CHCCS305A Assist Clients With Medication WBK

CHCCS305A
CHCCS305A
Assist clients with
Assist clients with
medication
medication
CHCCS305A.
Assist clients with medication
Author
John Bailey
Copyright
Text copyright 2008, 2010, 2011 by John N. Bailey.
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John Bailey 2008, 2010, 2011 /age 6e-uence: /age 2 o( 282
#@##6;08!. !ssist clients +ith
)edication
#ontents
ASSIST CLIENTS WITH MEDICATION CHCCS305A...................................................................10
Description:............................................................................................................................. 10
About this Unit of Study Introduction....................................................................................... 10
This Learning Guide Coers:.................................................................................................. 10
Learning !rogra":.................................................................................................................. 10
Additiona# Learning Support................................................................................................... 11
$aci#itation.............................................................................................................................. 11
$#e%ib#e Learning.................................................................................................................... 1&
Space..................................................................................................................................... 1&
Study 'esources.................................................................................................................... 1&
Ti"e........................................................................................................................................ 1&
Study Strategies..................................................................................................................... 1(
Using This Learning Guide..................................................................................................... 1(
ICONS............................................................................................................................................ 14
)o* to Get the +ost out of ,our Learning Guide:..................................................................1-
Additiona# 'esearch. 'eading and /ote Ta0ing.....................................................................1-
PERFORMANCE CRITERIA.......................................................................................................... 16
SKILLS AND KNOWLEDGE.......................................................................................................... 20
'e1uired 2no*#edge.............................................................................................................. &1
RANGE STATEMENT.................................................................................................................... 23
EVIDENCE GUIDE......................................................................................................................... 31
1. PREPARE TO ASSIST WITH MEDICATION.............................................................................34
1.1 ESTABLISH AUTHORITY TO PROVIDE ASSISTANCE WITH ADMINISTRATION OF MEDICATION IN LINE
WITH ORGANISATION GUIDELINES AND PROTOCOLS AND JURISDICTIONAL LEGISLATIVE AND
REGULATORY REQUIREMENTS........................................................................................................ 35
3hat is a "edication error4.................................................................................................... (-
$igure : 'e#ationship bet*een "edication errors and aderse drug reactions.......................(5
)o* often do "edication errors occur4.................................................................................. (6
$igure : The "edication error iceberg..................................................................................... (6
3hy do "edication errors occur4........................................................................................... (7
$igure : S*iss cheese "ode# of error preention: ..................................................................(8
$igure : The person and syste"s approaches to "edication error.........................................90
The reasons for incorrect "edication use in acute care.........................................................91
I"proing syste"s:................................................................................................................. 91
$igure: The /ationa# Inpatient +edication Chart....................................................................9&
............................................................................................................................................... 9&
$igure : Docu"entation of aderse drug reactions pre and post /I+C pi#ot...........................99
............................................................................................................................................... 99
The /I+C resu#ts in c#earer prescribing.................................................................................. 99
The /I+C is i"proing the ad"inistration of :as re1uired; "edications..................................9-
'easons for "edication prob#e"s in the co""unity..............................................................9-
I"proing "edicine use in the co""unity.............................................................................. 9-
+edication reie* serices are i"proing "edication use in the co""unity.........................95
Continuing to i"proe the safety and 1ua#ity of "edication use in Austra#ia..........................96
John Bailey 2008, 2010, 2011 /age 6e-uence: /age ; o( 282
1.2 DEMONSTRATE AN UNDERSTANDING OF ORGANISATION POLICY AND GUIDELINES RELATING TO
ASSISTING WITH MEDICATION WITHIN WORK ROLE RESPONSIBILITIES................................................4
'o#e of the Aged Care 3or0er................................................................................................ 98
$o##o*ing Guide#ines............................................................................................................... -0
<rganisationa# Guide#ines....................................................................................................... -1
Actiity.................................................................................................................................... -&
1.3 IDENTIFY LINES OF AUTHORITY! ACCOUNTABILITY AND ACTIONS TO BE TAKEN TO HANDLE
CONTINGENCIES............................................................................................................................ 53
)and#ing Contingencies.......................................................................................................... -(
Actiity.................................................................................................................................... --
1.4 IDENTIFY LEVEL AND TYPE OF PHYSICAL ASSISTANCE REQUIRED BY THE CLIENT TO ADDRESS
THEIR PERSONAL NEEDS IN TAKING MEDICATIONS...........................................................................5"
Actiity.................................................................................................................................... -7
1.5 IDENTIFY LEVEL AND TYPE OF SUPERVISION REQUIRED BY THE CLIENT TO SELF ADMINISTER
MEDICATIONS................................................................................................................................ 5
Actiity.................................................................................................................................... 50
1.# IDENTIFY AND REPORT TO A SUPERVISOR AND$OR HEALTH PROFESSIONAL IF THERE ARE ANY
CIRCUMSTANCES OR CHANGES IN THE CLIENT%S CONDITION OR PERSONAL NEEDS THAT MAY IMPACT
ON ASSISTING THE CLIENT WITH THEIR MEDICATION.........................................................................#1
'eporting changes ................................................................................................................ 51
Changes in condition.............................................................................................................. 5&
Case Study 1.......................................................................................................................... 59
$igure : Conditions................................................................................................................. 5-
Case Study &.......................................................................................................................... 56
!rocedures for reporting changes.......................................................................................... 57
$igure : !rogress=c#inica# notes............................................................................................... 58
Actiity.................................................................................................................................... 58
1." CONFIRM THAT ALL FORMS OF MEDICATION TO BE ADMINISTERED! INCLUDING DOSE
ADMINISTRATION AIDES ARE COMPLETE! READY FOR DISTRIBUTION AND UP TO DATE! CONFIRM WITH
SUPERVISOR AND OBTAIN AUTHORITY TO PROCEED......................................................................... "1
Types of +edication................................................................................................................ 61
!resentation of "edications................................................................................................... 6&
Dose Ad"inistration Aids........................................................................................................ 6&
$igure : +edication organi>ers............................................................................................... 6(
$igure : ?#ister !ac0s.............................................................................................................. 69
$igure : Sachets..................................................................................................................... 6-
Ad"inistering +edications...................................................................................................... 6-
Aged Care 3or0er;s 'o#e....................................................................................................... 65
Authority to !roceed............................................................................................................... 66
Actiity :.................................................................................................................................. 67
1.& CONFIRM THE PROCEDURE TO BE USED FOR MEDICATION TO BE ADMINISTERED.......................&1
Assisting *ith se#f@"edication................................................................................................. 71
)e#ping the o#der person to ta0e the "edication.....................................................................71
1. ?ui#d trust............................................................................................................................ 7&
&. Ancourage the o#der person............................................................................................... 7&
$igure :................................................................................................................................... 7(
Actiity.................................................................................................................................... 79
Actiity :.................................................................................................................................. 7-
(. !roide priacy................................................................................................................... 75
9. !repare the person for the "edication................................................................................ 75
$igure :................................................................................................................................... 76
Actiity :.................................................................................................................................. 76
-. !repare for ad"inistering the "edication........................................................................... 77
Actiity.................................................................................................................................... 77
5. A%p#ain the procedure......................................................................................................... 81
Actiity :.................................................................................................................................. 8(
1. IMPLEMENT PERSONAL HYGIENE PROCEDURES ACCORDING TO ORGANISATION POLICY AND
PROCEDURE TO MINIMISE INFECTION.............................................................................................. 4
$o##o*ing persona# hygiene procedures................................................................................. 89
)o* cross@infection occurs..................................................................................................... 89
John Bailey 2008, 2010, 2011 /age 6e-uence: /age < o( 282
!reenting Cross@Infection..................................................................................................... 8-
Actiity.................................................................................................................................... 85
1.1' IDENTIFY AND IMPLEMENT DUTY OF CARE PROCEDURES IN RELATION TO ADDRESSING
INDIVIDUAL CLIENT NEEDS.............................................................................................................. "
Identifying your duty of care.................................................................................................... 86
Duty of care responsibi#ities.................................................................................................... 86
Actiity.................................................................................................................................... 87
2. PREPARE THE CLIENT FOR ASSISTANCE WITH ADMINISTRATION OF MEDICATION. .100
2.1 IMPLEMENT ALL NECESSARY CHECKS TO ENSURE THE CLIENT AND THEIR MEDICATIONS ARE
CORRECTLY IDENTIFIED ACCORDING TO ORGANISATION PROCEDURES AND CARE PLAN...................1''
!reparing an o#der person to ta0e their "edication..............................................................100
1. Greet the o#der person...................................................................................................... 101
&. Ancourage participation.................................................................................................... 101
Actiity.................................................................................................................................. 10&
(. !roide priacy................................................................................................................. 10(
9. +a0e the o#der person co"fortab#e.................................................................................. 109
$igure : ?ed positions........................................................................................................... 109
Actiity :................................................................................................................................ 10-
-. See0 assistance fro" other staff...................................................................................... 10-
Actiity :................................................................................................................................ 10-
............................................................................................................................................ 107
CHECKING THE MEDICATION AND THE IDENTITY OF THE OLDER PERSON.......................................1'&
1. Chec0 the instructions...................................................................................................... 107
&. Chec0 that the person is the correct one.......................................................................... 107
(. Chec0 that the "edication and ad"inistration "ethod is correct......................................108
9. Chec0 that the "edication is current and in good condition..............................................108
-. Chec0 the a"ount to be ta0en.......................................................................................... 108
5. Chec0 *hether anything has to be done to the "edication before being ta0en................110
6. Chec0 the route................................................................................................................ 111
Actiity :................................................................................................................................ 11&
7. Chec0 *hether there are any *arnings or adice.............................................................11(
8. Chec0 that the ti"e for ta0ing the "edication is understood............................................11(
Actiity :................................................................................................................................ 119
$igure :................................................................................................................................. 11-
Actiity :................................................................................................................................ 115
Actiity.................................................................................................................................. 117
10.Chec0 *hether the person is ta0ing any other "edication...............................................117
Actiity.................................................................................................................................. 118
............................................................................................................................................ 1&0
2.2 CLARIFY SPECIFIC ASSISTANCE REQUIRED TO ADDRESS PERSONAL NEEDS OF EACH CLIENT IN
LINE WITH ORGANISATION PROCEDURES LISTED IN THE RANGE STATEMENT AND WITHIN WORK ROLE
RESPONSIBILITIES........................................................................................................................ 12'
3atching the o#der person as they ta0e their "edication.....................................................1&0
a. 3hat you are e%pected to do *hen assisting *ith "edication..........................................1&1
$igure :................................................................................................................................. 1&1
Actiity :................................................................................................................................ 1&&
b. 3hat you "ust not do....................................................................................................... 1&9
c. 3ho you "ust report to..................................................................................................... 1&9
d. )o* to record *hat you hae done.................................................................................. 1&-
Actiity.................................................................................................................................. 1&-
2.3 CORRECTLY IDENTIFY AND GREET EACH CLIENT AND PREPARE THEM FOR MEDICATION............12#
$o##o*ing procedures to identify the o#der person................................................................1&5
Actiity.................................................................................................................................. 1&7
2.4 CHECK CLIENT MEDICATIONS ACCORDING TO THE PROCEDURES IDENTIFIED IN THE ORGANISATION
GUIDELINES DEFINED IN THE RANGE STATEMENT..........................................................................12
Chec0ing "edications........................................................................................................... 1&8
Dose ad"inistration aids...................................................................................................... 1&8
Actiity :................................................................................................................................ 1(1
+a0ing sure the o#der person receies the right "edication.................................................1(1
Actiity :................................................................................................................................ 1((
Chec0 the dose ad"inistration aid........................................................................................ 1((
Chec0 the care instructions.................................................................................................. 1(-
Actiity :................................................................................................................................ 1(-
Chec0 the "edication is not da"aged. conta"inated or e%pired.........................................1(5
Chec0 the dose ad"inistration aids are intact......................................................................1(6
Actiity : 'esearch................................................................................................................ 1(7
2.5 E(PLAIN THE ADMINISTRATION PROCEDURE TO THE CLIENT IN LINE WITH REQUIREMENTS AND
ORGANISATION PROCEDURES AND ENSURE THEIR NEEDS ARE MET................................................141
The aged care *or0erBs ro#e................................................................................................. 191
Assisting *ith +edication...................................................................................................... 191
aCTab#ets............................................................................................................................... 19&
bCLi1uid "edicines................................................................................................................ 19(
cCTopica# "edication............................................................................................................. 199
dCAye treat"ents.................................................................................................................. 199
eCAar drops........................................................................................................................... 19-
fC!atches.............................................................................................................................. 19-
gC!'/ "edication................................................................................................................ 195
Actiity.................................................................................................................................. 196
Actiity: 'o#e p#ay................................................................................................................. 198
2.# PRIOR TO GIVING MEDICATION! OBSERVE THE CLIENT TO CHECK FOR ANY PHYSICAL OR
BEHAVIOURAL CHANGES THAT MAY INDICATE A NEED TO REPORT TO SUPERVISOR OR HEALTH
PROFESSIONAL IN ACCORDANCE WITH ORGANISATION POLICIES AND PROCEDURES.........................14
Getting per"ission to proceed.............................................................................................. 198
Authorisation to proceed....................................................................................................... 1-0
OBSERVING CHANGES IN THE OLDER PERSON............................................................................. 15'
Types of changes................................................................................................................. 1-1
$igure : !hysica# changes..................................................................................................... 1-1
+onitor the o#der personBs condition..................................................................................... 1-9
Actiity :................................................................................................................................ 1--
2." RECOGNISE CIRCUMSTANCES WHEN APPROPRIATE ACTION IS TO REPORT OBSERVED CLIENT
HEALTH STATUS RATHER THAN PROCEEDING WITH ADMINISTRATION OF MEDICATION AND SEEK ADVICE
OF SUPERVISOR OR HEALTH PROFESSIONAL.................................................................................15#
/otifying your superisor if there is a difficu#ty *ith the se#f@"edication................................1-5
Types of difficu#ties............................................................................................................... 1-5
$igure : Difficu#ty................................................................................................................... 1-7
)o* you find out about a difficu#ty........................................................................................ 1-8
!rocedures to report the difficu#ty......................................................................................... 1-8
2no*ing *ho to contact if a difficu#ty arises.......................................................................... 150
Actiity.................................................................................................................................. 151
'eporting difficu#ties or errors............................................................................................... 15&
/otify your superisor........................................................................................................... 15&
2eep the o#der person infor"ed........................................................................................... 15(
'ecord *hat has happened.................................................................................................. 15(
Actiity.................................................................................................................................. 15(
3. ASSIST/SUPPORT CLIENT WITH ADMINISTRATION OF MEDICATION............................165
3.1 REMIND AND PROMPT CLIENT TO TAKE MEDICATION AT CORRECT TIME....................................1#5
Actiity :................................................................................................................................ 155
Actiity.................................................................................................................................. 156
3.2 ASSIST CLIENTS WITH ADMINISTRATION OF MEDICATIONS AS REQUIRED IN ACCORDANCE WITH
LEGISLATION. ORGANISATION POLICIES AND THE LEVEL OF SUPPORT NEEDED AS IDENTIFIED IN THEIR
CARE$ SUPPORT PLAN.................................................................................................................. 1#&
Understanding the #egis#ation and regu#ations......................................................................157
Actiity : 'esearch................................................................................................................ 158
Assist the o#der person to ta0e their "edication as prescribed.............................................160
!reparing and giing the "edication.................................................................................... 161
1. !repare the e1uip"ent..................................................................................................... 16&
$igure : A1uip"ent............................................................................................................... 16(
$igure : +edication Tro##ey .................................................................................................. 169
John Bailey 2008, 2010, 2011 /age 6e-uence: /age % o( 282
Actiity.................................................................................................................................. 16-
&. !repare the "edication..................................................................................................... 16-
$igure : !rogress /otes........................................................................................................ 165
!repare to gie the "edication according to instructions......................................................165
$igure : +edicines and Guide#ines....................................................................................... 166
Actiity : 'o#e !#ay................................................................................................................ 168
3.3 SUPERVISE AND OBSERVE CLIENTS WHEN TAKING MEDICATION AND CONFIRM WITH THEM THEIR
INGESTION OR COMPLETION......................................................................................................... 1"
Superising the "edication................................................................................................... 168
3atching the o#der person after they hae ta0en the "edication.........................................171
Understanding a personBs progress notes............................................................................ 17&
Loo0ing for changes............................................................................................................. 17&
Chec0ing the personBs condition........................................................................................... 17(
$igure : Anaphy#a%is reactions.............................................................................................. 17(
'esponding according to procedures................................................................................... 179
Docu"enting the situation.................................................................................................... 179
Actiity.................................................................................................................................. 175
3.4 COMPLETE DOCUMENTATION$ RECORD OF MEDICATION ADMINISTRATION ACCORDING TO
ORGANISATION PROCEDURES....................................................................................................... 1&"
Actiity.................................................................................................................................. 177
+edication Charts................................................................................................................. 177
$igure : Antries on a "edication chart.................................................................................. 178
Actiity.................................................................................................................................. 178
3.5 OBSERVE CLIENT FOR ANY CHANGES IN THEIR CONDITION LISTED IN THE RANGE STATEMENT AND
SEEK ASSISTANCE FROM A HEALTH PROFESSIONAL! SUPERVISOR! MEDICAL OFFICER OR EMERGENCY
SERVICES AS INDICATED IN THE ORGANISATION%S POLICIES............................................................11
Loo0ing for Changes............................................................................................................. 181
Chec0ing the condition of a person...................................................................................... 18&
'esponding to a personBs reaction to their "edication.........................................................18&
$igure : !hysica# changes..................................................................................................... 18(
$igure : ?ehaioura# changes............................................................................................... 18-
Actiity.................................................................................................................................. 18-
3.# DISCARD WASTE PRODUCTS ACCORDING TO ORGANISATION PROCEDURES AND$ OR
MANUFACTURER%S INSTRUCTIONS................................................................................................. 1"
Safe#y thro*ing a*ay any *aste "ateria#............................................................................. 186
Disposing of 3aste............................................................................................................... 187
Disposa# of conta"inated. unused or e%pired "edications...................................................187
$igure : Sharps Containers................................................................................................... 188
Disposa# of "edication containers........................................................................................ 188
+ethods of disposa# ............................................................................................................. 188
4. ASSIST/SUPPORT MEDICATION ADMINISTRATION ACCORDING TO
PRESCRIPTION/INSTRUCTIONS............................................................................................... 200
4.1 PREPARE MEDICATIONS AND ADMINISTER TO THE CLIENT OR SUPPORT THEIR SELF
ADMINISTRATION ACCORDING TO THE SPECIFIC REQUIREMENTS OF THE FORM OF MEDICATION! IN
STRICT ACCORDANCE WITH DEFINED LEGISLATION AND ORGANISATION PROCEDURES AND WRITTEN
PRESCRIPTION INSTRUCTIONS...................................................................................................... 2'1
4.2 IMPLEMENT ALL NECESSARY CHECKS TO ENSURE THE RIGHT MEDICATION IS GIVEN AT THE RIGHT
TIME! TO THE RIGHT PERSON! IN THE RIGHT AMOUNT! VIA THE RIGHT ROUTE..................................2'1
Chec0ing the "edication...................................................................................................... &01
Actiity.................................................................................................................................. &01
$igure : !rescribed ti"es...................................................................................................... &0&
Actiity :................................................................................................................................ &09
Actiity :................................................................................................................................ &09
The right person................................................................................................................... &0-
Actiity :................................................................................................................................ &0-
The right a"ount.................................................................................................................. &05
Actiity :................................................................................................................................ &05
The right route...................................................................................................................... &06
$igure : 'outes of Ad"inistration......................................................................................... &06
John Bailey 2008, 2010, 2011 /age 6e-uence: /age = o( 282
4.3 ASSIST THE CLIENT TO TAKE THE MEDICATIONS AS REQUIRED! IN ACCORDANCE WITH THEIR
NEEDS AND DOCUMENTED PROCEDURES...................................................................................... 2'&
Assisting an o#der person to ta0e prescribed "edication......................................................&07
$o##o*ing doctorBs orders...................................................................................................... &07
$o##o*ing the prescription..................................................................................................... &07
4.4 SUPERVISE AND OBSERVE THE CLIENT WHEN TAKING THE MEDICATION AND CONFIRM WITH THE
CLIENT THEIR INGESTION OR COMPLETION.................................................................................... 2'
3hat can go *rong4............................................................................................................. &08
4.5 IMPLEMENT DOCUMENTED PROCEDURES FOR MEDICATION NOT BEING ADMINISTERED OR
ABSORBED! SUCH AS THROUGH E(PELLING$ VOMITING! REFUSAL OR DAMAGE TO MEDICATION AND
REPORT TO SUPER VISOR AND$ OR HEALTH PROFESSIONAL...........................................................211
3hat "ight happen.............................................................................................................. &11
a. Side@effects....................................................................................................................... &11
b. Aderse reactions............................................................................................................. &1&
c. A##ergic reactions.............................................................................................................. &1&
d. Affects fro" ta0ing "ore than one "edication..................................................................&1&
+onitoring the o#der person.................................................................................................. &1(
Side@effects and reactions to #oo0 for.................................................................................... &1(
4.# RECORD ALL REQUIRED DETAILS OF MEDICATION ADMINISTRATION AND OTHER DETAILS IN THE
APPROPRIATE DOCUMENTS ACCORDING TO THE LEGISLATION AND ORGANISATION%S PROCEDURES. .214
$igure : +edication Ad"inistration for"............................................................................... &19
$igure : Care /otes.............................................................................................................. &1-
'ecording the detai#s of "edication ad"inistration..............................................................&1-
Actiity : ............................................................................................................................... &15
Docu"enting the detai#s of the "edication........................................................................... &15
4." OBSERVE THE CLIENT FOR ANY POSSIBLE MEDICATION EFFECTS LISTED IN THE RANGE
STATEMENT AND REPORT TO A SUPERVISOR OR HEALTH PROFESSIONAL........................................21&
4.& COLLECT USED EQUIPMENT! DISCARDED MEDICATIONS$ APPLICATORS AND RUBBISH AND PLACE IN
APPROPRIATE$ DESIGNATED RECEPTACLE ACCORDING TO INSTRUCTIONS.......................................21
!rocedures for hand#ing dirty e1uip"ent and rubbish..........................................................&&0
5. COMPLY WITH ORGANISATIONS PROCEDURES FOR HANDLING THE RANGE OF
ISSUES/ CONTINGENCIES WHICH MAY ARISE.......................................................................221
5.1 REPORT TO SUPERVISOR AND$ OR HEALTH PROFESSIONAL ALL CONCERNS WITH THE
ADMINISTRATION OF MEDICATION )SUCH AS* CLIENT REFUSAL TO TAKE SOME OR ALL MEDICATIONS!
