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HSC 3047 : Part 2 Support the use of medication in social care settings: Medication administration. Sheena Helyer 12.2012. Medication delivery: learning o utcomes. To understand techniques for administering medication To be able to give the following safely:- Tablets Eye Drops

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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 Helyer12.2012

medication delivery learning o utcomes
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

medication instructions
Medication instructions

When a pharmacist dispenses medication against a valid

prescription it must be clearly labelledwith:-

  • 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’

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care plan and recording
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.

HSC 3047 Medication delivery

verbal messages and changes
Verbal messages and changes

Cumbria.nhs.uk

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.

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preparation
Preparation

Pictures provided by weiku.com, colourbox.com mpeb.org

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)

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principles underpinning medication delivery
Principles underpinning medication delivery

Pictures provided by communityservices.heartofengland.nhs.uk

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.

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principles underpinning medication delivery1
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.

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principles underpinning medication delivery2
Principles underpinning medication delivery

Pictures provided by bbc.co.uk

Correct identification

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

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confidentiality
Confidentiality

Pictures provided by health.com

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

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can the service user self medicate
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?

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are there any ethical concerns
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?

HSC 3047 Medication delivery

the route by which to give medication
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

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routes by which to give medication
Routes by which to give medication
  • 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

These routes are not covered in this training program and are normally undertaken by qualified medical staff

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the form of a m edicine
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 foildroptestkits.com capsule.com telegraph.co.uk

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form of medicine
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

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the form of medicine
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.

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measuring devices
Measuring devices

Pictures provided by measuredrugs.com

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

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slide19

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

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buccal medication
Buccal medication

Pictures provided by buccalopeni.nlm.nih.gov

Medication 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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slide21

Sublingual medicineGlyceryltrinitrate /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

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administering medicine into the eyes
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

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intra ocular medicine
Intra-ocular medicine

Pictures provided by allaboutvision.com pharmslat.unc.edu kaboudle.com perso.numericable.fr

HSC 3047 Medication delivery

giving nasal drops
Giving nasal drops

Pictures provided by medicineworld.org

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

HSC 3047 Medication delivery

nasal spray
Nasal spray

Pictures provided by peoplespharmacy.com

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

HSC 3047 Medication delivery

ear drops
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 hands

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discard after opening
Discard after opening……
  • Eye drops and ointment 28 days
  • Barrier creams 3 months
  • Creams with active ingredients 1 month
  • Medication delivery systems 2 months

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transdermal patches
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.

HSC 3047 Medication delivery

transdermal patches1
Transdermal patches.

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

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topical medicine
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

topical medicine1
Topical medicine

Pictures provided by amazon.co.uk personalpharmacy.co.uk

HSC 3047 Medication delivery

inhalers and nebulisers
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

inhalers and space halers
Inhalers and space halers

Pictures provided by inhalerforasthma.org

HSC 3047 Medication delivery

inhalers and space haler
Inhalers and space haler

Volumatic: space haler

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

HSC 3047 Medication delivery

nebulisers
Nebulisers

Pictures provided by expresschemist.co.uk nebulisermask2

HSC 3047 Medication delivery

oxygen
Oxygen
  • Oxygen is highly flammableit 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

oxygen1
Oxygen

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

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different formats
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

encourage independence
Encourage independence

Pictures provided by toolmanager.com livingwithablackdog.wordpress.com alzheimers.org.uk

HSC 3047 Medication delivery

encourage independence1
Encourage independence

Pictures provided by sciencephoto.com

Proctorhealth.co.uk

Qualifiedseniorcare.com

Epillmedicationremindersblogspot.com

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the following o utcomes have now been covered
The followingoutcomes have now been covered:-

Outcome 4

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

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the following outcomes have now been covered
The following outcomes have now been covered:-

Outcome 6

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