047 :Part 2 Support the use of medication in social care settings: Medication administration Sheena Helyer 12.2012.

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Presentation on theme: "HSC 3047 :Part 2 Support the use of medication in social care settings: Medication administration Sheena Helyer 12.2012."— Presentation transcript:

1 HSC 3047 :Part 2 Support the use of medication in social care settings: Medication administration
Sheena Helyer

2 Medication delivery: learning outcomes
To understand techniques for administering medication To be able to give the following safely:- Tablets Eye Drops Nasal medication Ear Drops Oxygen Inhaled medication Nebulised medication Medication patches Creams To be aware of devices which can be used to help people take their medicines independently HSC 3047 Medication delivery

3 Medication instructions
When a pharmacist dispenses medication against a valid prescription it must be clearly labelled with:- The dispensing date The name of the medicine The dose and frequency The route The service user’s full name and date of birth Special instructions Warnings or cautions Name of pharmacy Use by date Instructions i.e. ‘Keep out of reach of children’ If a label is damaged or illegible the medicine should not be given until the label has been replaced. Labels on bottles are easily damaged if liquid dribbles down the outside so they must be wiped clean after use. Damaged labels will need to be replaced by the pharmacy. HSC 3047 Medication delivery

4 Care plan and recording
Care staff should always read the care plan before giving medicine and check exactly what support is required. There should be a record of what medication should be given and where to find it e.g. ‘in the fridge’ .This will need to be written out once a month and double checked. The care plan will indicate the level of administration e.g. prompting or administering on behalf of the service user. The carer should sign the record sheet once he/she is sure that the medication has been swallowed or delivered. Any medicine which cannot be given must also be recorded and the reason documented. Any medication not given, gaps on the medication sheet or irregularities must be reported to the manager. Show the learners their local recording sheet and check that they know how to fill it in. Care staff should not give any medicine which is not labelled properly by the pharmacy HSC 3047 Medication delivery

5 Verbal messages and changes
It can be dangerous to accept instructions by phone Carers must follow their local policy in this situation Usually if there are any changes to the regular medication the dosette box will need to be sent back to the pharmacy for the changes to be made. Warfarin doses may need to be changed following INR blood tests. This is usually organised by the GP and pharmacy. Care staff should not have to go through a dosette box removing tablets which have been discontinued as this could lead to a serious drug error. HSC 3047 Medication delivery

6 Preparation Make sure you have all the necessary equipment ready to give medication. This might include the following:- Tissues Waste bag Tablet cutter or crusher Measuring device Cloth Gloves Glass of water (not hot drink) Students must be advised not to give tablets with hot drinks as the heat may damage the tablet or the coating Pictures provided by, HSC 3047 Medication delivery

7 Principles underpinning medication delivery
Infection control Hands should be washed and clean prior to medication administration. Ensure that there are adequate facilities. It is good practice to wear gloves for administration of eye, ear and nasal medication. It is essential to wear gloves when applying medicated cream. The trainer should discuss the various hand washing arrangements they have encountered in peoples’ homes and suggest that in some cases alco gel or paper towels may need to be taken to the home. Pictures provided by HSC 3047 Medication delivery

8 Principles underpinning medication delivery
Dignity and Privacy Staff should always be polite, gentle and respectful of the service user’s wishes and choices. Privacy may be needed if there are other occupants in the home and clothing is being removed e.g. applying a patch. HSC 3047 Medication delivery

9 Principles underpinning medication delivery
Correct identification If there is more than one person receiving care their supplies and documentation must be clearly identified and separated. Pictures provided by HSC 3047 Medication delivery

10 Confidentiality Information about a service user’s medication is confidential. It should only be shared if permission has been given by the service user or in exceptional circumstances. Protection in law is enshrined in the Human Rights Act 1998, the Data Protection Act 1998 and Common Law. Further guidance has been given in the Health and Social Services and Public Safety Code of Practice on Protecting the Confidentiality of Service Users’ Information. Jan 2012 Pictures provided by HSC 3047 Medication delivery

11 Can the service user self-medicate?
Has the person been self medicating recently? Does the person show any signs of confusion? Does the person understand how and why they should take the medication? Has the person got the required manual dexterity and skills to take the medication? Is the person able to mobilise to the place where the medication is kept? Is the service user showing any signs of suicidal behaviour? Have they ever taken an overdose in the past? There may be a local risk assessment form to show the learners which helps managers to decide the level of assistance which is required. HSC 3047 Medication delivery