INCOMPLETE INGESTION! MISSED OR MISSING DOSES+ ACCORDING TO ORGANISATION PROCEDURES
AND PROTOCOLS......................................................................................................................... 222
An o#der person refuses to ta0e their "edication..................................................................&&&
Interention for <ccasiona# 'efusa#...................................................................................... &&(
$re1uent or !ersistent !attern of 'efusa#............................................................................. &&(
<ther +edica# Concerns....................................................................................................... &&9
5.2 IDENTIFY! REPORT! RECORD AND ADDRESS INDIVIDUAL%S REACTIONS TO MEDICATION ACCORDING
TO ORGANISATION GUIDELINES AND HEALTH PROFESSIONAL%S INSTRUCTIONS.................................225
Causes................................................................................................................................. &&-
$igure : Anaphy#a%is............................................................................................................. &&-
A%a"s and Tests.................................................................................................................. &&6
Treat"ent............................................................................................................................. &&6
<ut#oo0 D!rognosisC.............................................................................................................. &&6
!reention............................................................................................................................ &&7
$igure : Drug Ad"inistration Chart....................................................................................... &&7
5.3 CLEARY IDENTIFY CONTAMINATED OR OUT OF DATE MEDICATION AND IMPLEMENT ORGANISATION%S
PROCEDURES FOR ENSURING SAFE AND APPROPRIATE DISPOSAL..................................................22
A%pired "edication............................................................................................................... &&8
5.4 IDENTIFY! REPORT AND RECORD CHANGES IN INDIVIDUAL%S CONDITION! INCLUDING WITHIN
ESSENTIAL TIMEFRAMES WHERE RELEVANT! ACCORDING TO ORGANISATION GUIDELINES.................23'
Co""on causes of changes in an o#der personBs condition.................................................&(0
Identifying a change in the o#der personBs condition.............................................................&(0
5.5 IDENTIFY PROCEDURES TO ADDRESS$ RESPOND TO CHANGES IN THE CLIENT%S CONDITION OR
NEEDS ACCORDING TO THE ORGANISATION%S GUIDELINES..............................................................231
'eporting a change in condition........................................................................................... &(1
5.# PROMPTLY REPORT TO THE SUPERVISOR OR HEALTH PROFESSIONAL ANY INCONSISTENCIES
OBSERVED WITH THE MEDICATION OR CLIENT AND TAKE ACTION IN ACCORDANCE WITH THE
ORGANISATION%S PROCEDURES OR HEALTH PROFESSIONAL%S INSTRUCTIONS..................................232
Dea#ing *ith inconsistencies................................................................................................. &((
$igure : +edication chec0#ist................................................................................................ &(9
Inco"p#ete ingestion or app#ication...................................................................................... &(6
Actiity :................................................................................................................................ &(7
Actiity :................................................................................................................................ &(8
5." DOCUMENT ALL INCONSISTENCIES AND ADDRESS ACCORDING TO ORGANISATION GUIDELINES AND
PROCEDURES.............................................................................................................................. 24'
6. COMPLETE THE DISTRI!UTION AND ADMINISTRATION OF MEDICATION.....................242
#.1 CLEAN AND STORE UNUSED AND$ OR USED MEDICATIONS! CONTAINERS AND ADMINISTRATION AIDS
IN ACCORDANCE WITH INDUSTRY AND THE ORGANISATION%S INFECTION CONTROL GUIDELINES.........242
+anaging tro##eys and used "edicine containers.................................................................&9&
Actiity :................................................................................................................................ &9(
Caring for "edication tro##eys............................................................................................... &9(
#.2 FOLLOW THE ORGANISATION%S ARRANGEMENTS AND PROCEDURES TO REPLENISH DOSE
ADMINISTRATION AIDS AND SUPPLIES OF MEDICATIONS..................................................................244
#.3 SECURELY STORE MEDICATION CHARTS$ CARE PLANS$ TREATMENT SHEETS ACCORDING TO
ORGANISATION PROCEDURES TO ENSURE SAFETY! SECURITY AND CONFIDENTIALITY.......................244
Storing current records......................................................................................................... &99
#.4 FOLLOW THE ORGANISATION%S PROCEDURES TO ENSURE MEDICATION STORAGE COMPLIES WITH
LEGISLATION AND MANUFACTURER%S INSTRUCTIONS! MA(IMISES SECURITY AND PREVENTS MEDICATION
DETERIORATION.......................................................................................................................... 245
Storing "edication................................................................................................................ &9-
Storing "edication secure#y.................................................................................................. &9-
Storing contro##ed drugs........................................................................................................ &9-
Co""on +edica# Abbreiations........................................................................................... &95
$igure : Abbreiations and their "eaning............................................................................. &95
Actiity :................................................................................................................................ &-0
RESOURCE EVALUATION FORM.............................................................................................. 252
John Bailey 2008, 2010, 2011 /age 6e-uence: /age $ o( 282
!ssist clients +ith )edication
#@##6;08!.
Description#
This unit describes the ,no+ledge and s,ills re-uired by care or support
+or,ers to assist clients +ith )edication
The unit addresses the pro*ision o( physical assistance +ith )edication or
supporting clients +ith sel( )edication in response to an assessed need
identi(ied by the client or their substitute decisionA)a,er (or assistance +ith
)edication, in accordance +ith the healthBsupportB care plan and in line
+ith 3urisdictional re-uire)ents
It )ay in*ol*e distribution and ad)inistration o( prescribed and o*er the
counter )edications +ithin a residential care (acility, or in a ho)e or
co))unity setting
A"out this &nit of Study 'ntroduction.
!s a +or,er, a trainee, or a (uture +or,er you +ant to en3oy your +or, and
beco)e ,no+n as a *aluable tea) )e)ber. This unit o( co)petency +ill help
you ac-uire the ,no+ledge and s,ills to +or, e((ecti*ely as an indi*idual and in
groups. It +ill gi*e you the basis to contribute to the goals o( the organisation
+hich e)ploys you.
It is essential that you begin your training by beco)ing (a)iliar +ith the
industry standards to +hich organisations )ust con(or).
This unit o( co)petency introduces you to so)e o( the ,ey issues and
responsibilities o( +or,ers and organisations in this area. The unit also
pro*ides you +ith opportunities to de*elop the co)petencies necessary (or
e)ployees to operate as tea) )e)bers.
his (earning )uide Co*ers#
/repare to assist +ith )edication
/repare the client (or assistance +ith ad)inistration o( )edication
!ssistBsupport client +ith ad)inistration o( )edication
!ssistBsupport )edication ad)inistration according to
prescriptionBinstructions
#o)ply +ith organisationCs procedures (or handling the range o( issuesB
contingencies +hich )ay arise
#o)plete the distribution and ad)inistration o( )edication
(earning Program#
!s you progress through this unit o( study you +ill de*elop s,ills in locating
and understanding an organisations policies and procedures. Dou +ill build
up a sound ,no+ledge o( the industry standards +ithin +hich organisations
)ust operate. Dou +ill beco)e )ore a+are o( the e((ect that your o+n s,ills
in dealing +ith people has on your success or other+ise in the +or,place.
Eno+ledge o( your s,ills and capabilities +ill help you )a,e in(or)ed choices
about your (urther study and career options.
Additional (earning Support
To obtain additional support you )ay:
search (or other resources in the ?earning 0esource #entre &?0#' o(
your learning institution. Dou )ay (ind boo,s, 3ournals, *ideos and other
)aterials +hich pro*ide additional in(or)ation about topics in this unit.
search (or other resources in your local library. 5ost libraries ,eep
in(or)ation about go*ern)ent depart)ents and other organisations,
ser*ices and progra)s. The librarian should be able to help you locate
such resources.
contact in(or)ation ser*ices such as In(olin,, F-ual 1pportunity
#o))ission, #o))issioner o( 7or,place !gree)ents, nion
organisations, and public relations and in(or)ation ser*ices pro*ided by
*arious go*ern)ent depart)ents. 5any o( these ser*ices are listed in
the telephone directory.
contact your local shire or council o((ice. 5any councils ha*e a
co))unity de*elop)ent or +el(are o((icer as +ell as an in(or)ation and
re(erral ser*ice.
contact the rele*ant (acilitator by telephone, )ail or (acsi)ile.
+acilitation
Dour training organisation +ill pro*ide you +ith a (lexible learning (acilitator.
Dour (acilitator +ill play an acti*e role in supporting your learning. Dour
(acilitator +ill )a,e regular contact +ith you and, i( you ha*e (ace toA(ace
access, should arrange to see you at least once. Dour (acilitator +ill contact
you by telephone or letter as soon as possible a(ter you ha*e enrolled to let
you ,no+:
ho+ and +hen to )a,e contact,
+hat you need to do to co)plete this unit o( study, and
+hat support +ill be pro*ided.
@ere are so)e o( the things your (acilitator can do to )a,e your study easier:
Gi*e you a clear *isual ti)etable o( e*ents (or the se)ester or ter) in
+hich you are enrolled, including any deadlines (or assess)ents.
#hec, that you ,no+ ho+ to access library (acilities and ser*ices.
#onduct s)all "interest groups" (or so)e o( the topics
se "action sheets" to re)ind you about tas,s you need to co)plete, and
updates on +ebsites.
6et up a "chat line". I( you ha*e access to telephone con(erencing or
*ideo con(erencing, your (acilitator can use these (or speci(ic topics or
discussion sessions.
#irculate a ne+sletter to ,eep you in(or)ed o( e*ents, topics and
resources o( interest to you.
Eeep in touch +ith you by telephone or eA)ail during your studies.
+le,i"le (earning
6tudying to beco)e a co)petent +or,er is an interesting and exciting thing to
do. Dou +ill learn about current issues in this area. Dou +ill establish
relationships +ith other candidates, (ello+ +or,ers, and clients. Dou +ill learn
about your o+n ideas, attitudes and *alues. Dou +ill also ha*e (un. &5ost o(
the ti)eH'
!t other ti)es, study can see) o*er+hel)ing and i)possibly de)anding,
particularly +hen you ha*e an assign)ent to do and you aren"t sure ho+ to
tac,le it ... and your (a)ily and (riends +ant you to spend ti)e +ith the)...and
a )o*ie you +ant to see is on tele*ision...
6o)eti)es being a candidate can be hard.
@ere are so)e ideas to help you through the hard ti)es. To study e((ecti*ely,
you need space, resources and ti)e.
Space
Try to set up a place at ho)e or at +or, +here:
you can ,eep your study )aterials,
you can be reasonably -uiet and (ree (ro) interruptions, and
you can be reasonably co)(ortable, +ith good lighting, seating and a
(lat sur(ace (or +riting.
I( it is i)possible (or you to set up a study space, perhaps you could use your
local library. Dou +ill not be able to store your study )aterials there, but you
+ill ha*e -uiet, a des, and chair, and easy access to the other (acilities.
Study -esources
The )ost basic resources you +ill need are:
a chair
a des, or table
a reading la)p or good light
a (older or (ile to ,eep your notes and study )aterials together
)aterials to record in(or)ation &pen and paper or noteboo,s, or a
co)puter and printer'
re(erence )aterials, including a dictionary.
9o not (orget that other people can be *aluable study resources. Dour (ello+
+or,ers, +or, super*isor, other candidates, your (lexible learning (acilitator,
your local librarian, and +or,ers in this area can also help you.
ime
It is i)portant to plan your study ti)e. 7or, out a ti)e that suits you and plan
around it. 5ost people (ind that studying in short, concentrated bloc,s o( ti)e
&an hour or t+o' at regular inter*als &daily, e*ery second day, once a +ee,' is
)ore e((ecti*e than trying to cra) a lot o( learning into a +hole day. Dou need
ti)e to "digest" the in(or)ation in one section be(ore you )o*e on to the next,
and e*eryone needs regular brea,s (ro) study to a*oid o*erload. Be realistic
in allocating ti)e (or study. ?oo, at +hat is re-uired (or the unit and loo, at
your other co))it)ents.
5a,e up a study ti)etable and stic, to it. Build in "deadlines" and set yoursel(
goals (or co)pleting study tas,s. !llo+ ti)e (or reading and co)pleting
acti*ities. 0e)e)ber that it is the -uality o( the ti)e you spend studying
rather than the -uantity that is i)portant.
Study Strategies
9i((erent people ha*e di((erent learning "styles". 6o)e people learn best by
listening or repeating things out loud. 6o)e learn best by "doing", so)e by
reading and )a,ing notes. !ssess your o+n learning style, and try to identi(y
any barriers to learning +hich )ight a((ect you. !re you easily distractedI !re
you a(raid you +ill (ailI !re you ta,ing study too seriouslyI Not seriously
enoughI 9o you ha*e supporti*e (riends and (a)ilyI @ere are so)e ideas (or
e((ecti*e study strategies:
5a,e notes. This o(ten helps you to re)e)ber ne+ or un(a)iliar in(or)ation.
9o not +orry about spelling or neatness, as long as you can read your o+n
notes. Eeep your notes +ith the rest o( your study )aterials and add to the)
as you go. se pictures and diagra)s i( this helps.
nderline ,ey +ords +hen you are reading the )aterials in this learning
guide. &9o not underline things in other people"s boo,s.' This also helps you
to re)e)ber i)portant points.
Tal, to other people &(ello+ +or,ers, (ello+ candidates, (riends, (a)ily, your
(acilitator' about +hat you are learning. !s +ell as helping you to clari(y and
understand ne+ ideas, tal,ing also gi*es you a chance to (ind out extra
in(or)ation and to get (resh ideas and di((erent points o( *ie+.
&sing his (earning )uide.
! learning guide is 3ust that, a guide to help you learn. ! learning guide is not
a text boo,. Dour learning guide +ill:
describe the s,ills you need to de)onstrate to achie*e co)petency (or
this unitJ
pro*ide in(or)ation and ,no+ledge to help you de*elop your s,illsJ
pro*ide you +ith structured learning acti*ities to help you absorb
,no+ledge and in(or)ation and practice your s,illsJ
direct you to other sources o( additional ,no+ledge and in(or)ation
about topics (or this unit.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1; o( 282
Icons
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1< o( 282
.ey Points
Fxplains the action ta,en by a co)petent person
E,ample
Illustrates the concept or co)petency by pro*iding exa)ples
Acti*ity
/ro*ides acti*ities to rein(orce understanding o( the action.
Chart
/ro*ides i)ages that represent data sy)bolically. They are used to
present co)plex in(or)ation and nu)erical data in a si)ple,
co)pact (or)at
'ntended !utcomes or !"/ecti*es
6tate)ents o( intended outco)es or ob3ecti*es are descriptions o(
the +or, that +ill be done
Assessment
6trategies +ith +hich in(or)ation +ill be collected in order to
*alidate each intended outco)e or ob3ecti*e.
How to )et the 0ost out of 1our (earning )uide#
%. -ead through the information in the learning guide carefully. 0a2e
sure you understand the material.
6o)e sections are -uite long and co*er co)plex ideas and in(or)ation.
I( you co)e across anything you do not understand:
tal, to your (acilitatorJ
research the area using the boo,s and )aterials listed under
0esourcesJ
discuss the issue +ith other people &your +or,place super*isor, (ello+
+or,ers, (ello+ candidates'J
try to relate the in(or)ation presented in this learning guide to your
o+n experience and to +hat you already ,no+.
!s, yoursel( -uestions as you go. 2or exa)ple "@a*e I seen this
happening any+hereI" "#ould this apply to )eI" "7hat i(....". This +ill
help you to ")a,e sense" o( ne+ )aterial, and to build on your existing
,no+ledge.
3. al2 to people a"out your study.
Tal,ing is a great +ay to rein(orce +hat you are learning.
3. 0a2e notes.
4. 5or2 through the acti*ities.
F*en i( you are te)pted to s,ip so)e acti*ities, do the) any+ay. They are
there (or a reason, and e*en i( you already ha*e the ,no+ledge or s,ills
relating to a particular acti*ity, doing the) +ill help to rein(orce +hat you
already ,no+. I( you do not understand an acti*ity, thin, care(ully about the
+ay the -uestions or instructions are phrased. 0ead the section again to
see i( you can )a,e sense o( it. I( you are still con(used, contact your
(acilitator or discuss the acti*ity +ith other candidates, (ello+ +or,ers or
+ith your +or,place super*isor.
Additional -esearch6 -eading and 7ote a2ing
I( you are using the additional re(erences and resources suggested in the
learning guide to ta,e your ,no+ledge a step (urther, there are a (e+
si)ple things to ,eep in )ind to )a,e this ,ind o( research easier.
!l+ays )a,e a note o( the author"s na)e, the title o( the boo, or article,
the edition, +hen it +as published, +here it +as published, and the na)e
o( the publisher. I( you are ta,ing notes about speci(ic ideas or in(or)ation,
you +ill need to put the page nu)ber as +ell. This is called the re(erence
in(or)ation. Dou +ill need this (or so)e assess)ent tas,s, and it +ill help
you to (ind the boo, again i( you need to.
Eeep your notes short and to the point. 0elate your notes to the )aterial
in your learning guide. /ut things into your o+n +ords. This +ill gi*e you a
better understanding o( the )aterial.
6tart o(( +ith a -uestion you +ant ans+ered +hen you are exploring
additional resource )aterials. This +ill structure your reading and sa*e you
ti)e.
CHCCS305A 8 Assist clients with medication.
