Welcome to the Pennsylvania Department of Public Welfare (DPW), Office of Developmental Programs (ODP) Medication Administration Course for life sharers. This course was developed by the ODP Office of the Medical Director in conjunction with the Lifesharing Coalition and with technical assistance from Community Health Connections, the Western Pennsylvania Healthcare Quality Unit. Please adjust your computer volume to a comfortable listening level. This is lesson 5 How to take medication properly.
Hello, I m Jill Morrow and I am the Medical Director for the Office of Developmental Programs. I ll be your presenter for this webcast.
This slide includes the learning objectives for lesson 5. In this lesson, we will learn more details about medication administration including how to use the five rights and the step-by-step administration process. We will also talk about special situations and medication boxes.
This lesson concentrates on administration of medication. Look at the slide to see where this step comes in the medication cycle. Administration is the actual process of giving the medication. It is usually paired with documentation, but remember that we discussed documentation in lesson 4. You will learn the steps of administration in this lesson.
So why all of the fuss about administering medication? It s just giving a pill, right? Wrong! Giving medication correctly is very important for getting the best effect from the medication and avoiding harm. In this lesson, we will cover the Five Rights of Medication Administration in more detail. What are these five rights? The five rights supply important information for medication administration: who is taking the medication, what it is, how much to take, when to take it, and how to take it. The five rights provide the instructions for giving medication and are listed on the slide: Person: who is taking the medication Medication: what medication are they taking Dose: how much of the medication are they taking Time: when are they taking the medication How given: by what route is the medication given Let s talk a little more about each of these rights.
Person seems easy. That is the person taking the medication. What if there are multiple people in the house who take medication? If you get the medication at the same pharmacy, the containers may look the same for each person. It is important to be able to identify who the medication is for, so that you don t give someone medication intended for someone else.
Medication is the drug that the person is taking. This also seems easy, but people may be on more than one medication and some of the medications may have similar names. For example, Zyrtec and Zyprexa could look alike if you looked at them quickly, but they do very different things. It is important to make sure that you have the right medication.
Dose is how much medication is taken. This is usually listed in milligrams, abbreviated as mg. However, the dose could be in other units, like micrograms or milliliters. The number of tablets to be taken is the dose. If the medication is in liquid form, the dose is written in a volume like 10 cc or ml. It is important to give the right amount of medication, because too little may not work and too much may cause side effects.
Time is when to give the medication. Some medications work best when given in the morning on an empty stomach. Others must be given with a meal. Some medications are given multiple times a day, while others may be given once. Medications that are given more than once a day have a specific number of times a day and will need to be spread throughout the day. Therefore, it is important to know when a medication is to be given. Agencies should have a policy about standard medication times, or use times specified by the healthcare practitioner. For example, morning could be defined as meaning 8 am and three times a day as 8 am, noon, and 6 pm. A note from the healthcare practitioner will allow for a medication to be given early or late depending on circumstances, like getting up late on the weekend. Such a note could also be used to override an agency specified time. For example, if a medication was to be given before bed and the agency defines bedtime as 9 pm, the healthcare practitioner s note could specify that the medication be given at 11 pm for someone who goes to bed later.
Route is how the medication is given. Most medication will be oral or by mouth. However, drops may be put into the ears or eyes and topical medication is put directly on the skin. The route for medication is how that form of the medication works best. Typically, that form will not work as well if given by another route. For example, eye drops to treat glaucoma, a condition with high pressure in the eye, would not work if taken by mouth.
Where do you find the five rights for medications? Every medication container, like blister packs and bottles, should have a pharmacy label with the five rights on it. Let s look at an example. On the slide is a pharmacy label with the information that you need. Try to find the five rights on the pharmacy label. Using a piece of paper, write down the five rights for this pharmacy label. Remember, the five rights are person, medication, dose, time, and route. Feel free to hit pause on this webcast while you think about the five rights and write them down. The correct answers are: Person: Melissa Sullivan Medication: Carbemazepine Dose: two tablets of 200 mg tablets Time: three times a day Route: by mouth Did you correctly identify the five rights? Now take a few minutes to pause this webcast and complete the following activity. Identify the five rights on a pharmacy label that you have for someone you are supporting or for yourself. If you don t have access to a pharmacy label, use the example on the next slide to practice.
