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

HSC 3047 :Part 2Support the use of medication in social care settings:

Medication administration

Sheena Helyer 12.2012

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 independentlyHSC 3047 Medication delivery

Medication instructionsWhen a pharmacist dispenses medication

against a validprescription 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’

HSC 3047 Medication delivery


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.


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.

Cumbria.nhs.uk


PreparationMake 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)

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Principles underpinning medication delivery

Infection controlHands 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.

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Dignity and PrivacyStaff 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.



Correct identificationIf there is more than one person receiving care their supplies and documentation must be clearly identified and separated.

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ConfidentialityInformation 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 health.com


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?


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?

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



Routes by which to give medicationThese 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

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. HSC 3047 Medication delivery

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Form of medicineTablets may come in a variety of formulationsEnteric coated……………..Helps to protect the stomach from the adverse effects of the medicine. It is absorbed after it has gone through the stomachSlow, 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


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.


Measuring devices

A spoon, syringe or plunger will often be supplied with liquid medications so that the dose can be measured accurately.

Pictures provided by measuredrugs.com

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 subcutaneousintra muscularintra venous

• Suppositories

• Enemas

• Pessaries



Buccal medicationMedication is placed between the gum and the upper lip so that it will dissolve quickly and be immediately absorbed into the blood stream

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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 rxlist.com

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


Intra-ocular medicine


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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 medicineworld.org


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 peoplespharmacy.com

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• Wash handsHSC 3047 Medication delivery

Discard after opening……

• Eye drops and ointment 28 days

• Barrier creams 3 months

• Creams with active ingredients 1 month

• Medication delivery systems 2 months


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.


Transdermal patches.


Pictures provided by pharmainfo.net imagesCAR170QG reference,medscape.com voices.yahoo.com

Topical medicine• Wash hands• Wear gloves• Apply to clean dry skin• Ensure privacy and dignity• Only apply to required area• Use medicated preparations sparingly


Topical medicine


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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


Inhalers and space halers


Pictures provided by inhalerforasthma.org


Inhalers and space haler

Pictures provided by realfirstaid.co.uk and hickeypharmacies.ie

Volumatic: space haler


Nebulisers

Pictures provided by expresschemist.co.uk nebulisermask2

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


Oxygen


Pictures provided by mynewmixwordpress.com easyoxygen.com homeoxygenmachines.com imagesCAD5H3KU


Different formatsMedicine often comes in different formatsFor example, DIAZEPAM is available as:-• A tablet• A slow release capsule• A liquid• An injection• An inhalation• A rectal suppositoryThe GP will decide on the best route depending on the needs of the person and the cost of the administration

Encourage independence


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Encourage independence

Pictures provided by sciencephoto.comProctorhealth.co.ukQualifiedseniorcare.comEpillmedicationremindersblogspot.com

The following outcomes have now been covered:-Outcome 41. 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



The following outcomes have now been covered:-

Outcome 61. The learner can explain the importance of the following principles in the use of medication:- Self medication or active participation Dignity and privacy Confidentiality2. 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 : Part 2 Support the use of medication in social care settings: Medication administration

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