Element Performance Criteria
%. Prepare to assist with medication
%.%
Fstablish authority to pro*ide assistance +ith ad)inistration o(
)edication in line +ith organisation guidelines and protocols and
3urisdictional legislati*e and regulatory re-uire)ents
%.3
9e)onstrate an understanding o( organisation policy and
guidelines relating to assisting +ith )edication +ithin +or, role
responsibilities
%.3
Identi(y lines o( authority, accountability and actions to be ta,en to
handle contingencies
%.4
Identi(y le*el and type o( physical assistance re-uired by the client
to address their personal needs in ta,ing )edications
%.5
Identi(y le*el and type o( super*ision re-uired by the client to sel(
ad)inister )edications
%.9
Identi(y and report to a super*isor andBor health pro(essional i(
there are any circu)stances or changes in the clientCs condition or
personal needs that )ay i)pact on assisting the client +ith their
)edication
%.:
#on(ir) that all (or)s o( )edication to be ad)inistered, including
dose ad)inistration aids are co)plete, ready (or distribution and
up to date, con(ir) +ith super*isor and obtain authority to proceed
%.;
#on(ir) the procedure to be used (or )edication to be
ad)inistered
%.<
I)ple)ent personal hygiene procedures according to organisation
policy and procedure to )ini)ise cross in(ection
%.%0
Identi(y and i)ple)ent duty o( care procedures in relation to
addressing indi*idual client needs
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1% o( 282
3. Prepare the client for assistance with administration of
medication
3.%
I)ple)ent all necessary chec,s to ensure the client and their
)edications are correctly identi(ied according to organisation
procedures and care plan
3.3
#lari(y speci(ic assistance re-uired to address personal needs o(
each client in line +ith organisation procedures listed in the 0ange
6tate)ent and +ithin +or, role responsibilities
3.3
#orrectly identi(y and greet each client and prepare the) (or
)edication
3.4
#hec, client )edications according to the procedures identi(ied in the
organisation guidelines de(ined in the 0ange 6tate)ent
3.5
Fxplain the ad)inistration procedure to the client in line +ith
re-uire)ents and organisation procedures and ensure their needs
are )et
3.9
/rior to gi*ing )edication, obser*e the client to chec, (or any physical
or beha*ioural changes that )ay indicate a need to report to
super*isor or health pro(essional in accordance +ith organisation
policies and procedures
3.:
0ecognise circu)stances +hen appropriate action is to report
obser*ed client health status rather than proceeding +ith
ad)inistration o( )edication and see, ad*ice o( super*isor or health
pro(essional
3. Assist=support client with administration of medication
3.%
0e)ind and pro)pt client to ta,e )edication at correct ti)e
3.3
!ssist clients +ith ad)inistration o( )edications as re-uired in
accordance +ith legislation, organisation policies and the le*el o(
support needed as identi(ied in their care B support plan
3.3
6uper*ise and obser*e clients +hen ta,ing )edication and con(ir)
+ith the) their ingestion or co)pletion
3.4
#o)plete docu)entationBrecord o( )edication ad)inistration
according to organisation procedures
3.5
1bser*e client (or any changes in their condition listed in the 0ange
6tate)ent and see, assistance (ro) a health pro(essional,
super*isor, )edical o((icer or e)ergency ser*ices as indicated in the
organisationCs policies
3.9
9iscard +aste products according to organisation procedures andBor
)anu(acturerCs instructions
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1= o( 282
4. Assist=support medication administration according to
prescription=instructions
4.%
/repare )edications and ad)inister to the client or support their
sel( ad)inistration according to the speci(ic re-uire)ents o( the
(or) o( )edication, in strict accordance +ith de(ined legislation and
organisation procedures and +ritten prescription instructions
4.3
I)ple)ent all necessary chec,s to ensure the right )edication is
gi*en at the right ti)e, to the right person, in the right a)ount, *ia
the right route
4.3
!ssist the client to ta,e the )edications as re-uired, in accordance
+ith their needs and docu)ented procedures
4.4
6uper*ise and obser*e the client +hen ta,ing the )edication and
con(ir) +ith the client their ingestion or co)pletion
4.5
I)ple)ent docu)ented procedures (or )edication not being
ad)inistered or absorbed, such as through expellingB*o)iting,
re(usal or da)age to )edication and report to super*isor andBor
health pro(essional
4.9
0ecord all re-uired details o( )edication ad)inistration and other
details in the appropriate docu)ents according to the legislation
and organisationCs procedures
4.:
1bser*e the client (or any possible )edication e((ects listed in the
0ange 6tate)ent and report to a super*isor or health pro(essional
4.;
#ollect used e-uip)ent, discarded )edications B applicators and
rubbish and place in appropriateB designated receptacle according
to instructions
5.
Comply with organisation>s procedures for handling
the range of issues= contingencies which may arise
5.%
0eport to super*isor andBor health pro(essional all concerns +ith the
ad)inistration o( )edication &such as: client re(usal to ta,e so)e or
all )edications, inco)plete ingestion, )issed or )issing doses'
according to organisation procedures and protocols
5.3
Identi(y, report, record and address indi*idualCs reactions to
)edication according to organisation guidelines and health
pro(essionalCs instructions
5.3
#learly identi(y conta)inated or out o( date )edication and
i)ple)ent organisationCs procedures (or ensuring sa(e and
appropriate disposal
5.4
Identi(y, report and record changes in indi*idualCs condition,
including +ithin essential ti)e(ra)es +here rele*ant, according to
organisation guidelines
5.5
Identi(y procedures to address B respond to changes in the clientCs
condition or needs according to the organisationCs guidelines
5.9
/ro)ptly report to the super*isor or health pro(essional any
inconsistencies obser*ed +ith the )edication or client and ta,e
action in accordance +ith the organisationCs procedures or health
5.:
9ocu)ent all inconsistencies and address according to organisation
guidelines and procedures
9.
Complete the distri"ution and administration of
medication
9.%
#lean and store unused andBor used )edications, containers and
ad)inistration aids in accordance +ith industry and the
organisationCs in(ection control guidelines
9.3
2ollo+ the organisationCs arrange)ents and procedures to replenish
dose ad)inistration aids and supplies o( )edications
9.3
6ecurely store )edication chartsBcare plansB treat)ent sheets
according to organisation procedures to ensure sa(ety, security and
con(identiality
9.4
2ollo+ the organisationCs procedures to ensure )edication storage
co)plies +ith legislation and )anu(acturerCs instructions, )axi)ises
security and pre*ents )edication deterioration
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1$ o( 282
6,ills and Eno+ledge
It is critical that the candidate de)onstrate the ability to:
/ro*ide assistance +ith ad)inistration o( )edications (or clients in
accordance +ith the clientCs indi*idual support needs, including
pro*iding physical assistance to ta,e the )edication or supporting a
client to sel( ad)inisters )edications
This assistance is to be pro*ided in accordance +ith the +or,erCs
de(ined 3ob role and al+ays in co)pliance +ith legal and organisation
policies and procedures including principles o( best practice relating to:
(ollo+ing instructions (or assisting +ith ad)inistration o( )edication as
per the clientCs healthBcareBsupport plan
(ollo+ing occupational health and sa(ety &1@6' guidelines
obser*ing, recording and reporting on the clientCs state o( health and
+ell being
)edication pro*ision including )anaging and reporting contingencies
+hich )ay arise
applying standard and additional precautions in in(ection control
correct docu)entation o( )edication ad)inistered
all +or, to be in accordance +ith health pro(essionalCs instructions
In addition, the candidate )ust be able to de)onstrate rele*ant tas, s,illsJ
tas, )anage)ent s,illsJ contingency )anage)ent s,ills and 3obBrole
en*iron)ent s,ills
These include the ability to:
9e)onstrate the (ollo+ing s,ills, including speci(ic le*els o( literacy and
nu)eracy and physical capabilities as re-uired to:
correctly read and (ollo+ all docu)entation rele*ant to the
ad)inistration o( )edication, including: clientCs healthBcareBsupport
plan, in(or)ation sheets, treat)ent sheets, instructions (ro) phar)acy
and health pro(essional (or ad)inistration and storage re-uire)ents o(
)edications
accurately use dose ad)inistration aids
obser*e, report and record discrepancies in the )edication,
instructions and ad)inistration procedures
recognise possible changes in condition o( the client through
obser*ation or as co))unicated by the client
report and record any changes in clientCs condition as listed in the
range state)ent be(ore, during and a(ter )edication has been ta,en, to
a super*isor and B or health pro(essional so action can be ta,en
discuss the sel(A)edication process +ith the client and the support
needed
negotiate the le*el and type o( physical assistance to be pro*ided to
address the clientCs needs
underta,e re-uired co))unication and docu)entation tas,s
*erbally report rele*ant details by telephone or (aceAtoA(ace
se e-uip)ent listed in the 0ange 6tate)ent e((ecti*ely and
appropriately
9istribute )edications in a ti)ely, appropriate and e((ecti*e +ay to
clients +ith di((ering needs and according to the (or) o( )edication
-e?uired .nowledge
The candidate )ust be able to de)onstrate essential ,no+ledge re-uired
to e((ecti*ely per(or) tas, s,illsJ tas, )anage)ent s,illsJ contingency
)anage)ent s,ills and 3obBrole en*iron)ent s,ills as outlined in ele)ents
and per(or)ance criteria o( this unit
These include ,no+ledge o(:
0ele*ant co))on+ealth and 3urisdictional legislati*e, regulatory, policy
and industry guidelines and re-uire)ents relating to the pro*ision o(
assistance +ith )edication ad)inistration
6tandard and additional in(ection control procedures
nderstanding o( potential haKards in the en*iron)ent including use o(
appropriate cleaning and sanitising procedures in relation to
)edication residue in containers
nderstanding o( duty o( care in assisting clients +ith )edication
ad)inistration +ithin scope o( o+n +or, role
Basic ,no+ledge o( co))only used )edicinesBdrugs, including
prescribed and o*er the counter )edications
The di((erence bet+een prescribed )edication and o*er the counter
)edication
The expected e((ect o( )edications being ad)inistered, the
conse-uences o( incorrect use o( )edication and o( )ain reasons (or
errors in )edication ad)inistration
Basic ,no+ledge o( body syste)s and ho+ illness a((ects people in the
context o( their li(e stage and support needs &e.g. age, intellectual
disability, sensory disability, etc'
!ppropriate storage o( )edications
@o+ and +hen to use the e-uip)ent listed in the 0ange 6tate)ent
!d)inistrati*e procedures (or )edications listed in the 0ange
6tate)ent
1rganisation procedures related to )edication, including
docu)entation o( )edication and the use o( )edication charts
#orrect handling o( )edications
Basic ,no+ledge o( so)e o( the ter)s and abbre*iations used in
relation to )edication such as /0N
0ange 6tate)ent.
Health professional
includes:
@ealth pro(essionals rele*ant to )edication
ad)inistration in speci(ic area o( +or,:
0egistered nurses
5edical practitioners &General /ractitioners
and )edical specialists'
/har)acist
#o)ple)entary )edicine therapist &sub3ect to
go*ern)ent and organisation policies'
9entist
/odiatrist
/sychologist
/sychiatrist
9ietitian
/hysiotherapist
1ccupational therapist
Commonwealth and
State/ Territory
legislation )ay include:
!ged #are legislation
9isability 6er*ices legislation &#o))on+ealth
and 6tate'
#o))unity care legislation and polices
Nurses 0egistration legislation
9rugs and /oisonCs !ct and 0egulations and
other rele*ant 6tateBterritory legislation,
regulations and policies
?egislation, regulations and policies rele*ant to
each 6tate or Territory
Authority to proceed
re(ers to:
Fnsuring all organisation guidelines are
(ollo+ed
Fnsuring the client has been assessed by a
health pro(essional (or the le*el o( assistance
re-uired and they or their decisionA)a,er
understands and can )a,e the re-uest (or
assistance
Fnsuring the client has up to date B current
docu)entation on the le*el o( assistance and
support re-uired in relation to )edication
Fnsuring that all docu)entation in relation to a
clientCs )edication has been chec,ed
Fnsuring that the prescribing health
pro(essional has docu)ented all )edications
and instructions
Supervisor )ay include: @ealth pro(essional
6uper*isor or tea) leader +ith experience and
appropriate -uali(icationBs in ad)inistration o(
)edication andBor assistance +ith sel(
)edication at a higher le*el than the +or,er
6uper*ision )ay be pro*ided on site or
through an on call syste)
Required medications
)ay include:
5edications prescribed (or a client by a health
pro(essional and dispensed by a phar)acist in
dose ad)inistration aids
5edications purchased o*er the counter and
identi(ied in the clientCs healthBcareBsupport
plan or drugB treat)ent sheet
/0N )edications:
as prescribed and instructed by the health
pro(essional
in response to sta(( obser*ation o( need as
identi(ied in drug sheet andBor
healthBcareBsupport plan and according to
rele*ant legislation, organisation guidelines
and clear +ritten instructions (ro) a health
pro(essional
in response to speci(ic in(or)ation pro*ided by
client, +here the )edication is docu)ented in
the clientCs healthBcareBsupport plan
Industry standards
include:
!ged #are !ccreditation 6tandards and
policies
9isability 6er*ice 6tandards and policies
@o)e and #o))unity #are National 6er*ice
6tandards and policies
6tate or Territory go*ern)ent policies
Required equipment )ay
include:
!d)inistration aid B )edication pac,
!pplicator (or lotions B oint)ents
!prons
#ontainer (or dirty spoonsBdishes
#otton +ool B gauKe
9rugBtreat)ent sheet or case record
Glo*es
@ealthBcareBsupport plan
Eey to )edication storageBcupboardBarea
5easuring cups
5edicine dishesBcups
5ortar and pestle
Nebuliser B spacer
/aper to+els and tissues
6poons
Tablet di*ider
Tea to+el
Tu)blers
7ater 3ug and cup
Organisation guidelines
for client identification
)ay include:
0e(erral to identi(ication such as photographic
identi(ication o( client in client cards
>isual recognition
0esponse by client
#on(ir)ation (ro) nursingBcare sta(( or clientCs
(a)ily or (riends
!ctions to be ta,en i( a client +ho is sel(A
ad)inistering (ails to identi(y the)sel*es
correctly
Organisation policy for
checing medications
with clients who are self!
medicating )ay include"
#on(ir)ing the (ollo+ing +ith the client:
the a)ount o( )edication &e.g. nu)ber o(
tablets or a)ount o( gel'
the ti)e (or sel(A)edication &e.g. once a day
+ith (ood'
the route o( sel(A)edication &e.g. by )outh'
any alterations authorised by the phar)acist,
registered nurse or health pro(essional &e.g.
crush tablets or )ix +ith +ater or (ood'
#hec,ing the )edication (or expiry date and
any ob*ious discrepancies such as colour
changes, disintegration or deterioration
#ose administration aids
may include"
Blister pac,s L single dose pac,s and )ultiA
dose pac,s
6achets
9osettes
Organisation guidelines
for checing medication
may include"
#hec,ing )edication is (ree (ro)
conta)ination or deterioration
#hec,ing that ad)inistration, instructions and
the identity o( the client correlate +ith
docu)entation
#hec,ing dose ad)inistration aids (or
e*idence o( ta)pering
#hec,ing that discrepancies in ad)inistration
are docu)ented appropriately
#hec,ing the procedure (or in(ection control,
storage and disposal
$repare the client for
assistance with
administration of
medication may include"
9iscussing the procedure
Fncouraging clientCs participation
!d3usting posture and position
6ee,ing assistance (ro) other sta(( i( a*ailable
and re-uired
/ro*iding pri*acy
!ppropriate exposure o( treat)ent area &in the
case o( lotion application'
Circumstances when
appropriate action is to
report o%served client
health status rather than
proceeding to
administer medication
may include %ut are not
limited to"
#lient unconscious
#hanges in condition o( the client that )ust be
i))ediately reported
#lient re(usal
Current needs may
include"
/ro*ision o( appro*ed /0N order according to
rele*ant legislation, organisation guidelines and
doctors orders
!ssistance in securing client cooperation
/osture or positioning o( client including
physically supporting the client
$repare medications
may include"
/lacing tabletsBcapsules (ro) dose
ad)inistration aids into a )edicine cup
5easuring li-uid )edications into )easuring
cup B spoon
9issol*ing po+der )edication in +ater
/lacing )edication in nebuliser B spacer
!ssistance pro*ided in ta,ing )edication by
grinding or di*iding tablets +here there are
clearly +ritten instructions
&ecessary checs
include"
#hec,ing )edication against the re-uire)ents
#hec,ing client details
#hec,ing the chart
#hec,ing (or authorisation
#hec,ing the clientCs healthBcareBsupport plan
#hec,ing the treat)ent sheets
References may include" 5I56 annual or drug re(erence guide
9rugs hotlineB9rug In(or)ation ?ine
'orms of medication
may include"
#apsules
FarAdrops
FyeAdrops
Inhalants
?i-uid
?otion and crea)
NoseAdrops
1int)ents
/atches
/o+der
Tablets
7a(ers
$ossi%le changes in
condition of the client
that must %e
immediately reported to
a supervisor or health
professional may
include( %ut are not
limited to"
#hanges to air+ay &e.g. cho,ing', changes to
breathing &including slo+ed, (ast or absent
breathing', changes in personCs colour &e.g. pale
or (lushed appearance or bluish tinge', or
changes to circulation &including unexpected
dro+siness, loss o( consciousness, and
absence o( pulse'
0ash
In(la))ation or redness
6+elling
@eadache
6,in tone
2eelings o( diKKiness
6lurring o( speech
Nausea and *o)iting
Blurred *ision
#on(usion
#hanges in beha*iour
!nything that appears di((erent (ro) the clientCs
usual state
1thers as ad*ised by health pro(essional
Incomplete ingestion
includes"
Inability or di((iculties in s+allo+ing tablets,
capsules or li-uids
F3ection o( )edication
>o)iting
0e(usal to ta,e )edications
#ocument all
inconsistencies may
include"
Incident reports
5edical charts
/rogress notes
#lientCs record o( )edications according to
!d*erse drug incident reports
)edication storage
procedures include"
!cting in accordance +ith de(ined 3ob role
?oc,ing and storing drugs according to
organisation policy and procedure
0e(erring to instructions (ro) health
pro(essionalB )anu(acturer
Industry guidelines may
include"
!ustralian /har)aceutical !d*isory #ouncil
&!/!#':
- Guidelines (or )edication )anage)ent in
residential aged care (acilities and
- Guiding principles (or )edication
)anage)ent in the co))unity 200%
6tate and Territory legislation, policies and
guidelines
1rganisation policies and procedures
1@6 industry guides
$hysical assistance
provided to administer
medication or support
self medication may
include"
9iscussing the process and addressing any
li,ely di((iculties
#on(ir)ing the ti)e and type o( )edication
Fstablishing the type and le*el o( support
re-uired by the client to ta,e B recei*e the
)edication
!d3usting posture or position
1pening bottles or dose ad)inistration aids
0e)o*ing tablets or capsules (ro) dose
ad)inistration aids
5easuring the a)ount o( li-uid re-uired into a
)edicine cup or a crea) onto the a((ected area
#rushing or di*iding tablets +here indicated by
phar)acist or health pro(essional
/lacing )edication into nebulisers or spacers
9issol*ing )edication in +ater
Fnsuring that (luids are a*ailable to assist +ith
s+allo+ing
/ro*iding pri*acy
NB 5edication dose )ust be
prepared by a phar)acist
John Bailey 2008, 2010, 2011 /age 6e-uence: /age ;0 o( 282
F*idence Guide
#ritical aspects (or
assess)ent and e*idence
re-uired to de)onstrate this
unit o( co)petency:
The indi*idual being assessed )ust pro*ide
e*idence o( speci(ied essential ,no+ledge
as +ell as s,ills
This unit )ust be assessed in the
+or,place under the nor)al range o( +or,
conditions
/rior to application o( s,ills in the
+or,place, assess)ents should be
underta,en in a si)ulated en*iron)ent as
an appropriate ris, )anage)ent strategy
!ssess)ent )ust be conducted on )ore
than one occasion to co*er a *ariety o(
circu)stances and )edication types
!ssess)ent )ust be underta,en by a
person +ith higher order )edication
)anage)entBad)inistration -uali(ications
and current ,no+ledge o( practices rele*ant
to )edications in the health and co))unity
ser*ices sectors
F)ployers should endea*our to )aintain
currency o( s,ills and ,no+ledge in line +ith
speci(ic +or,place andBor 3urisdictional
re-uire)ents, through annual +or,place
s,ills assess)ents
!ccess and e-uity
considerations:
!ll +or,ers in co))unity ser*ices should
be a+are o( access, e-uity and hu)an
rights issues in relation to their o+n area o(
+or,
!ll +or,ers should de*elop their ability to
+or, in a culturally di*erse en*iron)ent
In recognition o( particular issues (acing
!boriginal and Torres 6trait Islander
co))unities, +or,ers should be a+are o(
cultural, historical and current issues
i)pacting on !boriginal and Torres 6trait
Islander people
!ssessors and trainers )ust ta,e into
account rele*ant access and e-uity issues,
in particular relating to (actors i)pacting on
!boriginal andBor Torres 6trait Islander
clients and co))unities
Context of and specific resources
for assessment:
This unit can be assessed independently,
ho+e*er holistic assess)ent practice +ith
other co))unity ser*ices units o(
co)petency is encouraged
#o)petency in this unit should be
assessed using all the rele*ant resources
co))only pro*ided in co))unity and
residential care ser*ice settings
6peci(ic tools )ay include:
o )edication charts and docu)entation
o )edications and e-uip)ent
o rele*ant policies and procedures
)anuals
o other docu)entation rele*ant to the
+or, context such as:
organisation charts
(loor plans
instructions (or the use o( e-uip)ent
speci(ic instructions (or sta((,
reporting procedures, organisation
docu)ents
client list
rele*ant guidelines and legislation
rele*ant e-uip)ent and cleaning agents
currently used in the +or,place
Method of assessment: !ssess)ent +ill include:
1bser*ation o( +or, per(or)ance
6upporting state)ent o( super*isorBs
!uthenticated e*idence o( rele*ant +or,
experience andBor (or)alBin(or)al
learning
#ase studies and scenarios as a basis (or
discussion o( issues and strategies to
sa(ely support the ad)inistration o(
)edication in speci(ic +or, en*iron)ents
and co))unities
7ritten assess)ent o( (unctional Fnglish
language, literacy and nu)eracy s,ills
appropriate to the le*el o( responsibility o(
the care +or,er
!nnual recon(ir)ation o( the essential
,no+ledge &including +ritten or oral
assess)ent' and co)petency by the
e)ployer +ithin a per(or)ance
)anage)ent (ra)e+or, is desirable
John Bailey 2008, 2010, 2011 /age 6e-uence: /age ;; o( 282
1. /repare to assist +ith
)edication
%.%
Fstablish authority to pro*ide assistance +ith ad)inistration o(
)edication in line +ith organisation guidelines and protocols
and 3urisdictional legislati*e and regulatory re-uire)ents
%.3
9e)onstrate an understanding o( organisation policy and
guidelines relating to assisting +ith )edication +ithin +or,
role responsibilities
%.3
Identi(y lines o( authority, accountability and actions to be
ta,en to handle contingencies
%.4
Identi(y le*el and type o( physical assistance re-uired by the
client to address their personal needs in ta,ing )edications
%.5
Identi(y le*el and type o( super*ision re-uired by the client to
sel( ad)inister )edications
%.9
Identi(y and report to a super*isor andBor health pro(essional i(
there are any circu)stances or changes in the clientCs
condition or personal needs that )ay i)pact on assisting the
client +ith their )edication
%.:
#on(ir) that all (or)s o( )edication to be ad)inistered,
including dose ad)inistration aids are co)plete, ready (or
distribution and up to date, con(ir) +ith super*isor and obtain
authority to proceed
%.;
#on(ir) the procedure to be used (or )edication to be
ad)inistered
%.<
I)ple)ent personal hygiene procedures according to
organisation policy and procedure to )ini)ise cross in(ection
%.%0
Identi(y and i)ple)ent duty o( care procedures in relation to
John Bailey 2008, 2010, 2011 /age 6e-uence: /age ;< o( 282
%.% Esta"lish authority to pro*ide assistance with administration of
medication in line with organisation guidelines and protocols and
/urisdictional legislati*e and regulatory re?uirements
5edicines are the )ost co))on treat)ent used in health care and
)edication is )ore rigorously tested than al)ost all other healthcare
inter*entions. Because they are co))only used, )edicines are associated
+ith )ore ad*erse e*ents than any other aspect o( health care. The
pre*alence o( )edication errors, +here )ista,es are )ade any+here in
the supply o( )edicines, is o( particular concern because )ost )edication
errors could be a*oided.