Let s practice again. Identify the five rights for this pharmacy label. List them on your scratch paper using the following as a guide: person, medication, dose, time, and route. Please pause this webcast while you complete this activity. The correct answers are: Person: Melissa Sullivan Medication: Prevacid Dose: two tablets (15 mg tablets) Time: one time a day Route: by mouth Did you identify correctly the five rights? If you would like more practice, look at other medication that you or the person you are supporting is taking or talk with your employer about how you can access additional pharmacy labels to use to practice this skill. If you had difficulty completing this activity and would like additional help, talk with your employer.
Now that you know the five rights and have practiced using them, it is time to talk about the steps of medication administration. Medication should be administered in the same way every time in order not to make mistakes. Errors in medication administration can harm people and using standard processes and reminder systems helps you avoid making errors. When administering medication, it is important not to skip any of the steps. We will use a five step process for administering medications. This process uses a three check method to assure that you have pulled out the correct medication and dose for the right person. The steps for administration are listed on the next slide and you would complete each step for each medication.
Don t forget to wash your hands before and after you administer medication. Let s look at the five steps of administration. Step 1: PULL MEDICATION OUT Look at the medication log to see what medications need to be given at this time. Pull out the containers with those medications and compare the five rights on the pharmacy label on the container to the medication log. This is Check 1. Step 2: POUR MEDICATION Check again to make sure that you have the right medication and dose for the right person at the right time by comparing the label to the medication log. This is Check 2. Take the dose of medication out of the container and put it on a clean surface (like a plate or cup). Step 3: RECAP MEDICATION As you close the container, check one more time to make sure that you have the right medication and dose at the right time for the right person. This is Check 3. Step 4: ADMINISTER MEDICATION Tell the person what medication they are taking. Give them the medication and, if needed, help them take it. For example, if they need help holding the cup of water to drink after swallowing the medication, help them hold it. If they are unable to put the medication in their mouth, you may need to do that. Step 5: DOCUMENTATION On your medication log, mark each of the medications that you gave, including the appropriate date and time.
Now we will discuss some special situations and what you can do if any of these happen. What if the pill is spit out or vomited? If the person spits out or vomits a dose of medication, you need to call the healthcare practitioner to get further instructions. What if the pill is refused? While people have the right to refuse taking their medication, it is important to try to figure out why they are refusing. Is it a bad time and would it be better to wait a little while to give it? Has someone told them something about their medication that has made them afraid to take it? Do they have an unwanted side effect to the medication that they haven t told you about? It is important to address why so that this doesn t become a chronic problem. You may need to work with the healthcare practitioner or someone from the agency to address what is interfering with the person taking their medication. What if the medication was given twice? If you give an extra dose of the medication, you need to call the prescribing healthcare practitioner to get instructions about what to do and look for. What about multiple missed doses? If you have multiple missed doses that are not refusals, you need to look at how to use reminders to remember to give the medication. Reminders can include calendars, timers, putting a plate or cup out for the medication, alarms on a watch or phone, computer reminders, etc. Combining medication administration times with times that you do other things can also help. For example, medication administration can be timed with meals. Taking medication at the same time as brushing your teeth in the morning or evening can also help you remember. Another example of a reminder is a sign on the refrigerator or bathroom mirror. You can use whatever will help you remember to give the medication.
Some people like to use pill boxes as reminders to take their medication. These often have room for 7 days worth of medication and also may allow for multiple times of medication administration in a single day. Regulations require that medication for people who do not self-administer be kept in its original container. People who selfadminister or are working towards self-administration can put their medication into a container for a trip or vacation or daily and weekly use. However, it is important to be sure that they know what medication to take and when because when all of the pills are in the pill box, the information about each pill is no longer available. Do not put medication for more than one person in the same container. If a pill box is going to be used, only the person and his or her family can take the pills from the original container and put them into a pill box. Another alternative to using a pill box for vacation or trips is having the pharmacist provide you with an additional container for each medication. They can dispense vacation medication separate from daily medication for the time period that you will be on vacation. This can be done with medication dispensed in bottles or blister packs. Remember as you administer each dose of medication, you need to be able to perform the three checks matching the five rights on the pharmacy label with the medication log. By following the standards outlined in this presentation, you will be able to safely administer medication and promote the health of the people you support. This concludes lesson 5. Please return to the course and begin lesson 6.