Administering Medications

1. Administering Medications CMT Training #3 The Center for Life Enrichment Resource: MTTP Student Manual

2. The “Six Rights” of Medication Administration • Right Person • Right Medication • Right Dose • Right Time • Right Route • Right Charting/Documentation • Each time you administer medication, your procedure must include verifying these “Six Rights” • Medication orders may change frequently and verifying the “Six Rights” ensures that errors do not occur

3. Safety Principles • Only one (1) CMT should be in the med room at a time • Wash hands BEFORE and AFTER administering medication to each individual • Always give your full attention to the task of medication administration • Preparation is done at the time of administration. NEVER “pre-pour” medications before the scheduled time • Prepare and administer medication for one person at a time. NEVER “pre-pour” medications • Administer medications that only YOU have prepared or poured • Chart immediately after you have given each dose of medication • Chart only medications that YOU have given. NEVER chart for another staff • Complete the “3 Way Check.” Compare the information on the signed HCP order/PMOF, MAR, and pharmacy label • Check for medication/food allergies indicated on the HCP order and MAR before giving medication

4. Safety Principles Continued… • Do NOT touch medications with your hands. Shake out into a cup or into a container cap, or place blister pack hole over medicine cup to punch out • Read each medication label three (3) times before administering- • When the medication is obtained from the storage area • When the medication is poured • Prior to administering • NEVER return unused medication to the bottle/container/blister • NEVER leave medication for the individual to take later • Be sure the medication is swallowed with an adequate amount of liquid. Stay with the individual the entire time while s/he takes the medication and verify that the medication has been swallowed • Avoid distractions and interruptions while preparing and administering medications • NEVER leave medications unattended

5. Safety Principles Continued… • Do NOT give expired medications. Always check the expiration date/stop date before pouring the medication • Do NOT administer medications beyond the order stop date or without a current HCP order • Do NOT administer medications that have changed color or consistency • Administer only those medications that you have taken from a properly labeled container • NEVER hide a medication error!

6. Hand Washing Procedures • The single most important factor in preventing and controlling the spread of infection is hand washing • A person’s hands are the most common way that germs are spread from person to person

7. When Do I Wash My Hands?(not limited to) • At the beginning of the shift or upon arrival at the job site • Before and after administering each individual’s medications • Before and after administering treatments • Before and after the use of gloves • At the end of your shift or when going off duty • Before handling or serving food • Before and after assisting with personal hygiene and/or grooming • When in doubt, wash your hands!

8. Hand Washing Steps • Wet hands • Apply soap; bring hands together and create a heavy lather. Wash 2-3 inches above the wrists; get soap under your fingernails and between your fingers • Wash well for at least 15-20 seconds or sing “Happy Birthday” twice (per CDC guidelines) • Rinse well • Pat hands dry with a clean paper towel. Discard it • Turn off faucet with another paper towel • If hand washing cannot be done, antibacterial instant hand sanitizer must be used

9. The Medication Administration Process • Wash hands before preparing and administering medication • Locate most recently signed HCP order/PMOF; all medications must have a current Health Care Provider (HCP) order and a pharmacy label to be administered • Verify the “Six Rights” • Check for drug allergies • Assemble necessary equipment (e.g. cup, water, paper towels, medicine cup, etc.) • For each does of medication, read the pharmacy label three (3) times • Pour the accurate dose of medication • Administer medications to the individual • Discard used medicine cups in a waste container • Chart medication administration by documenting correctly on the MAR • Clean all equipment and medication area

10. Administering Medications to the Individual • Never leave medication box unlocked or unattended • Administer medications only in appropriate and designated areas • Identify the person and whether there is a special way the person takes his/her medication. This information should be provided on the MAR (Nurses Order) • Check route and time • Explain the procedure to the person using a calm, positive approach • The person should always be in an upright position to facilitate swallowing • If the person is capable, give the person the medication cup and a glass of water. Unless otherwise noted, each individual should be given a full glass of fluid each time medications are administered • If required, assist the person as needed • Remain with the person until the medication is swallowed

11. Ensuring Personal Rights, Privacy, & Dignity • Guidelines for ensuring an individual’s rights in the administration of medications include, but are not limited to: • Address the individual by name • Offer privacy during medication administration • Keep medications in a secure, non-public area • Do not hang medication records on the wall • Do not have individuals line up to receive medications • Each individual and/or his guardian/family has the right to be involved with the decision making process regarding treatment plans/medication therapy. Individuals should be encouraged to participate as fully as they are capable in the decision making process regarding medication • The individual has the right to refuse treatment/services, including medication. This right must be balanced with the agency’s responsibility to provide health care for the individual. If an individual refuses treatment/medications, the RN CM/DN must be contacted IMMEDIATELY • Medication can only be given for the benefit of the individual. In the case of behavior modifying drugs, they may not be given for the convenience of the staff or as a substitute for programming • As appropriate, self-administration of medication should be encouraged/taught

12. Medication Errors(not limited to) • The medication was given to the wrong individual • Wrong medication was given • The medication was given in the wrong dosage • The medication was given at the wrong time or not at all • A medication was administered via the wrong route • The individual was given a medication when there is a documented allergy to the medication • The medication administered was expired, discontinued, or contaminated • The administration of the medication was not documented appropriately • If you are responsible for a medication error or if you identify that someone else has made a medication error, you must IMMEDIATELY report the error to the RN CM/DN and appropriately document the error

13. PRN Medication Administration • “As needed” medications are also called “PRN” medication orders • For example, a pain reliever such as Tylenol may be ordered as a PRN to treat a headache • It is important to remember that individuals who have difficulty communicating may be unable to ask for medication when they need it. You may have to observe behaviors or body language to determine that a PRN medication is needed • The CMT must obtain permission from the RN before administering any PRN medications • A PRN medication may only be administered if the HCP order is current; medications must be ordered/re-ordered at least every 90 days

14. Any Questions?