!ustralia is tac,ling so)e o( the issues associated +ith )edication errors
through syste)s based solutions, such as the standardised National
Inpatient 5edication #hart, +hich is helping !ustralian hospitals reduce
the ris, o( har) to hospitalised patients (ro) )edicines. F((orts to reduce
har) (ro) )edicines in the co))unity are also being i)ple)ented
through the pro*ision o( )edication re*ie+ ser*ices, consu)er reporting o(
ad*erse )edicine e*ents and acti*ities to pro)ote -uality use o(
)edicines.
5hat is a medication error@
7hile in the *ast )a3ority o( cases )edicines are prescribed and used
sa(ely, patients )ay be har)ed by un+anted e((ects. 5any side e((ects or
ad*erse reactions are predictable and are accepted ris,s o( treat)entJ they
can be a*oided or )ini)ised by care(ul prescribing and use. 6o)e
ad*erse reactions are unpredictable and there(ore una*oidable. In
contrast, )edication errors L )ista,es or lapses +hen )edicines are
prescribed, dispensed or used L are a*oidable.
5ost )edication errors do not result in har) to the patient. @o+e*er, the
use o( any )edicine carries an inherent ris,. /atients can experience
ad*erse reactions or side e((ects (ro) )edicines but not all such ad*erse
e((ects are due to error.
!n ad*erse drug reaction &!90' as been de(ined by the 7orld @ealth
1rganisation &7@1' as:
Any response to a drug which is noxious, unintended and occurs at doses
used for prophylaxis, diagnosis or therapy.
!d*erse drug reactions can be considered to (all into t+o broad groups L
those +hich can be predicted (ro) ,no+ledge o( a drugCs e((ects on the
body &Type !', and ad*erse drug reactions +hich are unpredictable,
unusual reactions that occur in particular indi*iduals &Type B'. Type B
reactions are less co))on but can be )ore serious than Type !
reactions.
The ter) )edication error has been de(ined in )any +ays.
A medication error is any preventable event that may cause or lead to
inappropriate medication use or patient harm while the medication is in the
control of health professional, patient or consumer.
5edication errors )ay be related to pro(essional practice, products,
procedures, en*iron)ent or syste)s. They )ay in*ol*e prescribing and
orderingJ dispensing and distributionJ preparation and ad)inistrationJ
labelling, pac,aging and no)enclatureJ co))unications and educationJ or
use and )onitoring o( treat)ent.
t+o
5edication errors !d*erse drug reactions
5edication errors are, by de(inition, pre*entable. 5ost errors do not result
in har) to the patient. @o+e*er, the o*erall incidence o( errors is an
i)portant indicator o( )edication sa(ety in an organisation and there(ore
cannot be ignored. 6o)e )edication errors cause serious ad*erse drug
reactions or side e((ects in patients. !d*erse drug reactions +hich occur
(ollo+ing a )edication error are there(ore pre*entable.
+igure # -elationship "etween medication errors and ad*erse drug reactions
' '' '''
'. 5edication errors that do not result in patient har) or errors +ith
potential (or har) but detected be(ore they reach the patient &Mnear
)issC'. Near )isses )ay indicate (ailure in syste)s predisposing to
error &Mhar) +aiting to happenC'. 2or exa)ple,
! dose o( 800 )g o( a)oxicillin gi*en instead o( 280 )g
7rong dose o( a drug calculated (or a patient in renal (ailure, but
corrected prior to ad)inistration
''. 5edication errors that result in patient har). 2or exa)ple,
/rescribing a non steroidal antiAin(la))atory drug to a patient +ith a
docu)ented history o( peptic ulcer disease, +ho su((ers a
gastrointestinal bleed as a result
9ispensing the +rong (or)ulation o( an antiAepileptic treat)ent
resulting in loss o( seiKure control
'''. !n ad*erse drug reaction that is not a result o( a )edication error. This
includes predictable or ,no+n side e((ects o( )edicines.
2or exa)ple,
! patient +ho experiences a hypersensiti*ity reaction to penicillin
+ho +as not pre*iously ,no+n to be allergic to penicillin
! patient +ho experiences hair loss (ollo+ing a course o( cancer
che)otherapy
John Bailey 2008, 2010, 2011 /age 6e-uence: /age ;% o( 282
How often do medication errors occur@
Because o( lo+ reporting rates the incidence o( )edication errors is not
,no+n. There are )any barriers to error reporting. ?o+ reporting rates
deny organisations and the authorities as a +hole the opportunity to learn
(ro) )ista,es.
Frrors )ay be intercepted be(ore they reach the patient. Frrors that do
reach the patient )ay be unnoticed. 6o)e errors that are noticed )ay not
be reported +here the patient has not co)e to any har). In cases +here a
patient has experienced an unto+ard e*ent as a result o( an error the
incident is )ore li,ely to be reported.
+igure # he medication error ice"erg
6o)e barriers to the reporting o( ad*erse e*ents and Mnear )issesC are:
lac, o( a+areness that an error has occurred
lac, o( a+areness o( the need to report, +hat to report and +hy
perception that the patient is unhar)ed by the error
John Bailey 2008, 2010, 2011 /age 6e-uence: /age ;= o( 282
(ear o( disciplinary action or litigation, (or sel( or colleagues
lac, o( (a)iliarity +ith reporting )echanis)s
loss o( sel( estee)
sta(( (eeling they are too busy to report
lac, o( (eedbac, +hen errors are reported
5hy do medication errors occur@
In order to reduce the ris,s, it is i)portant to understand +hat causes
)edication errors. Frrors occur +hen both hu)an and syste) (actors
interact in a chain o( e*ents L o(ten co)plex L resulting in an undesirable
outco)e.
Too o(ten it is only the actions o( indi*iduals +hich are considered to be the
cause o( error. ?atent conditions +ithin an organisation and triggering
(actors in clinical practice should also be considered as i)portant causes
o( error.
uman beings ma!e mista!es because the systems, tas!s and processes
they wor! in are poorly designed. " ?ucian ?eape.
The )a3ority o( )edication is prescribed, dispensed and ad)inistered
sa(ely. The o*er+hel)ing )a3ority o( sta(( are highly )oti*ated indi*iduals
+ho +or, together as a tea) to achie*e the best outco)es (or their
patients. @o+e*er, the ris, o( error is ine*itable in any industry or
pro(ession and )ista,es do occasionally occur. Frrors that result in serious
har) to patients are al+ays distressing, not 3ust (or the indi*idual or (a)ily
a((ected but also (or sta(( and organisations associated +ith the error.
@ar)(ul )edication errors are particularly distressing as they occur at a
*ery personal le*el and con(ound the ai) o( treat)ent, +hich is to i)pro*e
health.
5ost organisations and health pro(essionals ha*e put in place a range o(
syste)s and chec,s to pre*ent )edication errors. @o+e*er, recent
experience has sho+n that in certain situations those sa(eguards ha*e not
been ade-uate and ha*e (ailed to pre*ent serious error and har) to
patients.
#urrent guidance and standards on prescribing, dispensing and
ad)inistration o( )edicines are (rag)ented and di*ided bet+een a range
o( pro(essional and regulatory bodies. They are o(ten +ritten (ro) a
unidisciplinary perspecti*e to )eet pro(essional rather than organisational
ai)s.
The M6+iss cheese )odelC o( syste) (ailure can be readily applied to
)edication errors. Fach slice o( cheese represents a de(ence, barrier or
sa(eguard against error. Ideally all the de(ences should be intact, but in
reality the layers are (ull o( holes.
!n error )ay get through holes in one or )ore layers o( de(ence but be
stopped at another stage in the process. The )ore layers o( de(ence there
are and the lo+er the li,elihood o( holes in those de(ences opening up, the
lo+er the ris, o( a da)aging error or accident occurring. There(ore in a
+ellAdesigned syste), +ith inbuilt and robust sa(eguards and de(ences, an
error +ould rarely be able to get through to cause har).
+igure # Swiss cheese model of error pre*ention#
6o)e layers o( de(ence against )edication error. In a nu)ber o( recent
(atal )edication errors e((ecti*e operation o( any one o( these de(ences
+ould ha*e sa*ed a li(e.
@oles in the de(ences open up as a result o( acti*e (ailures and latent
conditions. The acti*e (ailures are unsa(e practices o( the people +or,ing
+ith a syste), (or exa)ple the prescriber (ailing to double chec, a
prescription, or the phar)acist (ailing to identi(y an incorrect dose on a
prescription. ?atent conditions re(lect the structure o( the organisation, its
resources, )anage)ent and processes +hich, either alone or in
co)bination +ith an acti*e (ailure, can result in error. 2or exa)ple, the lac,
o( a co)puterised prescribing syste) +ith inbuilt syste)s to highlight an
erroneous prescription or the lac, o( an e((ecti*e co))unication syste)
bet+een pri)ary and secondary care.
T+o approaches to hu)an error can be described: the person approach
and the syste)s approach. The person approach (ocuses on the errors
)ade by indi*iduals. The reaction to these errors tends to be to na)e,
bla)e and sha)e.
!lthough pro(essionals )ust ta,e responsibility (or their actions, bla)ing
doctors, phar)acists or nurses (or errors does not encourage a culture o(
reporting or learning. In order to (unction sa(ely an organisation needs to
understand its ris,s so that it can )ini)ise the) by building in de(ences
and sa(eguards. These ris,s can only be identi(ied i( there is co))it)ent
to an open culture o( reporting throughout the organisation.
The syste)s approach accepts that hu)ans are (allible and there(ore
errors can be expected to occur L and )ay recur regardless o( the
John Bailey 2008, 2010, 2011 /age 6e-uence: /age ;$ o( 282
co)petence o( indi*iduals +or,ing +ithin the syste). 0ather than (ocusing
on the indi*idual it (ocuses on the conditions under +hich indi*iduals +or,
and ho+ those conditions can predispose to errors. nderstanding the
conditions that )ay predispose to error enables syste) de(ences to be
de*eloped such that the errors are a*oided.
+igure # he person and systems approaches to medication error.
2orget(ulness
Inattention
/oor )oti*ation
#arelessness
Negligence
0ec,lessness
9istraction
HE PE-S!7
APP-!ACH
/oster ca)paigns
/rocedure re*ie+
9isciplinary action
Threat o( litigation
0etraining
Na)ing, bla)ing and
sha)ing
CA&SES !+
E--!-
Nurses
/hysicians
6urgeons
!naesthetists
/har)acists
1ther healthcare
+or,ers
-EAC'!7 !
E--!-
Frror pro*o,ing
conditions +ithin
the +or,place e.g.
ti)e pressure,
understa((ing,
inade-uate
e-uip)ent, (atigue,
inexperience.
7ea,nesses in
de(ences
e.g. un+or,able
procedures, design
de(iciencies,
e-uip)ent (ailure
HE S1SE0S
APP-!ACH
Frror is generaliKed
rather than isolated
6yste) is re*ie+ed to
li)it the incidence o(
error
6yste) is re*ie+ed so
that i( an error occurs
its da)aging e((ects
are )ini)ised
John Bailey 2008, 2010, 2011 /age 6e-uence: /age <0 o( 282
he reasons for incorrect medication use in acute care
The )ost co))on cause o( )edication error in acute care is a slip error
&doing the +rong thing' or a lapse error &not doing so)ething'. 6lips by
doctors o(ten occur +hile re+riting drug charts and slips by nurses usually
happen +hen they are chec,ing the na)e and dose o( a drug prior to
ad)inistration. It has been esti)ated that bet+een 2. and 8. o(
!ustralian drug charts contain prescribing errors, +hile ad)inistration
errors occur at a rate o( bet+een 8. and 18.. 5edication errors are
there(ore a signi(icant proble) (or !ustralian hospitals and there is
e*idence to sho+ it is also a proble) in other settings o( care.
!nalysis o( )edication errors in !ustralian hospitals sho+ed that (ailure to
read or )isreading o( charts is the )ost co))on causal (actor contributing
to incidents. This is signi(icant gi*en that charts are the )ain )eans o(
co))unicating )edication orders. 1ther studies con(ir) that )ost errors
are due to slips in attention that occur during routine prescribing,
dispensing and ad)inistering, +ith errors being signi(icantly )ore (re-uent
out o( hours +hen busy, distracted sta(( are o(ten dealing +ith un(a)iliar
patients. They also con(ir) that the causes o( error are usually
)ulti(actorial in*ol*ing +or,ing en*iron)ent (actors as +ell as tea),
indi*idual, patient and tas, (actors.
'mpro*ing systems#
The National Inpatient 5edication #hart is designed to i)pro*e )edication
sa(ety in acute care 6yste)s solutions, such as standardisation, or )a,ing
things as routine as possible, are recognised as the best +ay to o*erco)e
slips and lapses, +hich are the )ost co))on causes o( )edication errors
in acute care.
In response to this, in !pril 200<, !ustralian @ealth 5inisters agreed that
all public hospitals should use a co))on )edication chart.
The National Inpatient 5edication #hart &NI5#' +as i)ple)ented during
200% and 200=, and is no+ being used nationally in all public hospitals
&+ith so)e li)ited *ariation' and in a large nu)ber o( pri*ate (acilities.
The NI5# &2igure on next page' standardises co))unication o(
)edication in(or)ation bet+een doctors, nurses and phar)acists, +ith the
ai) o( reducing har) to patients (ro) )edication errors. /reA and post
i)ple)entation audits o( charts, conducted by the (or)er !ustralian
#ouncil (or 6a(ety and Nuality in @ealth #are, de)onstrated both
i)pro*e)ent in docu)entation and reduced ris, to patients
+igure# he 7ational 'npatient 0edication Chart
The (ollo+ing details )ust be +ritten on all )edication charts:
co)plete na)e o( resident
date o( birth o( resident
allergies )ar,ed yes or no and details
a doctorCs signature (or e*ery )edication ordered
e*ery order dated by the )edical practitioner
all routes o( ad)inistration
legible )edication na)es
identi(iable doctor signatures
correct (re-uency identi(ied (ro) the doctorCs orders
correct dosages (or the )edication ordered
registered nurses signature (ollo+ing ad)inistration
rele*ant )onths and years
the date o( the next ad)inistration o( in(re-uent )edicines &eg,
)edicines gi*en 2A; )onthly', e*en i( the ad)inistration does not occur
+ithin the ti)e span co*ered by that chart
i( alternati*e )ethods o( ad)inistering )edications are necessary, eg,
Mcrush )edications able to be crushedC
p.r.n. )edication orders
)edication phone orders
dateBs o( re*ie+s by the accredited phar)acist and )edical practitioner
details o( resident sel(Aad)inistered )edications.
Based on data, prior to the NI5# i)ple)entation, co)paring 21,000
)edication orders at ;1 sites +ith ;8,000 )edication orders (ro) ;00 sites
a(ter i)ple)entation, the i)ple)entation o( the NI5# has i)pro*ed the
sa(ety o( so)e i)portant aspects o( prescribing in )ost hospitals.
The NI5# is reducing the ris, o( patients getting a drug to +hich they ha*e
an allergy
1ne o( the )ost (re-uently occurring and a*oidable ad*erse drug e*ents is
the reAexposure o( patients to )edications that ha*e pre*iously been
identi(ied as causing an ad*erse drug reaction &!90', such as an allergy.
The docu)entation o( this in(or)ation so that it is *isible to all prescribers,
nurses and phar)acists on patient )edication charts is a signi(icant sa(ety
(eature o( prescribing syste)s.
2igure 4.4 de)onstrates that docu)entation related to ad*erse drug
reactions i)pro*ed (ollo+ing the NI5# pilot. The recording o( )edication
+hich had pre*iously caused an !90 i)pro*ed co)pared +ith baseline,
+hile docu)entation o( !90 details also i)pro*ed.