12 Are there any ethical concerns?
Might there be unpleasant side effects? Might the medication increase the risk of falling? Might the medication alter the person’s life expectancy? Does the service user understand why they are taking this medication? Is the medication being given as a means of control? Encourage the learners to discuss any ethical issues they may have encountered during their employment. Any concerns must be raised with the service manager and/or GP. Medication which might be controversial might include antipsychotic medication, chemotherapy, hormone suppressants and sedation. HSC 3047 Medication delivery

13 The route by which to give medication
Oral - by mouth and swallowed Buccal - placed between the gum and teeth Sublingual - under the tongue Inhalation - breathed through the nose/mouth Topical - outer surface of the skin Transdermal - patch on the surface of the skin Intra-ocular - instilled into the eyes Intra-aural - instilled into the ears Intra nasal - instilled into the nose It is possible to give medication by the wrong route and this could be dangerous or make the medicine ineffective. For example a carer gave a service user her anti depressant drops into her eye causing her to have red sore eyes. HSC 3047 Medication delivery

14 Routes by which to give medication
These routes are not covered in this training program and are normally undertaken by qualified medical staff Rectal given via the rectum Vaginal given via the vagina PEG given via percutaneous endoscopic gastrostomy Intravenous injection injected into the vein Intramuscular injection injected into the muscle Subcutaneous injection injected under the skin HSC 3047 Medication delivery

15 The form of a medicine Tablets: These are made of compacted powder. Some have a polymer coat to make them smoother and easier to swallow. If they are scored down the centre they may be cut in half. Some need to be wrapped in foil so they are not exposed to moisture or sunlight. Some may need to be dissolved in water. Capsules: Hard shelled capsules contain powder or mini pellets. Soft shelled capsules are made of a gelling agent to contain oils or liquids. Tablets and capsules should be given using a non-touch technique. They may be placed in the service user’s hand or into a spoon or pot for the service user to take them. Pictures provided by four_colours_of_pillswikipedia HSC 3047 Medication delivery

16 Form of medicine Tablets may come in a variety of formulations Enteric coated……………..Helps to protect the stomach from the adverse effects of the medicine. It is absorbed after it has gone through the stomach Slow, modified or…………Released gradually over a period of controlled release time. These should never be crushed or opened. Chewable………………… Used when tablets are too big to swallow. Soluble…………………… .Easier to take when dissolved in water HSC 3047 Medication delivery

17 The form of medicine Liquid medicine: This may be described as an elixir, a mixture, a suspension, a solution or a syrup depending on what the active ingredient is mixed with. There is often advice to shake the bottle before use as the ingredients may become more concentrated at the bottom or separate out. Always use the measuring device which is supplied with the bottle and keep it clean and dry. Be careful not to confuse measurements of volume i.e. mls with measurements of strength i.e. mgs. Some liquids may need to be stored in the fridge. Point out to the learners that using a household spoon it is not possible to accurately measure the dose. Always use a spoon or pot with measurements and ensure that the light is good so mistakes are not made. If too much is poured out then discard the excess. Do not return to the bottle. Wipe the bottle clean if it has dripped down the side as drips can obscure the writing on the label. HSC 3047 Medication delivery

18 Measuring devices A spoon, syringe or plunger will often be supplied with liquid medications so that the dose can be measured accurately. Do not use if the measurements are no longer visible Pictures provided by HSC 3047 Medication delivery

19 Invasive techniques which should only be undertaken by a qualified nurse or carer who has received specific training and is permitted by the care provider Injections subcutaneous intra muscular intra venous Suppositories Enemas Pessaries HSC 3047 Medication delivery

20 Buccal medication Medication is placed between the gum and the upper lip so that it will dissolve quickly and be immediately absorbed into the blood stream Pictures provided by HSC 3047 Medication delivery

21 Sublingual medicine Glyceryl trinitrate /GTN is often given for angina/chest pain via the sublingual route, under the tongue where there are lots of blood vessels so that the pain can be relieved quickly. Pictures provided by HSC 3047 Medication delivery

22 Administering medicine into the eyes.
Always wash hands and wear gloves Explain the procedure Check the expiry date Remove contact lenses Use separate containers for L and R eye Warm the container by rotating it in your hands Service user should sit back or lie down Gently pull down the lower eye lid Service user to look up or to the side Close the eye for 30 secs Wipe excess away with a tissue Leave one minute between drops HSC 3047 Medication delivery

