1. Assembly Bill #2609 Health and Safety Code Effective January 1,2008 MEDICATION TRAINING FOR DIRECT CARE STAFF

2. 9 Topics  Role, Responsibilities and limitations of staff assisting with self administration of medication, including tasks limited to licensed medical professional  Terminology specific to medication assistance  Different Types of Medication orders including prescription, over-the-counter, controlled and other medication

3. Con’t  Basic Rules and precautions of medication assistance  Medication forms and routes for medication taken by Residents  Description of Procedures for providing assistance with self administration of medication in/out of the facility and Medication documentation system

4. Con’t  Guidelines for proper storage, security and documentation of centrally stored medication  Description of processes used for medication ordering, refills and the receipt of medication from the pharmacy  Medication side effects, adverse reaction and errors

5. Requirements  Complete at least 2 hours on the job training  Complete written competency test with a passing score or 90% or better  Complete 4 hours continuing education every year

6. I. YOUR ROLE AND RESPONSIBILITY 1.Coordinating quality care by communicating with resident’s Primary Physician, RN and family members regarding health condition. 2.Dispensing medication and assisting resident take their medication. 3.Assuring that the medication they take matches with what is prescribed 4.Storing medication safely. 5.Ordering and refilling medication, never allowing residents to run out of medication. 6.Documenting all medication taken. 7.Destroying medications as needed and in accordance with state and facility procedures 8.Documenting all communication with Primary Care Physician, RN and families. 9.Continual observation of each residents for potential adverse reaction to medication and or signs/symptom indicating the need for a change to medication regimen.

7. Limitations Med Aide -Can assist with oral medications -Can assist with transdermal medication -Can assist with topical medication -Can assist with inhalers -Can administer eye,ear and nose drops -Hand a prefilled syringe to a resident Only Licensed Personnel -Draw medication into a syringe -Administer an injection -Insert suppository -Administer enema -Titrate a medication (decide how much of medication to give)

8. II. TERMINOLOGY Absorb- to soak up or take in Adverse Reaction -A range of untoward reaction Controlled substance- Drugs that are potentially addictive Discontinued-No longer taken Dispense-Preparing and packaging a prescription Document-to record Dose-The amount of a drug to be taken Interaction-A situation where drugs interfere or alter each others action Label-information written on the medication package Medication- Chemical used to treat or prevent illness Medication Administration Record(MAR)- A record that list all medications Medication Pass -Scheduled time of the day to administer medication Over-the-counter -OTC, a drug that can be purchased or used without prescription Polypharmacy-many drugs PRN- as needed or if necessary Route-The way a drug is put into or onto the body Side Effects -Physiologic effects not related to desired drug effects

9. III.MEDICATION ORDERS  Prescription Medications: These medications may not be purchased without a physician’s order.  Over-the-Counter Medications: Medication that may be purchased without a prescription.  Controlled Medication: Is also known as a scheduled drug. The distribution of these medication is controlled because of the drug abuse potential or risk.

10. TYPES OF ORDERS  ROUTINE ORDERS: This is an order that is carried out until the physician cancels it by another order or until a prescribed number of days elapse.  PRN Orders: This an order to be given when a resident requires it.  SINGLE ORDERS(one time order): This is a medication to be given only at a specific time.  STAT ORDERS: This is an order that is to be implemented immediately.  HOLD ORDERS: Sometimes a physician will want to hold a medication for a period of time. A medication may be held provided order has been received.  DISCONTINUED ORDERS: Often times a medication may be discontinued for a resident. Upon receiving the physician order, the medication is permanently stopped and the medication destroyed or returned to the pharmacy per protocol.

11. IV. BASIC RULES AND PRECAUTION OF MEDICATION ASSISTANCE  Make sure all supplies are available for medication pass.  There must be a written, dated and signed physician’s order in the client’s record before a Med Aide can assist with self administration of medication.  Only one staff should assist a client with medication at any given time.  Wash your hands before, after and between assisting with medications.  Always prepare medication in a clean, well lit, quiet area. Allow plenty of time, avoid rushing, and stay focused.  To avoid errors, set up the medication immediately before assisting a client with self administration.  Wear gloves as indicated with medications requiring protection and whenever assisting with topical, transdermal medications, as well as eye, ear and nose drops. This will protect the resident as well as avoiding absorption of medication into your skin.  Do not allow interruptions when you are working at the med area.  When deciding how much medication to give, always verify any confusion with RN.  Never give expired medication  Verify drug allergies.  Medication should never be disguised by putting it in food or liquid.  Always remember the 6 RIGHTS: 1. Right Client 2. Right Drug 3. Right Dose 4. Right Time 5. Right Route 6. Right Documentation

12. V.MEDICATION FORM and ROUTES  FORMS: Capsules Tablets Powders Drops Liquids Inhalers & Sprays Topical Skin Preparation (ointments, creams) Suppositories

13.  ROUTES: Oral (tablets or liquids) Sublingual/Buccal Topical (ointments,lotions & transdermal) Eye Drops Ear Drops Nasal Drops or Sprays Inhalers