5ost i)portantly (or patient sa(ety, the reAprescribing o( )edicines to +hich
patients had pre*iously experienced an !90 +as reduced.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age <; o( 282
+igure # Documentation of ad*erse drug reactions pre and post 7'0C pilot
he 7'0C results in clearer prescri"ing
The clear docu)entation o( drug na)es, (or)s &especially controlled or
sustained release', routes, doses and (re-uencies are essential (or sa(e
and e((ecti*e co))unication o( prescribing decisions and instructions (or
nurse supply and phar)acist dispensing.
! designated chec, box +as included in the NI5# to indicate i( a
sustained or controlled release (or)ulation o( )edication +as to be
ad)inistered. The inad*ertent ad)inistration o( standard release
)edication can ha*e ad*erse e((ects on a patient. In all but one o( the
se*en 3urisdictions +hich reported this data, the proportion o( standard
release )edications +ith the (or)ulation indicated had increased to
bet+een ;1. and 8<. o( cases (ro) a lo+ o( 18. at baseline.
6ix o( the se*en sites that reported the proportion o( regular orders +ith
(re-uency instruction errors (ound these to be less (re-uent a(ter
i)ple)entation o( the chart, ranging (ro) 2. to 8. in error (ro) a
baseline o( =.2.. In association +ith reducing the opportunity (or
ad)inistration o( a )edication at a (re-uency not intended by the
prescriber, prescribers +ere pro)pted to enter the ad)inistration ti)es,
according to a standard ad)inistration ti)e guide included on the NI5#.
The data indicated that prescribers entered dosing ad)inistration ti)es in
;;. to 8%. o( cases +ith the ne+ chart co)pared +ith only 18. at
baseline.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age << o( 282
he 7'0C is impro*ing the administration of Aas re?uired> medications
5edication to be ta,en Mas re-uiredC )ust be prescribed in such a +ay that
nurses can sa(ely and e((ecti*ely tailor )edication ad)inistration to
speci(ic patient sy)pto)s.
The co))on classes o( )edication prescribed as re-uired, or pro re nata
&co))only abbre*iated to /0N', are pain relie*ers, laxati*es and
)edicines (or nausea and *o)iting.
2ro) the e*idence a*ailable, /0N (re-uency docu)entation re)ains an
area (or concern in )any sites +ith bet+een 1;. and 1$. o( orders not
ha*ing any (re-uency o( ad)inistration indicated.
-easons for medication pro"lems in the community
#onsu)ers report poor co))unication, lac, o( in(or)ation and lac, o( coA
ordination o( care as co))on reasons (or proble)s arising (ro) )edicine
use. In sur*eys o( !ustralian adults +ith chronic illness at least a -uarter
reported that the side e((ects o( their )edicines had ne*er been explained
to the), +hile 3ust under a third said they had ne*er had their )edicines
re*ie+ed by their doctor. 1nly (our in ten recei*ed +ritten instructions or a
plan to )anage their care at ho)e.
1ne in (i*e chronically ill adults reported they did not (ollo+ their doctorsC
ad*ice. 2or the )a3ority o( these respondents it +as because they did not
agree +ith the ad*ice. @al( o( the respondents (ound the cost prohibiti*e,
+hile a si)ilar nu)ber thought the ad*ice +as too di((icult to (ollo+.
9octors, too, ha*e reported that the )ost co))on reasons (or error are
associated +ith poor co))unication and coAordination o( care. They
highlighted that poor co))unication bet+een the)sel*es and patients,
poor co))unication +ith other health pro(essionals and patients seeing
other practitioners all contributed to error.
'mpro*ing medicine use in the community
F((orts to i)pro*e use o( )edicines and reduce ad*erse e*ents in the
co))unity ha*e (ocused on i)pro*ing prescribing and )edicine use,
enabling consu)ers to report ad*erse )edicine e*ents, the pro*ision o(
)edicine re*ie+ ser*ices and practice guidelines (or )edication use in the
co))unity and in agedAcare (acilities.
Ten years ago !ustralia had none o( these ser*ices in place, +hile today
robust ser*ices are pro*ided based on the rigorous research that
underpinned their de*elop)ent.
/ractice change is di((icult and di((usion o( inno*ation in health care is
notoriously slo+. To ensure the di((usion o( inno*ation &in this instance,
ser*ices to i)pro*e )edicine use and reduce ad*erse e*ents' re-uires
upta,e by bet+een 18. and 80. o( the population. I)portantly, the
-uality use o( )edicines ser*ices pro*ided in !ustralia has no+ reached
ade-uate le*els o( upta,e a)ongst !ustraliaCs general practitioners, +ith
hal( *oluntarily participating in -uality use o( )edicines acti*ities such as
clinical audits, case studies and acade)ic detailing &educational *isits
underta,en at doctorsC practices' deli*ered by the National /rescribing
6er*ice. The le*el o( engage)ent a)ong health pro(essionals at all le*els
pro*ides a strong plat(or) (or i)ple)entation o( strategies speci(ically
(ocused on reducing ad*erse )edication e*ents and integrating the) +ith
the -uality use o( )edicines initiati*es.
0edication re*iew ser*ices are impro*ing medication use in the community
1ne signi(icant -uality use o( )edicines initiati*e, (unded by the
#o))on+ealth Go*ern)ent, is the )edication re*ie+ ser*ice (or those at
ris, o( )edication related proble)s, both in the co))unity and in
residential aged care.
5edication re*ie+ ser*ices ha*e been sho+n to reduce ad*erse
)edication e*ents. 1ne !ustralian study in*ol*ing 1000 consu)ers at high
ris, o( )edication )isad*enture (ound o*er $0. o( people +ho recei*ed
the ser*ice had one or )ore )edication related proble) +ith, on a*erage,
each ha*ing three proble)s. /roble)s included the need (or additional
)edicines or tests, inappropriate selection o( )edicines, ad*erse drug
reactions and patient con(usion about )edicines. In 82. o( the cases,
these proble)s could be resol*ed or i)pro*ed. ! syste)atic re*ie+ o(
rando)ised controlled trials assessing )edication re*ie+ ser*ices
con(ir)s the e((ecti*eness o( the ser*ice in i)pro*ing )edication use and
surrogate outco)es.
6ince the initiation o( the ser*ice o*er 1%0,000 ho)e )edication re*ie+s
ha*e been (unded in !ustralia, +ith ;;,000 conducted in 200=, +hile o*er
;1,000 collaborati*e re*ie+s in the agedAcare sector +ere conducted in
200=.
Training and accreditation standards ha*e been established and )ore than
1==8 accredited phar)acists are trained to pro*ide the ser*ice. This
represents signi(icant di((usion o( inno*ation +ithin the health syste), as
these ser*ices are no*el and syste)s to support their i)ple)entation had
to be de*eloped. Targeted -uality i)pro*e)ent acti*ity +ill (acilitate (urther
i)pro*e)ents in deli*ery o( the ser*ices. These ser*ices are also being
integrated +ith other ele)ents o( the health syste) and used to (acilitate
co-ordination o( care +hen people trans(er bet+een health (acilities, such
as hospital and agedAcare. These progra)s also de)onstrate )ore
appropriate )edicine use in those recei*ing the ser*ice co)pared to those
+ho did not.
6yste)s to alert us to proble)s +ith )edicines are integral to i)pro*ing
)edication sa(ety. 7hile !ustralia has +ell de*eloped syste)s (or health
pro(essionals to report suspected ad*erse drug reactions, consu)er
participation in these syste)s has been consistently ad*ocated. In 200;,
the (or)er !ustralian #ouncil (or 6a(ety and Nuality in @ealth #are (unded
an 18 )onth national pro3ect i)ple)enting an ad*erse )edicine e*ent
telephone line that pro*ides consu)ers +ith ad*ice about the suspected
ad*erse e*ent and collects data on the e*ents +hich, +here appropriate,
contribute to national phar)aco*igilance. In its (irst year the ser*ice
recei*ed o*er 2000 calls, +ith one in (i*e calls resulting in an ad*erse
reaction report to the !ustralian !d*erse 9rug 0eactions !d*isory
#o))ittee. The ser*ice is pro*ing success(ul in contributing to identi(ying
pre*iously unrecognised reactions, as e*idenced by consu)er reports o(
ad*erse e*ents associated +ith hypnotics.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age <% o( 282
Continuing to impro*e the safety and ?uality of medication use in Australia
The de)onstrated successes in de*eloping and i)ple)enting no*el
solutions (or )edication sa(ety in !ustralia o*er the last ten years highlight
our capacity to reduce the har)s that occur +ith )edicines. @o+e*er,
because o( the co)plexity o( )edicines, their use throughout all aspects o(
the health care syste), the )any people in*ol*ed in their )anu(acture,
distribution, supply and use and e*ol*ing ,no+ledge about +hat +or,s
best, there is still )uch +or, to be underta,en.
In 2002, the (or)er !ustralian #ouncil (or 6a(ety and Nuality in @ealth
#are, in its national report on )edication sa(ety, highlighted a nu)ber o(
syste)s solutions ,no+n to be e((ecti*e in i)pro*ing )edication sa(ety.
These included indi*idual patient )edication supply syste)sJ clinical
decision support syste)sJ ad*erse drug e*ent alertsJ syste)s that pro*ide
ade-uate chec,ing, such as bar codingJ as +ell as pro*ision o( clinical
phar)acy ser*ices and discharge )edication )anage)ent ser*ices. 7hile
i)ple)entation o( so)e o( these syste)s is occurring at a 3urisdictional
le*el, there is still a re-uire)ent (or national leadership to support
+idespread i)ple)entation o( these initiati*es and the de*elop)ent o(
syste)s to )onitor i)ple)entation and in(or) policy de*elop)ent.
Fxa)ples o( initiati*es (or (urther de*elop)ent are:
se o( +ard stoc, patient supply syste)s has been associated +ith
ad)inistration error rates o( 18. co)pared +ith indi*idual patient
supply syste)s error rates o( 8. to 8.. #urrently, the extent o(
institutions +ith indi*idual patient supply syste)s is un,no+n.
6canning )edications at the ti)e o( dispensing has been sho+n to
reduce errors. It is not a )andatory re-uire)ent across the country,
although the practice has been i)ple)ented in so)e states. 6canning
has also been sho+n to reduce )edication ad)inistration errors, but
again, the extent o( institutions +ith ad)inistration scanning syste)s is
un,no+n.
9ischarge )edication )anage)ent ser*ices ha*e also been sho+n to
be e((ecti*e. @o+e*er, the consistency o( i)ple)entation across all
3urisdictions and its integration +ith other ser*ices is unclear.
2inally, as the exa)ple o( the National Inpatient 5edication #hart sho+s,
standardisation o( health care is one o( the e((ecti*e +ays o( reducing
)edication incidents. @o+e*er, standardisation, by de(inition, re-uires the
rigorous +or, o( standards de*elop)ent, as +ell as agree)ent by all
sta,eholders and the integration o( the standards into practice. 1ne o( the
current opportunities (or standardisation lies +ith the in(or)ation
technology syste)s being de*eloped (or health settings. These details are
discussed belo+.
#o)puterised prescribing ordering and entry syste)s ha*e been sho+n to
reduce ad*erse )edicine e*ents. @o+e*er, consu)ers can be at ris, o(
increased )isad*enture i( syste)s de*eloped to support i)pro*e)ents in
one sector o( the health syste) &e.g. general practice' cannot
co))unicate +ith syste)s in another &e.g. phar)acy or hospital'.
2urther, *ariable results in i)pro*e)ents in care +ill be seen i( ad*erse
drug e*ent alert syste)s di((er bet+een 3urisdictions or i( presentation o(
in(or)ation is inade-uate. 7hile the NI5# is an exa)ple o( a standardised
paper based chart, si)ilarly standardised technology alerts and
John Bailey 2008, 2010, 2011 /age 6e-uence: /age <= o( 282
presentation o( in(or)ation in in(or)ation syste)s +ill reduce the potential
(or errors.
Flectronic prescribing syste)s, especially those syste)s o((ering
ad*anced decision support (unctions, ha*e been sho+n to reduce ris, o(
)edication errors and ad*erse drug e*ents in hospital settings. ?in,ing
prescribing +ith ad)inistration and dispensing in(or)ation syste)s (urther
decreases opportunities (or error. #urrently i)ple)entation o( electronic
)edicines )anage)ent syste)s in hospitals is lo+. 5ore research is
needed into i)ple)entation (actors and guidelines de*eloped to assist
hospitals i)ple)ent the technology sa(ely.
5any countries are ha)pered in their e((orts to pro)ote sa(er patient care
and i)pro*e use o( )edicines by the lac, o( a coordinated approach and
national strategy. !ustralia has the ad*antage o( +ell de*eloped policies
and strategic (ra)e+or,s in place (or supporting )edicines and -uality in
health care. Eey policies include the National 5edicines /olicy and its
Nuality se o( 5edicines 6trategy and the #o))issionCs progra) to
de*elop a coordinated national strategy (or enhancing )edication sa(ety.
The National 5edicines /olicy ad*ocates syste)s solutions, the use o(
data to in(or) progra) de*elop)ent and the (unda)ental need (or
consu)er participation and collaborati*e, )ultiAdisciplinary acti*ity. The
#o))ission supports these directions, as they pro*ide a strong plat(or)
on +hich to i)pro*e )edication sa(ety. 7ith coordinated action,
i)pro*e)ents in )edication sa(ety are under+ay and are set to continue.
%.3 Demonstrate an understanding of organisation policy and guidelines
relating to assisting with medication within wor2 role responsi"ilities
It is i)portant (or an aged care +or,er to understand the rules about
helping an older person ta,e their )edication. !n older person"s
)edication )ust be )anaged sa(ely and correctly according to speci(ic
legal and organisational policies and procedures. In so)e cases, the aged
care +or,er )ay need to assist a younger person +ith a disability. The role
o( the aged care +or,er is to )a,e sure they ha*e the authority to proceed
+ith assisting a person to sel(A)edicate. To do this an aged care +or,er
needs to:
understand their 3ob role
,no+ +ho else is in*ol*ed in the care o( the person
(ollo+ legislation that outlines +ho is and +ho isn"t authorised to assist
the person to sel(Aad)inister
understand and apply +or,place guidelines
understand +hat )edication is to be gi*en
understand the )edication procedure.
-ole of the Aged Care 5or2er
!n aged care +or,er )ust understand the extent o( their role in helping an
older person ad)inister their o+n )edicine. 2or instance, it )ay be the
aged care +or,er"s role to super*ise and help the older person ta,e their
o+n )edicine i( the person li*es in a supported residential ser*ice or i( they
are li*ing in their o+n ho)e. @o+e*er, in a highAcare nursing ho)e,
)edication is usually gi*en by a registered nurse.
! trained aged care +or,er helps super*ise and )onitor an older person
ta,ing their )edication in the (or) o( tablets, crea)s or li-uids. nder no
circu)stances are they allo+ed to gi*e an in3ection, +hich )ust al+ays be
carried out by a registered nurse or doctor. !s +ell as setting out the
)edicine and +atching the person ta,e it, they )ust also record +hat they
ha*e done and +atch (or sideAe((ects. They )ust obser*e changes in the
person"s condition bet+een *isits and report any changes to their
super*isor. They can also assist the older person to store the )edicine
appropriately. !n aged care +or,er is not authorised to )a,e any
decisions about the )edication, o((er )edical ad*ice or change the
)edication. 2or instance, i( an older personCs has eye drops (or both eyes
and the eyes are loo,ing better a(ter the second day o( instilling the
eyedrops you cannot 3ust stop the) because o( this.
7hen you (irst start +or, you +ill be gi*en an induction or orientation that
includes your contract o( e)ploy)ent, 3ob description and a policies and
procedures )anual to read. These describe your legal responsibilities, +ho
you report to, your tas,s +hen assisting +ith )edication, and the records
you )ust ,eep. These guidelines are based on legislation and the rules
and regulations o( your +or,place.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age <$ o( 282
+ollowing )uidelines
The organisation you +or, (or pro*ides initial and ongoing training to )a,e
sure you understand the procedures, ,no+ and understand the li)itations
o( your role and the ability to gi*e )edication unsuper*ised in a ho)e or
residential care setting. Dour role in*ol*es )ore than 3ust passing the
person their )edication or +atching the) ta,e it. Dour role includes the
(ollo+ing responsibilities:
Dou )ust (ollo+ all instructions gi*en by the health pro(essional in the
older person"s care plan or progress notes. Dou cannot )a,e a
decision about the )edication and change it in any +ay, e*en i( the
older person has a reaction to the )edicine or they as, you to gi*e
the) )ore.
Dou are legally re-uired to docu)ent and report all your obser*ations
about the older person, such as the )edicine they too, or did not ta,e,
their condition and any reactions they ha*e.
Dou )ust ne*er gi*e an in3ection.
Dou can help the older person to sel(A)edicate but you )ust not
ad)inister the )edicine yoursel(. It is against the la+ (or aged care
+or,ers to ad)inister )edication. It is also i)portant that you
understand that older people need to (eel they ha*e control o*er their
li*es. 7hen they ad)inister their o+n )edicine they ,eep their
independence and retain their sel(Aestee) and dignity.
Dou ha*e a duty o( care to )a,e sure the person is ta,ing the
prescribed )edication in the correct +ay. Dou )ust not ,no+ingly:
assist the) to ad)inister the +rong )edicine
+ithhold their )edicine
(orce the) to ta,e their )edicine.
Dou )ust (ollo+ all occupational health and sa(ety guidelines to
pre*ent the spread o( in(ection and )aintain a clean and hygienic
en*iron)ent.
The )ost i)portant guideline to re)e)ber is that the right )edicine and
dose )ust be gi*en to the right person at the right ti)e by the right route.
Dou need to ,no+:
+hich )edications are to be ta,en
ho+ o(ten each )edication is to be gi*en, (or instance, e*ery (our
hours, one a day, )ane and so on, so ,no+ledge o( abbre*iations is
i)portant
ho+ )uch to gi*e, (or instance, t+o tablets, one drop in each eye
the health and physical condition o( the older person, (or instance,
+hether they ha*e di((iculty s+allo+ing, disorientated, topical &on s,in'
loo, (or rashes and so on
This in(or)ation +ill be docu)ented in the personCs care plan, progress
notes and so)e in(or)ation +ill be on the )edication chart such as ho+
)uch to gi*e, ho+ o(ten and so on.
0e)e)ber, legislation re(ers to all the rules and procedures that are
+ritten by the go*ern)ent about ho+ to deal +ith )edication. Dou )ust
co)ply +ith the). It is against the la+ to ignore the). !n !ct is a piece o(
legislation +ritten by the go*ern)ent. !n !ct describes +hat people )ust
do. That is +hy organisational policies and policies are i)portant and )ust
be co)plied +ith to (ollo+ the la+.
!rganisational )uidelines
Dour e)ployer or +or,place is responsible (or ensuring that an older
person"s )edication is ad)inistered and stored sa(ely and correctly. To do
this there should be clearly +ritten guidelines and steps that you are
expected to (ollo+. I( you are unsure o( anything you a told, clari(y it
i))ediately +ith your super*isor. Ne*er, do so)ething you are unsure o(
then consult your super*isor as i( you )a,e a )ista,e and be a+are you
are )ore than li,ely to do this. Dour super*isor and colleagues )ay get
*ery angry +ith you as so)eone +ill ha*e to (ix your )ista,es, +hich ta,es
a lot o( ti)e and e((ect to (ix +hich then increases their +or,load, this could
ha*e been alle*iated by (irstly as,ing your super*isor (or help.
The guidelines tell you:
ho+ to +or, +ith an older person
+hat you are expected to do +hen assisting +ith )edication
+hat you )ust not do
+ho you )ust report to
ho+ to record +hat you ha*e done.
The support you gi*e o(ten depends on the abilities o( the older person.
They )ay be independent or se)iAindependent. The independent person
)ay need )ini)al help (ro) you, (or instance, a si)ple tas, li,e helping
the) open their bottle o( pills. ! se)iAindependent person )ay be li)ited
in +hat they can do and )ay need you to get the )edicine (ro) the
cupboard and prepare the )edicine so they ha*e the correct dosage.
