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www.uwosh.edu/ccdet 1
CBRF Medication Administration Training
Developed by:University of Wisconsin Oshkosh CCDET
Approved by:Wisconsin Department of Health Services
Division of Quality Assurance Bureau of Assisted Living March 1, 2014
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Training Topics Resident Rights Legal Responsibilities Facility Policies and Procedures Delegated Procedures Medication Management Medical Terms and Abbreviations Medication Packaging, Labeling and
Storage Types of Medications Medication Administration
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SECTION I: INTRODUCTION TO MEDICATION ADMINISTRATION
Under certain conditionsAfter successful completion of this
training course
CBRF resident assistants (RAs) may administer medication to residents:
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Role of the Caregiver
Approximately 800,000 drug-related injuries occur in U.S. long-term care facilities every year
Errors occur at many levels Most are preventable
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Honoring Resident Rights
Residents have the RIGHT to: Receive medication as prescribed Refuse medication Participate in planning Refuse care and treatment Make decisions
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Med Administration Differences
Staff-administered with supervision Staff-administered without supervision Self-administered by resident
Activity: Residents’ Rights and Medication Administration
Ways that medication can be administered:
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CBRFs and staff regulated by Wisconsin law
Division of Quality Assurance roles Dept. of Safety and Professional
Service roles CBRF legal requirements
Legal Issues
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Allows RNs to: Delegate tasks Provide direction and assistance Observe and monitor Evaluate
Nurse Delegation
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Delegated/Supervised by RN
Description
Injection Using a needle
Rectal or VaginalInto the rectum or
vagina
NebulizerInhaled as a vapor from a machine
Stoma Through a stoma
Enteral “Feeding” tube
Medication Administration Procedures
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Training and Supervision Related to Delegated Tasks
Conditions that must be met: You must be trained Perform nurse delegated-tasks that are
EXACTLY the same as your training
Activity: Delegated Tasks
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SECTION II: THE FACTS ABOUT MEDICATIONS
This section covers:Types and forms of medications Factors that can affect medications Classes of medicationsPain management systems
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Forms You May Administer when Delegated by an RNInjectables Douches
Suppositories Enemas
Forms You May Administer After Completing this TrainingTablets (or pills) Aerosols or inhalers
Capsules Transdermal patches
Liquids Drops
Powders Ointments/salves/sprays
Dosage Forms
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Purposes and Effects-Medication Terminology
Drug indication Drug effect or action Side effect Drug allergies Specific administration information
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Factors that Impact Drug Effectiveness
Age Drug interactions Fluids Renal function Gender
Activity: Drug Effects
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Classes of Commonly Used Drugs
Analgesic Antifungal
Antibiotic Antiparkinson
Anticoagulant Antipsychotic
Antidepressant Cardiovascular
Antidiabetic Cholesterol
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More Drug Classes
Cognitive Enhancers Respiratory
Gastrointestinal Sedative
Ophthalmic Hypnotic
Osteoporosis Thyroid
Urinary Incontinence
Activity: Using the Drug Classification Reference Tool
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Medical Abbreviations
Error-prone Easy to misinterpret Ask if you’re not sure PRN Medications
Activity: Understanding Abbreviations Do Not Use List
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Generic vs. Trade Name Drugs
Generic = New drug name Trade = Brand name Medications: Look Alike/Sound
Alike
Activity: Look Alike/Sound Alike Medications
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Pain Management
Causes of Pain Pain Management Scales
Numeric Pain Assessment ToolWong-Baker Faces Pain Rating Scale
Checklist of Non-Verbal Indicators Facility Policy
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Pain Management Medication
Acetaminophen Mild painNon-steroidal anti-
inflammatories (NSAIDs) Mild to moderate painOpioids Severe and chronic pain
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Controlled Substances
Millions of Americans use prescription drugs for non-medical reasons.
