APPENDIX 1 PROCEDURES FOR ADMINISTERING MEDICATION

Transcription

1 APPENDIX 1 PROCEDURES FOR ADMINISTERING MEDICATION 1. Wash and thoroughly dry hands and any utensil that may be required e.g. medicine spoon, measure, glass, tablet cutter 2. Where a clinical tasks protocol is in place, undertake such preparations and infection control procedures as required. 3. Check the service user s identity, and allergy status 4. Check against the medication administration record (MAR), care plan and risk assessment that the medication has not been changed and confirm which medicines are due. 5. Check the physical state of the medicines, including the expiry date and labelling and that it has been suitably stored. If the Medicines label and MAR chart do not appear to match then should be sought before administration from the service manager. 6. Check the required dose and any special instructions on the dispensing label (e.g. not to be given with milk or antacids or to be taken with food etc.) and take appropriate action. 7. Contact the home care manager if there are concerns that the dose has already been given by somebody else. 8. Measure with the supplied liquid measure or count the dose and give it to the service user, if it is not in a compliance aid. 9. Ensure that the service user is either in a standing position or sitting upright. A home carer should not attempt to assist with medication for someone who is in a prone position. Medicines should be swallowed with plenty of water e.g ml of water or at least half a glass. 10. Check that the medication has been taken. 11. For applications of creams and ointments disposable powder free gloves must be worn. 12. Before commencing administration of medication, hands must be washed with liquid soap to prevent contamination. This should be repeated if gloves have been worn. 13. Record on the medication administration record that the medicine has been given or that it has been offered and refused (in the case of the latter a protocol should have been agreed regarding notification of other agencies/appropriate professional). 14. Return the medicines to a safe storage place as identified on the risk assessment. 15. Return the medication administration record sheet to the service user s notes. 16. Wash hands.

2 Confirm if patient has had their liquid medicine- can be with relative or in record Giving Liquids Orally (by mouth) Wash Your Hands /Unsure Do NOT give liquid and document in care record with reasons. Check name of patient matches name on medicine bottle Check name of medicine on label matches the name of medicine on the bottle (Brand and generic) Are there cautions e.g. with food Check dose: 2.5ml/half spoonful 5ml/one spoonful 10ml/two spoonfuls 15ml/three spoonfuls 20ml/four spoonfuls Never use a household teaspoon/desert spoon to give medicine Measure the required amount onto a medicine spoon or a measuring cup. If dose is less than 5ml/spoonful, use an oral syringe. Offer liquid to patient- if patient spits out, record in care record and do not repeat the dose and take from pharmacist or GP The pharmacy can provide oral syringes for giving doses below 5ml Offer patient drink after medicine to remove any unpleasant tastes. Wash medicine spoon/cup or syringe, replace cap of medicinestore in dark cool place.

3 Confirm if patient has had their inhaler (can be with record or relative) Don t give inhaler dose but write in care record. /Unsure Using Inhalers Attach inhaler to spacer deviceif no spacer refer to pharmacy. Check name of patient on inhaler is correct When aiding a patient with an inhaler the inhaler must come with a spacer device to get maximum benefit If spacer is dirty, after giving dose to patient rinse in warm water and leave to dry thoroughly. DO NOT wipe with a cloth to dry or use when wet. Always give a small drink of water after steroid inhalers to prevent fungal infections of the mouth- if you are unsure if the inhaler is a steroid, offer water anyway. Check name of inhaler on label matches box or device. What do instructions say? One or two puffs? With inhaler attached to spacer press ONE puff into spacer and offer to patient. Ask patient to breathe steadily and deeply four of five times. Repeat if necessary for a SECOND puff Ensure tops/lids are replaced firmly and stored in cool dry place If patient still seems breathless or uncomfortable after inhaler doses have been given refer to their health care professional for.

4 Confirm if patient has had their eye drops Do NOT give eye drops and write in care record. Does the bottle need reordering if it s nearly empty- ask pharmacy /Unsure Are drops in date? (Look for expiry date) Write date of opening on bottle. Drops which need to be stored in the fridge will have it on label or say store between 2-8 C on the box Administering Eye Drops Check patients name on bottle is correct Check name of medicine on pharmacy label matches bottle Is the bottle sealed as new? Check- is date of opening written on the bottle and within 28 days of today or is date on pharmacy label within 28 days of today Does label/care record give exact instructions for number of drops and how many times a day drops should be given? Instructions may be verbally confirmed by pharmacy or GP but this must be written in care record Remove lid of bottle and Do not touch eye with bottle dropper Ask patient to bend head slightly backwards Using thumb gently pull on lower eyelid Squeeze bottle to release one of the drops Release eyelid Ask patient to blink and Wipe excess with tissue Repeat this procedure for second drop or other eye if necessary Use eye medications in the right order 1. Aqueous solutions e.g. chloramphenicol then 2. Drops which sting e.g. atropine then 3. Suspensions e.g. dexamethasone then 4. Eye ointments e.g. Lacrilube Replace lid of bottle and store in a cool, dry place or fridge if necessary - refer to usual or Do not use drops risk of infection Return stock to pharmacy. Write in care records if dose not given Refer to pharmacy/gp Eye drops should not be used 28 days after they are opened A test drop may be squeezed into a clean tissue to see how the bottle works before putting in the eye Are there different drops to be added? WAIT 5 minutes then repeat from top of chart

5 Giving Controlled Drug (CD) Medication (Tablets, Capsules, Liquids or Patches) These guidelines are good practice recommendations The appropriate medication chart should be used in conjunction with this chart for all CD medications Check name of patient matches label on CD medication carefully Check dose on label matches dose to be given in care record Check how many tablets, capsules or how much liquid should be given Are there any other instructions on the label IS EVERYTHING CHECKED OK AND NO PROBLEMS? Give to patient in line with appropriate medication flow chart. Refer any queries to pharmacy or GP practice or report to supervisor for. RECORD IN CARE PLAN Write clearly in record exactly what was given to patient and sign record. If your policy states two persons must signthe second person must check and sign the care record