Acti*ity
7hy is it i)portant (or the aged care +or,er to understand rules in helping
older people ta,e their )edicationI
OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO
?ist % things that aged care +or,ers need to be a+are o(.
?ist the aged care +or,ers responsibilities in (ollo+ing guidelines.
7hat is the signi(icance o( legislation and acts on policies and proceduresI
%.3 'dentify lines of authority6 accounta"ility and actions to "e ta2en to
handle contingencies
!uthority )eans that the aged care +or,er has per)ission to report the
condition o( an older person, assist +ith sel(A)edication, )a,e sure the
older person is ta,ing it, and report any changes in their condition a(ter
they ha*e ta,en it.
!ccountability is the principle that indi*iduals are responsible (or their
actions and the results or conse-uences o( their actions.
Handling Contingencies
! contingency is an e*ent that )ay occur but is not li,ely to. F*en though a
contingency is unli,ely to occur, it )ust be prepared (or in case it does
occur in the (uture.
ypes of contingencies
Things )ay not al+ays go to plan. 2or instance, the older person )ay
re(use to ta,e the )edication, they )ight *o)it a(ter ta,ing it or you )ay
be unsure about the instructions you ha*e been gi*en. @ere is a list o(
so)e other things that )ay occur.
Issues concerning the older person
The older person:
is con(used and can"t identi(y the)sel*es. Dou ha*e not +or,ed +ith
the) be(ore so you do not ,no+ +hether they are the correct person.
)ay spit out the )edication
has s+allo+ing di((iculties
)ay be in pain.
Issues concerning the aged care +or,er
he aged care wor2er#
(orgets to gi*e )edication
(inds that so)eone else has not gi*en it
(inds that so)eone did not sign (or )edication they ha*e helped to
ad)inister
has no clear guidelines as to +hether anything can be done to the
)edication to )a,e it easier (or the older person to ta,e it, such as
crushing, dissol*ing it or ta,ing +ith (ood.
Issues concerning the )edication
The identi(ication on the pac,age does not )atch the older person A
the )edication has been incorrectly dispensed by the phar)acist.
The blister pac, is not sealed.
Tablets are )issing.
5edication (alls on the (loor and can"t be (ound.
The )edication is past its use by date or expiry date and )ay not be
as e((ecti*e
9ealing +ith contingencies is co*ered in )ore detail later.
Acti*ity
7hat is authorityI
7hat is accountabilityI
In your o+n +ords, +hat does contingency )eanI
?ist types o( contingencies aged care +or,ers )ay (ace +hen dealing +ith
)edications.
#an you thin, o( 2 other contingencies needed +hen dealing +ith
)edicationsI
Gi*e an exa)ple o( a contingency you )ay (ace in e*eryday li(e.
%.4 'dentify le*el and type of physical assistance re?uired "y the client to
address their personal needs in ta2ing medications
7here aged care +or,ers are e)ployed to assist older people +ith their
)edicines, they ha*e a responsibility to ensure that:
the care plan is (ollo+ed
the person"s current condition is obser*ed prior
to, during and a(ter each )edication e*ent
all necessary sa(ety chec,s are co)pleted
)edication e*ents are (ree (ro) error and in
accordance +ith the organisation"s policies and
procedures
rele*ant reports and records are co)pleted.
Assisting people with medicines
!ll +or,place procedures can be bro,en do+n into si)ple steps. @o+e*er,
)any steps +ithin a procedure )ay ta,e place at the sa)e ti)e, and
changes to this procedure +ill be re-uired to re(lect indi*idual needs and
(acility policies.
Be(ore assisting a person +ith their )edicines, it is i)portant that you loo,
(or any change in their current health condition or any beha*iour that )ay
i)pact on their ability to sa(ely ta,e their )edication.
6uch changes )ay include &but are not li)ited to':
alterations in the ability to s+allo+
changes in )e)ory and )ental (unctioning
changes in le*els o( consciousness.
!ny changes in the person"s condition should be reported to your
super*isor i))ediately.
The e-uip)ent re-uired to assist +ith )edication +ill depend on the type
o( )edication being ta,en, and includes:
care plan or health record, )edication chart
or signing chart
glo*es
paper to+els and tissues
tablet di*ider
+ater 3ug and cup
)edicine or )easuring cups and spoons
nebuliser or spacer de*ice.
Acti*ity
7hat assistance is re-uired in the (ollo+ing scenarios based on their care
planI 0ate the le*el o( assistance as lo+, )ediu) or high.
a' Jenni li*es at ho)e and has had a se*ere stro,e to her le(t side. 6he
is able to s+allo+ tablets +hole but at ti)es (inds it di((icult to push her
tablets through the dose ad)inistration aid. ?e*el o( assistance
re-uired is:OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO
b' 0ay is in a high care aged care (acility due to )ultiple diseases and
has proble)s +ith s+allo+ing. 0ayCs care plan states he is to ha*e
thic,ened (luids and needs constant super*ision +ith )edications and
(eeding. ?e*el o( assistance re-uired
is:OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO
c' 9orothy is in the de)entia unit and uses a +heelchair (or )obility.
6o)e days 9orothy can be aggressi*e due to her (rustration +ith
de)entia on these days +hat le*el o( assistance is
re-uired:OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO
?ist places, +or,ers should chec, to see the le*el o( assistance clients
need in ta,ing )edications.
?ist the e-uip)ent that )ay be re-uired to assist +ith gi*ing )edication.
%.5 'dentify le*el and type of super*ision re?uired "y the client to self
administer medications
It is i)portant to let the older person ,no+ ho+ the )edication +ill be
ad)inistered be(ore they ta,e it.
In the (irst instance, the doctor and phar)acist, or other health
pro(essional, are responsible (or prescribing and explaining the type,
a)ount and purpose o( the re-uired )edication. It is your role to )a,e
sure that these instructions are understood and (ollo+ed. !l+ays chec, the
older person"s le*el o( understanding be(ore proceeding. !ns+er any
-uestions or concerns about the )edication process that an older person
)ay raise. I( you don"t ,no+ the ans+er, (ind out (ro) your super*isor.
Ne*er gi*e )isleading or +rong in(or)ation.
!n older person )ay +ish to sel(Aad)inister so)e o( their )edication
+ithout assistance. 1lder people should be encouraged to )aintain their
independence. !ged care +or,ers should be care(ul not to do too )uch
and ta,e a+ay the opportunity (or the older person to do things (or
the)sel*es. The older person"s independence, dignity and pri*acy )ust be
respected at all ti)es. !ged care +or,ers )ust allo+ extra ti)e (or older
people to co)plete certain acti*ities. Their ability should be assessed by a
health pro(essional, and aged care +or,ers should pro*ide assistance only
as docu)ented in the older person"s care plan.
I( you are assisting an older person to sel(A)edicate, let the) ,no+ that
you trust the) and are con(ident in their ability to ta,e their )edication.
Tell the) you +ill sho+ the) +hat to do in case they ha*e (orgotten or are
e)barrassed and don"t +ant you to +atch. Dou )ay ha*e to explain or
re)ind an older person each ti)e you *isit. 1lder people )ay su((er
)e)ory loss that is not related to an illness but is si)ply a degenerati*e
process due to old age. This )ay a((ect their ability to re)e)ber. They
need to be reassured about +hat to do. 0epeating the instructions +ill gi*e
the) the con(idence to ,no+ +hat to do and help the) to (eel in control.
Dou )ay need to assist a person by:
explaining to the) ho+ )uch to ta,e
opening their tablet container
crushing the tablet &i( the phar)acist or doctor has instructed, and i(
+or,place procedures allo+'
sho+ing the) ho+ to ad)inister it.
Dour speci(ic tas,s +hen helping so)eone to sel(A)edicate are to:
help to get the older person ready and co)(ortable to ta,e the
)edication
get the )edication ready, (or exa)ple by unscre+ing the bottle lid,
getting the
correct nu)ber o( tablets out, re)o*ing tablets (ro) a dosage
ad)inistration aid
ha*e the e-uip)ent they need to ta,e the )edication ready, i(
necessary
sho+ the person +hat to do &you )ay need to do this e*ery ti)e you
see the)'
+atch the) ta,e the )edication
docu)ent +hat has happened
report any reaction the person has, i( necessary
clean up.
?i,e the pre*ious section &1.<' the type or le*el o( super*ision re-uired +ill
depend on the clientCs ability and understanding o( ho+ to sel( )edicate
such as a person li*ing in their ho)e +ill ha*e di((erent abilities to a person
li*ing in a high care aged care (acility. !lso a personsC ability to sel(
)edicate can change due to a condition, reaction to )edication or illness.
0e)e)ber to noti(y your super*isor o( any changes as soon as possible
and docu)ent the changes in the clinicalBprogress notes.
Acti*ity
?ist ; things that aged care +or,ers need to help older people )aintain.
7ho should assess a clientsC ability to sel(Aad)inister )edicationsI
7hat docu)entation should aged care +or,ers loo, at to see a clientsC
le*el o( super*ision re-uiredI
?ist 8 +ays a +or,er can help a client to sel(A)edicate.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age %0 o( 282
%.9 'dentify and report to a super*isor and=or health professional if there
are any circumstances or changes in the client>s condition or personal
needs that may impact on assisting the client with their medication
-eporting changes
In order (or a person to be able to ta,e their o+n )edication they )ust be
assessed by a health pro(essional as being able to understand +hat they
ha*e to do and ,no+ +hen they ha*e to ta,e it. !n i)portant responsibility
o( the aged care +or,er is to regularly chec, the older person ability to still
be able to sel(A)edicate or to ta,e or apply the )edication the)sel*es.
Dou as an aged care +or,er needs to loo, (or any changes in the older
person"s condition that )ight a((ect their ability to sel(A)edicate. Dou
should pay particular attention to:
their )ental state, (or exa)ple: 9o they see) con(usedI
their )obility, (or exa)ple: #an they +al, as (ar as they used toI
their breathing, (or exa)ple: Is their breathing noisier or (aster than
usualI
their beha*iour, (or exa)ple: 9o they see) )ore depressed than
usualI
There are )any reasons their condition )ay ha*e changed and )ay
include the (ollo+ing:
their existing health condition )ay ha*e +orsened
the doctor )ay ha*e changed their )edication
the person )ay ha*e )ixed their )edications
the person )ay ha*e (orgotten or chosen not to ta,e their )edications
the person )ay ha*e de*eloped another condition, such as the (lu
the person )ay be unable to sleep, +hich )a,es it harder (or the) to
thin, clearly
stress(ul e*ents in the person"s li(e )ay be a((ecting their abilities, (or
instance, the death o( a lo*ed one, (inancial di((iculties, (a)ily
proble)s, the onset o( de)entia or changed ho)e en*iron)ent.
!s an aged care +or,er you need to ,no+ ho+ to encourage the older
person to tell you i( they are ha*ing di((iculties. Dou also need to ,no+
+hat to do i( you spot a change in a personCs beha*iour or condition. !
change in their ability to sel(A)edicate could indicate that they are ha*ing
trouble in other areas o( their li(e. It )ay )ean the le*el o( assistance )ay
ha*e to be increased.
It is up to you to record +hat you see and +hat the older person tells you.
That is all. Dou )ust not change the )edication. The person"s doctor or
other health pro(essionals are the only people +ho can )a,e decisions
about )edication, so it is i)portant you report changes as soon as
possible. 9o not ad)inister anything i( you are concerned about the
person"s condition. 9ocu)ent in the progress notes and report all changes
to your super*isor or in the agreed )anner according to organisational
policies, procedures and guidelines as soon as possible.
Changes in condition
The (irst ti)e you )eet the older person, you establish their condition and
+hat )edication they are ta,ing through obser*ation and introducing
yoursel(. Dou need to )onitor their condition e*ery ti)e you *isit. This can
be done in a nu)ber o( +ays:
%. !"ser*e them#8
7atch the older person (or signs that their condition has changed since
you last sa+ the). 2or instance: !re they s+eatingI 9o they loo,
con(usedI !re they scratching the)sel*esI 9o they ha*e a di((erent s,in
toneI !re they slurring their speech )ore than usualI
3. (isten to the person#8
The older person )ay tell you that they (eel di((erent or (eel concerned that
their )edication is )a,ing the) (eel +orse. Fncourage the) to tal, to you.
Get the) to describe exactly ho+ they (eel. !s, -uestions that (ollo+Aup
+hat the person is saying to gain clari(ication and to gain )ore in(or)ation
that )ay be re-uired. It is your 3ob to record this clearly so the doctor can
(ollo+ it up.
3. As2 ?uestions#8
@elp the older person to be speci(ic about the +ay they (eel or loo,. !s,
-uestions such as, "!re you concerned that the ne+ )edication is )a,ing
you sic,I" !s, direct -uestions so you can pinpoint ho+ they (eel and +hat
)ight be causing it, (or exa)ple:
7here is the painI
9o you +ant to *o)itI
7hen did you start to itchI
7here does your head acheI
7hen did the pain startI
7here is the painI
Is it a sharp pain or a dull acheI
@a*e you eaten todayI
@a*e you eaten so)ething you don"t usually eatI
@a*e you had enough sleepI
@a*e you had a (allI
!s, the) +hether they ha*e ta,en their )edication today. !s, the) to
sho+ you +hat )edication they ha*e ta,en. Dou )ay (ind that the person"s
physical beha*iour has changed and they ha*e beco)e +ithdra+n, angry,
depressed, uncooperati*e or (rustrated. The )ore you (ind out, the )ore
in(or)ation you +ill be able to +rite in your progress notes. 0e)e)ber you
are not )a,ing a diagnosis. Dou are si)ply recording +hat the person tells
you about ho+ they (eel.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age %; o( 282
@a*e a loo, at the (ollo+ing case study.
Case Study %.
!nnette )ade her regular *isit to 9a)ien at 0$;0hrs on Thursday )orning.
6he ,ne+ that the doctor had changed 9a)ien"s )edication on 5onday,
so she +as ,een to see ho+ 9a)ien +as ad3usting to it. 6he noticed he
had put on a thic, cardigan e*en though it +as -uite a +ar) )orning.
9a)ien +as shi*ering and had to sit do+n as he said he (elt diKKy.
"@a*e you eaten todayI" !nnette as,ed. "Des," 9a)ien replied.
"@a*e you ta,en your 8.00 o"cloc, pillI" "Des," 9a)ien said. "But e*er since
I"*e had these ne+ pills I"*e (elt terrible. I ,eep thin,ing I ha*e to get used
to the) but I (eel +orse than e*er. 7hat should I doI"
!nnette ,ne+ she had to call her super*isor i))ediately and report the
situation to the). 6he ,ne+ that 9a)ien )ust not ta,e any )ore
)edication until the super*isor and doctor +ere in(or)ed. 6he as,ed
9a)ien a (e+ )ore -uestions about ho+ he (elt and +hat else he had
done that )orning. 6he +rote his ans+ers do+n, then called the
super*isor. 6he told 9a)ien +hat she +as doing. 6he )ade 9a)ien as
co)(ortable as she could.
In this case study, the aged care +or,er had a duty o( care not to )a,e the
person +orse. They )ust not gi*e )ore )edication i( they thin, there is
so)ething +rong. !t this stage they do not ,no+ +hat the proble) is P it
)ay be the ne+ )edicine, but it could also be so)ething the person has
eaten or done. !n aged care +or,er is not -uali(ied and is not authorised
to diagnose the proble) or initiate (urther treat)ent. They should
i))ediately noti(y their super*isor. Their super*isor +ill tell the) the
correct procedure to (ollo+.
The (ollo+ing are conditions that )ay occur. In all o( these cases, you
)ust (ollo+ procedures and noti(y your super*isor. In so)e circu)stances
you )ay need to call an a)bulance or per(or) e)ergency (irst aid
procedures i( -uali(ied and as,ed to do so, (or instance cardiopul)onary
resuscitation &#/0'. In such instances, your organisational policies and
procedures +ill ha*e clearly de(ined guidelines to (ollo+. It is your
responsibility to (ollo+ the). @ere are so)e exa)ples o( conditions and
+hat to loo, (or on the (ollo+ing pagesJ
John Bailey 2008, 2010, 2011 /age 6e-uence: /age %< o( 282
+igure # Conditions
Condition 5hat to loo2 for...
#hanges to air+ay #ho,ing
Not able to s+allo+
#hanges to breathing 6lo+
2ast
2aint
#irculation
nexpected dro+siness
#olour change to hands and toes
0apid pulse
2aint pulse
0ash #ontinual scratching
0edness
0aised or (lat
#olour
In(la))ation
0edness
@eat &older person is hot to touch'
6+elling
/ain
6+elling 6+ollen hands, throat or nasal passage
@eadache
#annot (ocus +ell
Is lightAsensiti*e
#an"t get up (ro) their bed
@earing loss
#annot hear
0inging in the ear
5atter co)ing (ro) the earBs
#annot understand instructions
?ac, o( (acial recognition +hen tal,ing to the)
Blurred *ision #annot read labels
nsteady on their (eet
6-uinting
Condition 5hat to loo2 for...
9iKKiness ?osing balance
2eeling (aint
Fye +ea,ness
Inability to )aintain nor)al seated balance
6lurring o( speech
#annot spea, clearly
7ords 3u)bled
#annot )a,e the)sel*es understood
Nausea
9ry retching
/ale
@as the urge to *o)it
>o)iting >o)iting as soon as )edication is ta,en
>o)it in the toilet bo+l or on their clothes
9iarrhoea ?oose bo+el )otions
Incontinence
#on(usion
#annot decide +hat to do
#annot re)e)ber +hen to ta,e the
)edicine
#hange in beha*iour
5ood changes, such as being )ore irritable
?ac, o( sleep or stress
6ubstance abuse or )isuse, (or exa)ple
co)bining )edications, ta,ing alcohol +ith
)edication
It is i)portant that you note these changes and ho+ they are a((ecting the
person. They )ay ha*e serious conse-uences (or the older person. 2or
instance, i( their hands ha*e beco)e s+ollen they )ay ha*e di((iculty
opening their )edication and be unable to ta,e it. I( they (eel diKKy they
)ay (aint and hurt the)sel*es. I( their *ision has been a((ected they )ay
not be able to read the )edicine label or chart clearly. 6lurred speech )ay
be an indicator o( a stro,e. I( they are *o)iting they +ill not be able to ,eep
their )edicine do+n. !ll these instances can be dangerous, +hich is +hy it
is crucial that you noti(y your super*isor as soon as you identi(y a change
in the person"s condition.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age %% o( 282
Case Study 3.
!drienne arri*es and (inds 5rs. Bour,e on the (loor. sually she is sitting
on her chair, and is ,notting and is tal,ati*e. Today, she see)s
disorientated and has bruising on her ar)s. 6he says she cannot get up,
(eels M(unnyQ and +ants to sleep.
1. 7rite (our -uestions !drienne +ould as, 5rs. Bour,e.
2. 7hy )ust !drienne as, -uestionsI
;. ?ist the things !drienne should do next.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age %= o( 282
Be a+are that other circu)stance or changes in the clientsC personal
needs include the (ollo+ing:A
#lient has to (ast or be Nil by 5outh &NB5' due to a procedure
#lient has so)e other pending )edical e)ergency in progress such as
being unconscious
The client is in hospital
#lient has gone a+ay (or the day +ith (a)ily
@a*ing a cold and ha*ing an inability to s+allo+
The list continues, so be a+are o( these and )a,e sure the correct
docu)entation is co)pleted as +ell as in(or)ation exchanged in the
co))unication boo, and during hando*er bet+een shi(ts.
Procedures for reporting changes
I( you are +or,ing in a co))unity residential setting you should
i))ediately contact the person in charge. This +ill be the 0egistered
Nurse or your super*isor &+ho )ay be the nurse'. #learly explain the
situation. 9o not proceed +ith gi*ing any )edication until you recei*e
(urther directions (ro) the). Dou )ust +rite the changed situation in the
older person"s care or progress notes. 0e)e)ber to record the date, the
ti)e, details o( the changed conditions and +ho you ha*e reported it to.
I( you are +or,ing in a person"s ho)e, telephone your super*isor
straighta+ay. Fxplain the situation. 9o not proceed +ith gi*ing )edication.
