Presentation on theme: "Pharmacology Information, Rules, and Laws For Medications"— Presentation transcript:
1 Pharmacology Information, Rules, and Laws For Medications Prepared by Scooter Brown, RN, Director of Nursing(For use by Mental Health clinic staff as Annual Refresher training.)New
2 Class Objectives Understand: Classifications of Medications Purpose/Intended Effects of MedicationsCommon Side Effects of MedicationsTIMA ProgramMedication Rules & Laws
3 What is Our Role With Medications? Help the Consumer Be IndependentHelp Keep the Consumer SafeFollow Federal and State Laws
4 Who Makes the Rules? Federal Drug Enforcement Agency (DEA) Texas Legislature per Texas Administrative CodeTexas Board of PharmacyTexas Medical BoardTexas Board of Nurse ExaminersTexas Department of Public Safety (DPS)Other
5 Is prescribing medication a guessing game? Medical research and studies determine a best course of treatment for doctors to follow for most major medical conditions.These are referred to as “standards of care” or “best practices” or “evidence based treatment”.
6 Texas Implementation of Medication Algorithms “Best Treatment”TIMATexas Implementation of Medication Algorithms
7 3. Patient/Consumer Education Four Parts to TIMA1. Algorithm2. Training to Staff3. Patient/Consumer Education4. Record Keeping
8 1. AlgorithmAn algorithm is a tool for solving problems by going through a series of steps. A medication algorithm recommends to the doctor which medication is best to use in a particular situation and what steps to follow if the first treatment does not work at all or does not work completely.
10 2. TrainingDoctors are trained so they can use the algorithms in the most effective way.The goal is to get as much improvement in symptoms as possible.This may mean trying different medications.
11 3. Patient & Family Education Information can increase the consumer’s understanding about illness and treatment so consumers can be a true partner in treatment
12 4. Record KeepingAssisting the consumer to keep a journal of medications, symptoms, side effects, etc., can help the doctor visit be more productive.Appropriate documentation of consumer’s statements, appearance, and actions verifies the consumer’s status as well as the staff member’s actions.Accurate documentation insures funding and compliance.
13 TIMA is for consumers with a diagnosis of: DepressionBipolar DisorderSchizophrenia
14 Teaching Consumers About Their Medications Expected Action of the MedicationBe realisticHelp the consumer track their progressTIMA Education Booklet is an excellent source for this
15 Teaching Consumers About Their Medications Reason for medicationsTeach the consumer about their diagnosis and conditionPlease use approved sources, such as TIMA and approved handouts or approved websites*
16 Teaching Consumers About Their Medications Possible Side Effects to the MedicationMay be temporaryHelp the consumer track the frequency and severityTIMA Education Booklet is an excellent source for this
17 Why are prescription medications different? Many medications require a prescription because they are too dangerous without a doctor’s supervision. Most prescriptions fall into this “dangerous drug” category. Other prescription medications have potential to become habit forming or may interfere with breathing. These are called “controlled substances” and are monitored even more strictly.
18 What categories of prescription medications do we use? AntidepressantsSeveral CategoriesMood StabilizersAnti-Manic/Anti-ConvulsantsAntipsychotics/NeurolepticsTypical & AtypicalFirst Generation/Second Generation orNew GenerationOtherAnti-Anxiety (Anxiolytic)/Anti-EPS/Anti-Parkinsonism/StimulantSedative/Hypnotic
19 Teaching Consumers About Their Medications How to TakeMedicationAs directed by the doctor. (Staff should check the latest doctor’s order. The directions may have changed since the Rx was filled)With a full glass of water and with food unless instructed by doctor, nurse, or pharmacist to take without food.If dose missed*, don’t double up. Don’t run out of meds.**Call the nurse or doctor.
20 Teaching Consumers About Their Medications “Five Rights” of MedicationRight Person(Correct Consumer Name on the Med Bottle)Right Medication(Correct Name of Medication on the Med Bottle)Right Dose(Correct Amount or Size of Pill)Right Time(Correct Time of Day)Right Route(Correct Way)
21 For Best Results Encourage Consumers To: Keep Clinic AppointmentsTake MedicationsAs PrescribedReport Symptoms or Side Effects
22 What are the rules for consumer’s medications? There must be a doctor’s order (prescription) for the medication.The medication container must be labeled by a pharmacist or doctor/practitioner.Only a doctor, pharmacist, or consumer may place the medications in the prescription bottle. A nurse may fill a consumer’s “pill minder”, “pill planner”, or similar container specifically designed for medication storage (or an RN may specifically delegate this function in accordance with the Nurse Practice Act guidelines.)Only the person on the prescription may use the medication or be in possession of the medication unless acting as a documented agent of a facility or practitioner.Only a nurse, doctor, or other practitioner may call in medication doses or instructions to a pharmacy.
23 Medication Procedures Medication Handling Guidelines for Staff
24 DefinitionsDispense: to prepare, package, compound, or label a dangerous drug.ONLY A DOCTOR OR PHARMACISTAdminister: removal of a medication from a previously dispensed, properly labeled container.ONLY A LICENSED HEALTH PROFESSIONALUNLESS SPECIFICALLY AUTHORIZED IN ACCORDANCE WITH THE RN DELEGATION RULES OF THE TEXAS RN NURSE PRACTICE ACTPrescribe: to authorize a “dangerous drug” or controlled substance to be dispensed.ONLY A LICENSED PRACTITIONER.
25 Transporting Medications Always verify and sign for the medications you accept to transport for any reason, and require the receiving person to do the same.
26 Transporting Medications Never leave medications in a vehicle-theft risk-heat or cold can damage or alter medications
27 Assisting Consumers With Their Pill Containers A licensed nurse may fill the pill containers in instances where the consumer is unable to do this.In special circumstances an RN may delegate a specific unlicensed person to do this as long as all the criteria for delegation is met.
28 Criteria for RN Delegation to Unlicensed Assistive Staff Consumer is in an independent living environment.Consumer or guardian is willing to participate in consumer’s care.Consumer has a stable predictable condition (chronic not recuperative).ProcessAn RN must make an assessment of the consumer to determine if delegation of the nursing task is appropriate.An RN must verify the competency of the unlicensed staff to perform the nursing task.RN should be available for consultation and questions.
29 If Filling Medication Pill Containers is Delegated to You It must be documented with RN signature and staff signature and consumer or guardian.Universal precautions must be observed (gloves and no touching pills).Use it as a teaching activity.Information about how to call the nurse or clinic prior to taking a medication if there are questions.Incorporate TIMA materials.
30 Items on the Prescription Bottle Verify The Following:Consumer NameMedication NameMedication DoseMedication TimeMedication RouteThese are also the“Five Rights”
32 Documentation Needs to be legible. Should indicate purpose of appointment, what was addressed, and consumer’s understanding of information, as well as action consumer is to take.If consumer reports problem, symptom, concern, question, etc., always document what action will be taken and by whom.If consumer indicates suicidal or homicidal thoughts, address those as appropriate: “Are you saying you feel like hurting yourself or someone else?...How do you think you might do that?...Do you think you might act on those feelings?” Notify the doctor, nurse, LPHA, or Clinic Director if yes to above and document that notification or follow up to comments.