23 Intra-ocular medicine
In the pictures gloves are not being worn….it is good practice to wear gloves Pictures provided by HSC 3047 Medication delivery

24 Giving nasal drops Wash and dry your hands and put on gloves
Lie the service user down with their head tilted right back Ask the service user to gently blow their nose Drop in required number of drops and spread over inside surface of the nose Ask the service user to remain there for at least 2 minutes Pictures provided by HSC 3047 Medication delivery

25 Nasal spray The service user may sit upright when a nasal spray is used. The bottle should be inserted in one nostril while the other one is gently compressed Pictures provided by HSC 3047 Medication delivery

26 Ear Drops Wash hands Explain procedure Lie on side/tilt to side
Warm drops if possible Pull the pinna back and up Use separate bottles for R+L Insert prescribed drops Remain in position 2-3mins Record HSC 3047 Medication delivery

27 Discard after opening……
Eye drops and ointment days Barrier creams months Creams with active ingredients 1 month Medication delivery systems months HSC 3047 Medication delivery

28 Transdermal patches Remove old patch.
Do not touch adhesive. Fold in half and dispose of it. Choose a clean, hair-free, accessible and healthy site. Date new patch. Record position of patch. Remove immediately if there are signs of allergy. Never cut a patch in half. Do not expose the application site to heat e.g. electric blanket. There have been controlled drug errors caused by not removing an old patch. If patches are placed on hot skin there will be increased absorption and potential overdosage HSC 3047 Medication delivery

29 Transdermal patches. HSC 3047 Medication delivery
Pictures provided by imagesCAR170QG reference, HSC 3047 Medication delivery

30 Topical medicine Wash hands Wear gloves Apply to clean dry skin
Ensure privacy and dignity Only apply to required area Use medicated preparations sparingly HSC 3047 Medication delivery

31 Topical medicine HSC 3047 Medication delivery
Pictures provided by HSC 3047 Medication delivery

32 Inhalers and nebulisers
Keep the equipment clean and dry Assemble properly The service user should sit up or stand to enable good lung expansion Ensure that the service user understands the proper technique. e.g. to press and breathe in at the same time HSC 3047 Medication delivery

33 Inhalers and space halers
Pictures provided by HSC 3047 Medication delivery

34 Inhalers and space haler
Volumatic: space haler Ideally the trainer should have examples of these inhalers for the learners to handle and try out. Pictures provided by and HSC 3047 Medication delivery

35 Nebulisers HSC 3047 Medication delivery
Pictures provided by nebulisermask2 HSC 3047 Medication delivery

36 Oxygen Oxygen is highly flammable it must be kept away from heat.
It must be given through the correct mask It must be given at the correct flow rate Check the service user has enough Tubing must not cause a slip, trip hazard Oxygen will dry out mucosa. Good mouth care is essential. Check the comfort of mask/cannulae A gentle non-flammable cream should be used to moisturise the skin An upright position supports breathing HSC 3047 Medication delivery

37 Oxygen HSC 3047 Medication delivery
Pictures provided by imagesCAD5H3KU HSC 3047 Medication delivery

38 Different formats Medicine often comes in different formats
For example, DIAZEPAM is available as:- A tablet A slow release capsule A liquid An injection An inhalation A rectal suppository The GP will decide on the best route depending on the needs of the person and the cost of the administration HSC 3047 Medication delivery

39 Encourage independence
Auto dropper to help give eye drops, cap to make it easier to unscrew a bottle and blister pack with individual tablets . Pictures provided by HSC 3047 Medication delivery

40 Encourage independence
Braille instructions on the tablet box, special cap to assist unscrewing and electronic reminders to take medicine. Pictures provided by HSC 3047 Medication delivery

41 The following outcomes have now been covered:-
1. The learner can describe the routes by which medication can be delivered. 2. The learner can describe different forms in which medication may be presented. 3. The learner can describe materials and equipment to assist in administering medication. Continued Any questions? HSC 3047 Medication delivery

42 The following outcomes have now been covered:-
1. The learner can explain the importance of the following principles in the use of medication:- Self medication or active participation Dignity and privacy Confidentiality 2. Explain how risk assessment can be used to promote an individual’s independence in managing medication. 3. Describe how ethical issues that may arise over the use of medication can be addressed. HSC 3047 Medication delivery

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