Dou +ill be gi*en ad*ice and instructions about +hat to do (ro) your
super*isor. 9ocu)ent the changes in the progress notes and
co))unication boo,, (ro) the pre*ious case study.
+igure # Progress=clinical notes.
Belo+, co)plete +hat !drienne +ould docu)ent on 5rs. Bour,e in her
progressBclinical notes
DAE='0E P-!)-ESS 7!ES
Acti*ity
@o+ +ould you identi(y changes in a clientCs condition or personal needsI
John Bailey 2008, 2010, 2011 /age 6e-uence: /age %$ o( 282
N!5F:
91B:
0115BBF9:
?ist 8 conditions and +hat to loo, (or +ith changes to a person.
7hy are obser*ation s,ills i)portant as an aged care +or,ersI
7hat +ould be the procedure (or reporting change o( an older person
+ithin a +or,placeI
John Bailey 2008, 2010, 2011 /age 6e-uence: /age =0 o( 282
%.: Confirm that all forms of medication to "e administered6 including
dose administration aides are complete6 ready for distri"ution and up
to date6 confirm with super*isor and o"tain authority to proceed
ypes of 0edication
There is a huge range o( )edication, and each one +ill be ad)inistered
according to the type o( )edication and the needs o( the older person. 2or
instance, you )ay ha*e to help an older person +ith:
capsules
ear drops
eye drops
inhalants
li-uids
lotions and crea)s
nose drops
patches &)edicated discs used to relie*e angina sy)pto)s and
applied directly to the s,in'
po+ders &used to dissol*e )edication in +ater'
tablets
+a(ers &placed under the tongue to dissol*e'.

Presentation of medications
The )edication +ill be prepared by the phar)acist in a nu)ber o( +ays.
They are o(ten pac,aged in prescribed a)ounts in 9!!s &9rug
!d)inistration !ids' to help the person ,no+ ho+ )uch to ta,e. Dou
should be (a)iliar +ith the di((erent types o( 9!!s.
9rug ad)inistrati*e aids &9!!' are de*ices de*eloped to assist atAris,
clients in better )anaging their )edicines by arranging their )edicines into
indi*idual doses according to the prescribed dose schedule throughout the
day.
! 9!! ser*ice in*ol*es the /har)acy preparing and pro*iding a 9!! to
clients to support their )edicine )anage)ent. !s part o( the ser*ice, the
/har)acist:
)a,es an assess)ent as to +hether the client +ould bene(it (ro) a
9!!J
prepares and )aintains a current pro(ile o( the clientCs )edicine
regi)enJ
considers +hich )edicines are appropriate (or pac,ing in the 9!!J
prepares and pro*ides 9!! to )eet the clientCs needsJ
)onitors the clientCs use o( the 9!! and their )edicine adherenceJ
addresses identi(ied issuesJ
supports the client in the -uality use o( )edicines that are not pac,ed
in the 9!!J
pro*ides counselling as appropriateJ
supports the client in their prescription )anage)entJ
considers other pro(essional ser*ices that )ay be o( bene(it (or the
client &e.g. /atient 5edication /ro(ile, @o)e 5edicines 0e*ie+'J
pro)otes continuity o( care by collaborating +ith the client and other
health pro(essionals as re-uired.
Dose Administration Aids
9ose ad)inistration aids )ay ta,e loo, li,e the (ollo+ing:A
9osettes
Blister pac,sAsingle and )ultiAdose pac,s
6achets
Dosette Bo,
! dosette box is a co))on +ay o( pac,aging pills to organise people"s
)edication. The re(illable plastic box is di*ided into co)part)ents. The
days o( the +ee, and ti)es to ta,e the pills are printed at the top o( the
box. 5edicines (or each day are placed in the box. It is easy to see +hat
pill to ta,e and +hen to ta,e it. !ll the older person has to do is ta,e out
the )edicine (or the correct day. They do not ha*e to re)e)ber ho+ )any
pills to ta,e. This has already been done (or the). ! plastic sliding lid
co*ers all the tablets. The older person"s na)e and photo is usually placed
on the box. 5any ser*ices pre(er not to use dosette boxes no+ that are
(illed by consu)ers such as nu)bers 1,2 and 8 in the picture belo+ as
they are easy to accidentally open, and )edication )ay beco)e )ixed up
or lost. @o+e*er, the dosette pac,s that are pre(erred are the ones (illed by
phar)acists such as nu)bers ; and < in the picture belo+.
+igure # 0edication organiCers
5edication organisers: 1, 2 and 8 are designed to be (illed by consu)ers,
+hile ; and < are designed to be (illed by phar)acists. &2ro) National
/rescribing 6er*ice ?i)ited, +++.nps.org.au'
Blister Pac2
! blister pac, is si)ilar to a dosette box. It is a container +here all stores a
person"s pills in indi*idual poc,ets that hold all o( the tablets to be ta,en at
a particular ti)e o( day. The bac, o( each poc,et lists the date and ti)e
they are to be ta,en. There is also a description o( the tablets that should
be in each poc,et. The containers are prepared by a phar)acist. 7hen it
is ti)e to ta,e the )edication, the tablets are si)ply pushed through the
(oil bac,ing o( the pac, into a )edicine cup or the older person"s hand,
ready to be ta,en. It is i))ediately ob*ious i( a pac, has been ta)pered
+ith because the (oil +ill be bro,en. Blister pac,s are not reAusable.
Eey (eatures o( the blister pac,:A
This )ultiAdose syste) is an indi*idually prepared blister pac, +hich is
(illed by the phar)acist
The phar)acist records on the pac, the na)e o( the client, and the
na)es, descriptions and -uantities o( the tablets
p to se*en tablets can be contained in each sealed co)part)ent
The clear blister pac, acts as a *isual re)inder o( +hich )edication is
to be ta,en next and +hen
John Bailey 2008, 2010, 2011 /age 6e-uence: /age =; o( 282
This syste) can be ad)inistered by a 0egistered Nurse, appropriately
trained care sta((, the clientCs (a)ily or the client
#lients are able to ta,e clearly labelled indi*idual blisters +ith the)
+hen they go out
Ti)e is sa*ed as sta(( do not need to repac, )edications (or the clients
to ta,e +ith the)
6igning sheets acco)pany the blister pac,s to docu)ent )edication
ad)inistration
6peci(ically designed )edications trolleys that )eet the 7or,place
@ealth and 6a(ety re-uire)ents are a*ailable (or the storage and
ad)inistration o( the blister
+igure # Blister Pac2s

Sachets
6ingleAdose sachets are prepared by a )edical practitioner, registered
nurse or phar)acist. They usually contain po+ders in the right a)ount (or
a single dose.
The 6achet 6yste) is a roll o( sachets preApac,ed +ith )edications by a
phar)aceutical co)pany using )achinery speci(ically designed (or this
purpose. 5edication in each sachet is easily identi(iable and the
)edication is supplied in )ultiAdose sachets dispensed in a continuous roll
(ro) a rigid sided cardboard box.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age =< o( 282
+igure # Sachets
Administering 0edications
The instructions you are gi*en on the care notes, )edication chart and
)edication containers +ill tell you exactly ho+ the )edication is to be
ad)inistered. Dou )ay ha*e to do so)ething to prepare the )edicine and
)a,e sure the )edicine is ta,en according to the instructions. 2or
instance:
the tablet )ay ha*e to be crushed to a po+der to )a,e it easy to ta,e
the tablet )ay ha*e to be di*ided to )a,e it easier to s+allo+
t+o types o( )edication, (or exa)ple a capsule and a li-uid, )ust not
be ta,en at the sa)e ti)e
the person )ust tilt their head +hen you apply drops
the pills )ust be ta,en +ith +ater
the )edication )ust be ta,en +ith so)e (ood.
2ollo+ the instructions. 9on"t do anything to the )edication unless you are
told to. 6o)e )edicine )ust ne*er be crushed because this +ill )a,e it
less e((ecti*e and )ay e*en cause )outh ulcers. #apsules should ne*er
be cut open, because so)e )edication is slo+ release and should not be
re)o*ed (ro) the capsule. The contents o( a capsule can be spilt easily i(
cut open. 6o)e pills should ne*er be ta,en i( the person has not eatenJ
instructions +ill state Rdo not ta,e on an e)pty sto)achQ.
7hen in doubt or i( unsure see, ad*ice (ro) your super*isor. 2or instance,
i( the )edication needs to be ta,en +ith (ood put so)e on a spoon +ith a
little bit o( porridge rather than putting it in the porridge as the porridge )ay
not get (inished.
Aged Care 5or2er>s -ole
!ged care +or,ers are expected to chec, +ith their super*isor that all
dose ad)inistration aids &9!!' are co)plete, ready (or distribution, and
are up to date.
Fach +or,place should ha*e a responsible person allocated to chec, all
)edication on deli*ery to ensure that it is co)plete. This )eans that each
aid is pac,ed +ith the correct )edication (or each older person. @o+e*er,
it is your responsibility to ta,e extra sa(ety precautions and chec, each
container indi*idually be(ore assisting the older person to ta,e their
)edication.
The aged care +or,er needs to chec, that:
%. he medication is correct and the person is correct8
Be(ore the )edication is gi*en to the older person you need to chec, that
the correct )edication is in the 9!! (or the correct person. ?oo, at the
in(or)ation pro*ided on the bac, o( the 9!!. The )edication should be
(ully labelled +ith a clear description o(:
the na)e o( the )edication
the na)e and date o( birth o( the older person it is pac,ed (or +ho it is
pac,ed by
the strength
the dose
the directions (or use
the date, day and ti)e it is to be used
any speci(ic instructions, (or exa)ple "9o not crush" or "Ta,e +ith
)eals"
the expiry date.
#hec, that all these ite)s are included on the 9!!. Tell your super*isor
i))ediately i( you notice that the +rong na)e is on the pac, or the +rong
a)ount o( )edication is included.
!lso chec, (or any (aults in the pac,aging. I( a dose ad)inistration aid is
bro,en or ta)pered +ith it should not be used, but returned to the
phar)acy +ithout delay. The super*isor should be in(or)ed i))ediately.
nder no circu)stances should an aged care +or,er re)o*e or add any
tablets to a dose ad)inistration aid.
!nything that is di((erent to +hat it should be is called a discrepancy or an
inconsistency.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age =% o( 282
3. he pre*ious dose has "een ta2en8
Dou need to )a,e sure that the )edication has been ta,en (or the
pre*ious ti)e or day. #hec, that the next tablet you are gi*ing is (or the
correct ti)e or day. I( a tablet has been )issed you need to noti(y your
super*isor i))ediately.
3. he medication has not passed its use8"y date8
It is i)portant that the )edication is chec,ed to )a,e sure it is +ithin the
useAby date. I( the date has passed, the )edication )ay no longer be a
bene(it to the person. It could be potentially dangerous (or a person to ta,e
)edication that has passed its useAby date.
Dou should also loo, (or other signs that the )edication )ay ha*e passed
its useAby date. 2or exa)ple, loo, (or any change in the )edication"s
colour. 5edication instructions )ay tell you +hat colour li-uid the
)edication is supposed to be. I( you are unsure, as, your super*isor.
The )edication )ust also )atch the doctor"s current prescription. The
phar)acist +ill ha*e chec,ed this be(ore dispensing the )edication. !
nurse )ay also ha*e chec,ed against the person"s )edication chart or
care plan.
9o not continue i( you notice a discrepancy. 0eport to your super*isor
+ithout delay.
Authority to Proceed
!ged care +or,ers need per)ission to assist older people to ta,e their
)edication. The aged care +or,er"s roleAis to super*ise and help the older
person ta,e their prescribed )edicine under super*ision (ro) a health care
pro(essional.
Be (a)iliar +ith the guidelines in your +or,place that outline the authority
you ha*e and the steps you should (ollo+ be(ore you assist an older
person +ith their )edication. 2or exa)ple, a registered nurse or the
person in charge )ay delegate the responsibility (or assisting +ith the
ad)inistering o( )edication to train and co)petent aged care +or,ers. !
registered nurse or endorsed enrolled nurse +ill ad)inister )edication in
)ost highAcare (acilities. !n aged care +or,er )ay assist to ad)inister
)edication to an older person in a lo+Acare (acility or in the co))unity.
It is the aged care +or,er"s responsibility to -uestion any instruction that
see)s unclear, inappropriate or unreasonable. Dou should direct this
-uery to your super*isor or the tea) leader on duty. I( they are not
a*ailable you should contact the older person"s doctor or the phar)acist
+ho prepared the )edication.
Be(ore you can help +ith the )edication you need per)ission (ro) your
super*isor. nder no circu)stances )ust you ad)inister the )edication
on your o+n +ithout per)ission. Dour super*isor +ill gi*e you per)ission
once they are con(ident that you ha*e done the (ollo+ing things:
0ead the older person"s care plan and )edication chart and
understand +hat )edication is to be gi*en.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age == o( 282
Dou ha*e identi(ied the older person by their photograph or na)e on
the dose ad)inistration aid or their )edication chart.
Dou ha*e chec,ed that the dose ad)inistration aid is pac,ed (or the
correct dosage, the correct day and the correct ti)e.
I( there is no dose ad)inistration aid, you ha*e chec,ed the
in(or)ation on the label o( the )edication to ,no+ the dosage and
ad)inistration instructions.
Dou ha*e chec,ed that the older person has agreed to ta,e the
)edication. 0e)e)ber that the older person has the right to re(use
)edication and you +ill need their per)ission or a re-uest (ro) the)
to assist the) in ta,ing their )edication.
Acti*ity #
?ist the di((erent types o( )edications.
7hat does 9!! )eanI
?ist ; types o( 9!! and gi*e a brie( description o( each.
7hat do aged care +or,ers need to chec, i( gi*ing an older person
)edicationI
?ist the ite)s needed to be on a 9!! label.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age =$ o( 282
7hat is authority to proceedI
%.; Confirm the procedure to "e used for medication to "e administered
Assisting with self8medication
Be(ore you can help an older person to ta,e their )edication you need to
)a,e sure they ,no+ +hat they are expected to do. In )any cases they
+ill ha*e to ta,e their )edication +hen you are not there, li,e early in the
)orning or late at night.
In the (irst instance, the doctor and phar)acist, or other health
pro(essional, are responsible (or prescribing and explaining the type,
a)ount and purpose o( the re-uired )edication. It is your role to )a,e
sure that these instructions are understood and (ollo+ed. Dou need to
clearly explain exactly +hat the person has to do and +hen they ha*e to
do it. Dou )ay need to assist a person by:
Dou )ay ha*e to explain or re)ind an older person +hat to do each ti)e
you *isit. 1lder people )ay su((er )e)ory loss that is not related to an
illness but is si)ply a degenerati*e process due to old age. This )ay a((ect
their ability to re)e)ber. They need to be reassured about +hat to do.
0epeating the instructions +ill gi*e the) the con(idence to ,no+ +hat to
do and help the) to (eel in control. It"s a good idea to as, the) +hat you
ha*e said and to sho+ you +hat they are to do.
Instructions (or ad)inistering )edication are (ound in the care plan, care
notes, care chart, on the )edication schedule on a 9!! and on the label
attached to the original )edication container.
Helping the older person to ta2e the medication
The next step is to assist the older person to ta,e their )edication. The
aged care +or,er )ust at all ti)es (ollo+ the legislation and +or,place
policies and procedures (or ad)inistering )edication. Dou ha*e a duty o(
care to )a,e sure you do not place the person in any danger or cause
the) har). Dou )ust (ollo+ the instructions you ha*e been gi*en. !t no
ti)e )ust you decide (or yoursel( +hat to do or alter the a)ount o(
)edication (ro) that speci(ied on the label or chart. !ll actions and
decisions )ust be ta,en +ithin your 3ob role. 7hene*er you are in doubt
you )ust contact your super*isor.
Be(ore you can ad)inister the )edication you need to (ollo+ a nu)ber o(
steps to prepare the older person (or )edication.Dour role is to )a,e sure
that the person is co)(ortable and e)otionally ready, the e-uip)ent is
prepared and the person ,no+s ho+ to ad)inister the )edication
correctly. Dou need to do the (ollo+ing:
%. Build trust
3. Fncourage the older person
3. /ro*ide pri*acy
4. /repare the person (or the )edication
5. /repare (or ad)inistering the )edication
9. Fxplain the procedure
%. Build trust
To be able to assist an older person to ta,e their )edication you need to
build a sense o( trust and con(idence bet+een you and the older person.
!n e((ecti*e aged care +or,er:
listens to +hat the older person is saying about the )edication, (or
exa)ple they say they don"t li,e it or are scared o( ta,ing it
is tolerant o( any di)inished physical or )ental abilities the person )ay
ha*e, (or exa)ple they need to be told +hat to do )any ti)es
clearly explains instructions about the )edication
)a,es sure the older person understands +hat they ha*e to do
is consistent and honest in their relationship +ith the older person.
The older person is )ore li,ely to be cooperati*e +hen they understand
+hy they need to ta,e the )edication and ,no+ that you are there to help
the).
3. Encourage the older person
!n i)portant part o( your role is to encourage the older person to ta,e their
)edication. 6o)eti)es an older person )ight resist ta,ing the )edication.
They )ay si)ply say they don"t +ant to ta,e it. 1thers )ay shout, thro+
things, *erbally abuse you or use o((ensi*e language.
Dour role is to (ind out +hy they don"t +ant to ta,e the )edication and (ind
a +ay to get the) in the right (ra)e o( )ind to cooperate. ?isten to +hat
they are saying and explain +hat you are going to do. 6tay cal). 6pea,
slo+ly and reassuringly. 9on"t rush the person or act i)patient. Eeep your
body language nonAthreatening. That is, don"t (ro+n, sha,e your (inger at
the) or sta)p your (eet. 9on"t )a,e any 3udge)ents. Dou +on"t ,no+ +hy
they don"t +ant to ta,e their )edication until you as, -uestions and (ind
out. 0e)e)ber also that you )ust support the older person"s right to
choose +hether or not they ta,e their )edication.
!*oid con(rontation and do not persist i( it is )a,ing the situation +orse.
0ecord +hat has happened so your super*isor and the health
pro(essionals can ad*ise +hat to do. Dou )ay ha*e to contact the
super*isor i))ediately i( it is urgent that the person ta,e the )edication as
soon as possible.
Be a+are o( +hy people )ay need encourage)ent to ta,e their
)edication. 1lder people )ay ha*e concerns about the )edication (or a
nu)ber o( reasons, e*en though the doctor )ay ha*e already discussed
this +ith the). 2or exa)ple:
+igure #
Situation 5hat they might say or
do
5hat you might do
They )ay be
concerned about +hat
)ight happen +hen
they ta,e the
)edication
SI") scared I )ight
cho,e."
SI don"t li,e ha*ing the
)as, on )y (ace."
Fxplain that their doctor has selected
this )edication as the )ost suitable
one (or their condition. Fxplain that
the ris, o( cho,ing is less i( they
relax.
9e)onstrate ho+ to use an aid.
They )ay +ant to do
so)ething their o+n
+ay
SI") going to cut the
capsule
in hal(. I can"t ta,e it li,e
it is."
Tell the) that the capsule cannot be
cut. #ontact the super*isor
straighta+ay and as, +hether the
capsule can be ta,en +ith a (ood
such as yoghurt or 3elly.
! change in routine
can be unsettling and
)a,e the) anxious
S5y sister is co)ing to
*isit.
#an I change the ti)e I
use the
nebuliserI"
Be (lexible +hen you can.
0espect the older person"s +ishes
and adapt the routine to suit the).
#hec, +ith your super*isor +hether
this is a possibility.
They )ay (eel
e)barrassed to accept
help or (eel bad about
their loss o(
independence
They )ay be irritable, not
loo, you in the eye or
*erbally abuse you.
!ssure the) they can do as )uch as
they can on their o+n.
Tell the) that you help )any people
in the sa)e +ay.
They )ay be in pain They )ay be irritable and
uncooperati*e i( they are
in pain, (or exa)ple i( it
hurts +hen they s+allo+.
Tal, to the) and encourage the) to
ta,e the )edication to relie*e the
pain. #ontact your super*isor (or a
solution.