“Diversion” means using a drug for another purpose or person
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Federal Controlled Substances Act
Schedule I High potential for abuse – no accepted medical use
Schedule II High potential for abuse – an accepted medical use
Schedule III Lower potential for abuse than I or II
Schedule IV Lower potential for abuse than III
Schedule V Lowest potential for abuse
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Opioids – pain CNS Depressants – anxiety and
sleep disorders Stimulants -sleep disorders and
ADHD
Commonly Abused Prescription Medications
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Increasing Awareness: What Caregivers Can Do
Watch for red flags of drug abuse or medication diversion
Don’t enable the abuser
Activity: Developing Best PracticesActivity: Applying Best Practices
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Reporting Drug Diversion
Wisconsin’s Caregiver Law:Abuse or neglect Misappropriation of propertyCriminal Charges and Penalties:Caregiver misconductCriminal violationPermanent record
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SECTION III: MEDICATION MANAGEMENT
Medication Administration System CBRF Policies and Procedures should cover:Administrative recordsOrdersPackaging requirementsLabeling
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Medication Administrative Records
The MAR is a written record of each resident’s medication regimen including:Prescription drugs Over-the-counter medicationsDietary supplements
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Medication Orders
DHS 83 requires a physician’s or practitioner’s order in each resident’s chart or record for all prescription or over-the-counter medications.
Transcription of Orders
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Medication Packaging and Labeling Requirements
Unit Dose Packaging Medication Samples Labeling Requirements Medication Transfers Expiration Dates
Activity: Review of Medication Packaging and Labeling
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Medication Procedures and Documentation
Required Documentation Special Requirements for PRN
Psychotropic Medication Other Reporting and Documentation
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Medication Errors
Causes of Medication Errors Wrong medication Wrong dose Wrong time/omission Wrong route Wrong technique
Activity: Recognizing Medication Errors
Ways to Prevent Errors
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Medication Storage
Staff- vs. Self-AdministeredRefrigerationChemicalsInternal/External SeparationControlled SubstancesRecord/Auditing
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Destruction & Disposal of Medication
Medications go with resident upon discharge
CBRF must have policy for disposing other types of medication
Witnessing and/or signing a medication destruction form is a big responsibility
Activity: Med Storage & Disposal
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CBRF Review and Monitoring Responsibilities
CBRF Responsibilities: Medication regimen review Medication review for scheduled
psychotropic medication Annual review requirements Other monitoring to assure
oversight
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SECTION IV: MEDICATION ADMINISTRATION
Follow requirements Know which meds you may or may
not administer Completing this course vs. nurse
delegation Understand medications Understand ordering, packaging,
labeling, etc. Use all resources available to you
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1.Right Individual 2.Right Drug3.Right Dose4.Right Time5.Right Route6.Right Documentation
The Six Rights of Medication Administration:
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Standard Precautions
Ways of doing your work to lower the chance of spreading diseaseHand hygieneProtective equipmentCare of the environmentSafe injection practices
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Routes and Procedures Demonstration
1. Oral Medications2. Oral Inhalers3. Eye/Ophthalmic Drops4. Eye Ointment5. Ear Drops6. Nasal Medications7. Transdermal Medication Patches8. Topical Medications
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Using the Medication Administration Record
Time and day Special instructions
Medication name & dosage
PRN orders
Route Documentation
Activity: Review the record
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Medication Administration Process Steps
Unlock the cabinet/cartObserve 5 medication rightsCheck 3 timesPractice hand hygienePut on gloves Inform the resident Be respectful
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More Medication Administration Process Steps
Administer meds Allow the resident to assist Observe the resident Remove gloves Repeat hand hygiene Document required information
Activity: Administering Medications
Activity: Understanding the Medication Process
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Training Topics Review Resident Rights Legal and Ethical Responsibilities Facility Policies and Procedures Delegated Procedures Medication Management Medical Terms and Abbreviations Medication Packaging, Labeling and Storage Types of Medications Medication Administration