?ac, o( pri*acy SI don"t +ant )y
granddaughter to see )e
li,e this."
6uggest they )o*e into another
roo).
-apport )eans ha*ing a (riendly relationship +ith another
person. Both people (eel co)(ortable +ith each other.
Acti*ity
In )a,ing a client (eel co)(ortable and )ore able to ta,e )edication list %
things an aged care +or,er should do.
?ist < reasons +hy a person )ay resist ta,ing their )edication.
Gi*e 2 reasons +hy it is i)portant to encourage a person to ta,e their
)edication.
E,ample
Jenni(er, an aged care +or,er, has been as,ed to *isit 5r. !braha). It is
the (irst ti)e that he re-uires assistance +ith his )edication. !(ter greeting
hi) and establishing a good rapport, Jenni(er explains the )edication and
+hat she +ill do to help hi). !t this point 5r. !braha) beco)es agitated
and re(uses to ta,e the tablets. SI can get by +ithout the). I don"t really
need the)," he says.
Jenni(er ,no+s that it is i)portant that he ta,e the )edication. 6he
reassures hi) that the tablets are easy to ta,e and he +ill be able to do it
on his o+n. 6he tells hi) they are a co))on tablet that she ,no+s a lot o(
people ta,e. @e cal)s do+n a bit. 6he explains that the label says he can
ta,e the) +hene*er he +ants to, as long as he has t+o a day. 1nce he
,no+s that Jenni(er is only there to chec, on the )edication, he (eels a bit
better.
!s, your super*isor (or tips you can gi*e to older people to encourage
the) to ta,e their )edication. Tips are not )edical ad*ice but things the
aged care +or,er can ad*ise the older person to help the) relax,
o*erco)e their (ear or help i( they are in pain. The (ollo+ing is a list o(
things you )ight do i( so)eone says the tablets are too large (or the) to
s+allo+.
ips
6trategies to encourage a person to s+allo+ i( they are scared o( cho,ing
The ris, o( cho,ing is less li,ely i( the older person:
is relaxed
ta,es only one tablet at a ti)e
drin,s plenty o( (luid +ith the tablet
sits +ith their head up and chin (or+ard
is allo+ed to ta,e their )edication +ith (ood
is allo+ed to cut the tablet in hal(J i( it cannot be cut in hal( explain that
the capsule has a so(t coating that )a,es it easy to slide do+n.
Acti*ity #
!n older person says, #$ can%t stand anything in my eyes. $ &ust won%t use
the drops. $ told the doctor $ will have trouble.%
Thin, o( the strategies you +ould use to encourage the person to ta,e their
)edication. Dou )ight as, a )ore experienced person to gi*e you any tips
they ha*e.
OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO
No+ role play this scenario and the strategies listed abo*e. 5a,e sure to
s+ap roles so e*eryone gets to experience the aged care +or,er and the
client.
3. Pro*ide pri*acy
/ri*acy is *ery i)portant to an older person. 6o)eti)es the person )ay
not +ant you, or anyone else, to be in*ol*ed. This can be a di((icult
situation, especially +hen you ha*e to record that you ha*e seen the)
sel(A)edicate. Dou need to explain to the) that you ha*e been as,ed by
the health pro(essional to record that the )edication has been co)pleted.
It is part o( the policies o( the +or,place that you )ust (ollo+.
?et the) ,no+ that you trust the) and are con(ident in their ability to sel(A
)edicate. Tell the) you +ill sho+ the) again +hat to do in case they ha*e
(orgotten or are e)barrassed and don"t +ant you to +atch.
7hile you )ust respect a person"s right to pri*acy, you should be sensiti*e
to the proble) and see ho+ you can +or, around the situation. 2or
exa)ple, i( the person has a *isitor +hen they need to ta,e their
)edication, they )ay not +ant the other person to ,no+ about it or to see
the) ta,e it. !s, the person i( you can see the) in another area o( the
house. Tell the *isitor that you need to as, the older person so)ething
pri*ately. In this +ay, the older person +ill still (eel in control.
4. Prepare the person for the medication
Fnsure the en*iron)ent is co)(ortable (or the older person be(ore they
ta,e their )edication. There are a (e+ things you can do to help the)
beco)e physically co)(ortable:
5a,e sure there is su((icient light to read the label.
5a,e sure their reading glasses are nearby or they ha*e a )agni(ying
glass to help the).
Fnsure dentures, i( +orn, are clean, in place and (it +ell.
Fnsure the person is sitting i( they are s+allo+ing )edication &an older
person should ne*er be lying do+n +hen they ha*e to s+allo+
)edication'.
!d3ust the older person"s posture or position to ensure they are sitting
upright +ith their head and chin (or+ard.
se cushions or pillo+s to )a,e the person co)(ortable.
se a ,nee table to pre*ent the person ha*ing to lean (or+ard.
I( they are in bed, prop the) up +ith pillo+s or a raised bed head i(
a*ailable.
@a*e the area +here crea) is to be applied (ree (ro) clothes.
I( the person is +earing an eye dressing, gently pull this do+n and
a+ay (ro) the (orehead, ta,ing care not to conta)inate the dressing.
+igure #
5a,e sure the person is co)(ortable be(ore they ta,e their )edication.
Activity :
2ro) the abo*e picture, list your obser*ations on ho+ )edications are
ta,en.
5. Prepare for administering the medication
5a,e sure all the necessary e-uip)ent is handy. This )a,es it easy to get
the )edication ready (or the older person. The older person +ill be )ore
relaxed i( e*erything is a*ailable and ready (or the). F-uip)ent you need
)ight include:
)edication such as lotions, li-uids, tablets, capsules, ear, eye or nose
drops
dose ad)inistration aids such as co)part)entalised boxes, blister
pac,s or sachets that ha*e been prepared by a )edical practitioner,
registered nurse or phar)acist
nebuliser or spacer
disposable glo*es
paper to+els and tissues
)ortar and pestle
tablet di*ider or pill cutter
+ater 3ug and cup
aprons
)edicine cups
)easuring cups
spoons in the correct )easure)ent.
Acti*ity
2ro) the list abo*e label the (ollo+ing pictures:A

/ro*ide the help re-uired to assist the older person to ta,e their
)edication. #hec, your 3ob guidelines or care notes that tell you +hat you
ha*e to do. 2or exa)ple:
"6erena has arthritis in her hands and cannot open the lids on the 3ars."
SBarry is slightly *isually i)paired and e*en +hen +earing glasses is
not al+ays accurate in reading the )easuring glass."
1ou may need to#
open bottles and re)o*e tablets
)easure the a)ount re-uired
crush or di*ide tablets +here indicated by the phar)acist &see Tip
belo+'
help plug in a nebuliser to a po+er point &re)e)ber you )ust not place
the )edication in the nebuliser'
help the older person to (it a )as,
get the )edicine and open the co)part)entalised box, blister pac, or
sachet that has been prepared by a )edical practitioner, registered
nurse or phar)acist
get )edication (ro) the (ridge and bring to roo) te)perature be(ore
ad)inistering, +hen appropriate
+ar) )edication in hands be(ore using, +hen appropriate
dissol*e )edicine in +ater
ensure that (luids, or so(t (ood li,e 3elly, are a*ailable to )a,e it easier
to ta,e the tablet and assist +ith s+allo+ing.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age $0 o( 282
ip#
6o)e )edications should ne*er be crushed or di*ided, as they )ay be
designed to dissol*e slo+ly in the person"s sto)ach, or the co*ering )ay
protect the person"s )outh and throat (ro) a harsh )edication. 1nly crush
or cut a capsule or tablet +here there is a clear instruction (ro) the health
pro(essional to do so.
6ho+ the older person ho+ to prepare (or their )edication. Gi*e the) tips
to help the). This +ill help the) (eel independent and gi*e the) control
o*er +hat they are doing. 2or exa)ple, you could gi*e the) the (ollo+ing
tips:
#hec, ho+ )uch they ha*e to ta,e on the label or chart.
@old the )easuring glass at eye le*el +hen (illing it.
Ta,e tablets one at a ti)e. 9on"t rush to ta,e the).
9on"t +orry i( you )a,e a )ista,e +hen preparing. 6tay cal). 6tart
again (ro) the beginning i( you need to.
9. E,plain the procedure
Fxplain ho+ they are going to sel(Aad)inister the )edicine. 9e)onstrate
(irst. Fxplain +hy it is being done in this +ay. Fxplain that your 3ob is to
ensure the )edication is ta,en sa(ely. 9iscuss the procedure and address
any li,ely di((iculties. !l+ays chec, the instructions to )a,e sure the
)edication is being gi*en at the right ti)e. Gi*e the) tips. 2or exa)ple:
Tell the) to try not to blin, +hen putting in eye drops.
6ho+ the) ho+ to tilt their head slightly +hen putting in ear drops.
Tell the) to put a cotton +ool ball in the ear to pre*ent the li-uid
dripping out.
Tell the) to ha*e a (a*ourite (ood ready to eat a(ter they ha*e ta,en
the )edicine &i( this is allo+ed'.
6ho+ the) ho+ to put a )as, on so there are no gaps.
In the (ollo+ing exa)ple, the aged care +or,er needs to chec, the label
care(ully to )a,e sure the crea) is being gi*en in the correct conditions.
E,ample
5r.s 9a*idson has 3ust been prescribed a topical corticosteroid crea) (or
contact der)atitis, +hich she has de*eloped on both hands and (orear)s
as +ell as her lo+er legs. The crea) has to be applied onto clean s,in.
Narelle, the aged care +or,er, tells 5r.s 9a*idson that the doctor has
reco))ended that she puts the crea) on a(ter her )orning sho+er
because the s,in +ill absorb the crea) better then.
To get the (ull bene(it (ro) the crea) it is *ery i)portant it is applied
correctly. Narelle tells 5r.s 9a*idson +hat she )ust do:
1. 7ash and dry your hands (irst. &Narelle +ould not need to use glo*es
here as she is only de)onstrating the procedure.'
2. /lace a s)all a)ount o( crea) in the pal) o( your hand &as
)entioned on the label or in the care boo,'. To help 5r.s 9a*idson,
Narelle says, S/ut a dob about the siKe o( a 10 cent piece. It +ill not
help to use any )ore crea) than this."
;. No+ bris,ly rub your hands together so the crea) is spread o*er your
hands.
<. !pply the crea) e*enly. se long stro,es. 2ollo+ the direction o( the
hair on your ar)s. 9o not rub.
8. se only on the a((ected areas.
%. The s,in +ill (eel as i( it has crea) on it, but it +on"t be greasy.
Narelle de)onstrates on hersel( (irst &+ithout using the crea)'. Then she
as,s 5r.s 9a*idson to try. Narelle tells her she is doing *ery +ell as 5r.s
9a*idson puts the crea) on +ith long stro,es.
Acti*ity #
0ead the case study then ans+er the -uestion.
Case study
5rs. 9a*idson had her corticosteroid crea) prescription (illed (or six days
use. 1n the third day Narelle noticed that al)ost threeA-uarters o( the tube
has been used already.
7hat should Narelle do to rein(orce the )ethod o( application so 5r.s
9a*idson re)e)bers ho+ )uch she should useI
John Bailey 2008, 2010, 2011 /age 6e-uence: /age $; o( 282
%.< 'mplement personal hygiene procedures according to organisation
policy and procedure to minimise infection
+ollowing personal hygiene procedures
1ne o( the )ost i)portant re-uire)ents +hen dealing +ith )edication is to
)a,e sure both you and the older person (ollo+ personal hygiene
procedures. It is crucial that you help )aintain a clean, hygienic
en*iron)ent at all ti)es to pre*ent in(ection (ro) spreading. In(ection is a
)edical condition that is caused by )icroAorganis)s such as bacteria and
*iruses. These are tiny particles that cause disease i( they lodge in the
hu)an body and )ultiply.
How cross8infection occurs
Cross8contamination can occur +hen substances interact +ith each
other and create an in(ection. #ross conta)ination is +hen bacteria )o*es
(ro) one place to another and causes an in(ection.
To pre*ent the spread o( in(ection you )ust:
+ash your hands be(ore and a(ter all procedures in*ol*ing direct
contact
co*er +ounds
use clean e-uip)ent (or each application
ensure the older person +ashes their hands
handle and clean conta)inated linen andBor clothing according to
occupational
health and sa(ety guidelines
pre*ent conta)ination o( aids used to apply )edication
+ash e-uip)ent a(ter use
correctly handle and dispose o( sharp instru)ents and bro,en glass
clean and deconta)inate all sur(aces used during application o(
treat)ents
dispose o( conta)inated +aste products appropriately.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age $< o( 282
E,ample
5r. 5c#ulloch has an in(ected +ound. It has been dressed by the district
nurse but the dressing has co)e loose and the +ound is no longer
co*ered. 5r. 5c#ulloch accidentally touches the exposed +ound then
(orgets to +ash his hands. @is tablets )ust be ta,en +ith (ood so he
prepares so)e sand+iches (or +hen the aged care +or,er arri*es to help
hi) +ith his )edication. @e o((ers the aged care +or,er a sand+ich, +hich
she eats.
In this instance there is the potential (or crossAconta)ination.
!n infection can occur +hen the body is in*aded by )icroAorganis)s
&ger)s' that cause disease.
Pre*enting Cross8'nfection
1ne o( the )ost i)portant re-uire)ents +hen dealing +ith )edication is to
)a,e sure both you and the olderAperson (ollo+ personal hygiene
procedures. It is crucial that you help )aintain a clean, hygienic
en*iron)ent at all ti)es to pre*ent in(ection (ro) spreading. In(ection is a
)edical condition that is caused by )icroAorganis)s &ger)s' such as
bacteria and *iruses. These are tiny particles that cause disease i( they
lodge in the hu)an body and )ultiply.
#rossAin(ection occurs +hen a ger) is carried (ro) one person to another
person or people. 2or this to happen, there needs to be a ger) and a
person to carry that ger) to one or )ore people. The ger) can be
trans(erred +hen, (or exa)ple:
T an in(ected person touches another person
T an in(ected person blo+s their nose on a tissue and then helps a
person apply a crea) to their ar)
T an in(ected person coughs or sneeKes and another person
s+allo+s or breathes in the ger)s.
Not all people +ill beco)e in(ected +hen an in(ectious ger) enters their
body. 6o)e people ha*e a strong i))une syste) that (ights the in(ection.
It is your duty o( care to pre*ent crossAin(ection by using standard sa(ety
precautions. !l+ays ,eep in )ind that sic, or aged people do not ha*e a
strong i))une syste) and they )ight be in(ected )uch -uic,er or )ore
easily than a healthy person. !n aged care +or,er can conta)inate an
older person +hile helping the) ta,e their )edication i( they ha*e not
(ollo+ed sa(ety precautions.
7or,places reco))end that you do not go to +or, i( you ha*e an
in(ectious disease that you can spread to others, (or exa)ple (lu,
gastroenteritis or a co))on cold.
Acti*ity
7hat is the si)plest and )ost e((ecti*e +ay o( pre*enting crossAin(ectionI
Gi*e an exa)ple o( ho+ crossAin(ection can occur in the +or,place.
@o+ o(ten should you +ash your hands at +or,I
?ist < in(ectious diseases that can be spread to others &sta((, clients' in the
+or,place.
6hould a +or,place ha*e a policy and procedure on hand+ashingI
Fxplain your ans+er.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age $% o( 282
%.%0 'dentify and implement duty of care procedures in relation to
'dentifying your duty of care
Duty of care is the ter) used to describe the legal obligations e)ployers
and e)ployees ha*e to each other and to those they are caring (or.
@ence, ta,ing reasonable care as your actions )ay a((ect so)eone else.
!s an aged care +or,er, you are in a position +here so)eone else is li,ely
to be a((ected by +hat you do, or do not do, and +here, i( you are not
care(ul, it is reasonably predictable that the other person )ight su((er so)e
har). Dou ha*e a duty to be care(ul, as +hat you do &or do not do' )ight
a((ect your client. Dou there(ore need to:
ensure you understand exactly +hat the support you are pro*iding is
and ho+ it a((ects the client and that the client ,no+s the nature o( the
support and its conse-uences and agrees +ith pro*ision o( the
support.
To be success(ul in a clai) (or negligence &a (ailure to do so)ething that
a reasonable person +ould do under the sa)e set o( circu)stance' a
client )ust sho+:
you o+ed the) duty o( care
that you breached duty o( care
the client experienced actual har) or in3ury
that they, the client, ha*e su((ered so)e loss as a result o( your
actions or o)issions.
9i((iculties arise in practice because it is di((icult to decide +hat is
reasonable in particular cases to a*oid (oreseeable har). I( you ha*e
di((iculties, i))ediately re(er your concerns to your super*isor (or ad*ice.
It is the aged care +or,er"s duty o( care to support an older person to
recei*e their )edication, as prescribed by the doctor and dispensed by the
phar)acist, in a ti)ely, clean and sa(e )anner. Dour responsibilities +ill
be listed in your 3ob description as +ell as the +or,place"s policies and
procedures )anual. Be a+are o( +hat you are expected to do. I( you are
unsure, as, your super*isor.
Duty of care responsi"ilities
@ere is a list o( your responsibilities +hen assisting +ith )edication.
%. #hec, care plans and other docu)entation to ensure you are a+are o(
the older person"s needs and abilities
3. /ro*ide assistance to )eet identi(ied needs
3. !ssist +ith ongoing re*ie+s to ensure identi(ied needs are being )et
4. Fnsure the sa(ety o( older people
John Bailey 2008, 2010, 2011 /age 6e-uence: /age $= o( 282
Chec2 care plans and other documentation to ensure you are aware
of the older personDs needs and a"ilities
Dou need to ,no+ about the older person"s needs in relation to ta,ing their
)edication. These +ill ha*e been assessed by a health pro(essional. Dou
)ay be re-uired to assist +ith )onitoring, reporting and recording an older
person"s ability to ta,e their )edication and the degree o( assistance they
+ill re-uire. Dou need to ,no+ about and )onitor the older person"s ability
to:
s+allo+
,no+ +here they are
,no+ +hat ti)e it is
open a )edication bottle or blister pac,
read and identi(y their tablets
loc, and unloc, their )edication cupboard or container sel(Aad)inister
)edication, (or exa)ple eye drops
co))unicate e((ecti*ely.
Dou should not assist in ad)inistering )edication i( you, a health
pro(essional or another aged care +or,er ha*e (ound that the older person
has a di((iculty +ith any o( the ite)s listed abo*e that has not been
obser*ed in pre*ious assess)ents.
Acti*ity
7hat is duty o( careI
7hat is negligenceI
@o+ do you display duty o( care in the +or,placeI
?ist < duty o( care responsibilities in assisting +ith a personsC )edications.
@o+ do you )aintain your duty o( care +hen )eeting clientsC indi*idual
needsI
John Bailey 2008, 2010, 2011 /age 6e-uence: /age $$ o( 282
2. /repare the client (or assistance
+ith ad)inistration o( )edication
3.%
I)ple)ent all necessary chec,s to ensure the client and their
)edications are correctly identi(ied according to organisation
3.3
#lari(y speci(ic assistance re-uired to address personal needs
o( each client in line +ith organisation procedures listed in the
0ange 6tate)ent and +ithin +or, role responsibilities
3.3
#orrectly identi(y and greet each client and prepare the) (or
)edication
3.4
#hec, client )edications according to the procedures
identi(ied in the organisation guidelines de(ined in the 0ange
6tate)ent
3.5
Fxplain the ad)inistration procedure to the client in line +ith
re-uire)ents and organisation procedures and ensure their
needs are )et
3.9
/rior to gi*ing )edication, obser*e the client to chec, (or any
physical or beha*ioural changes that )ay indicate a need to
report to super*isor or health pro(essional in accordance +ith
organisation policies and procedures
3.:
0ecognise circu)stances +hen appropriate action is to report
obser*ed client health status rather than proceeding +ith
ad)inistration o( )edication and see, ad*ice o( super*isor or
health pro(essional
3.% 'mplement all necessary chec2s to ensure the client and their
medications are correctly identified according to organisation
Preparing an older person to ta2e their medication
Be(ore you can ad)inister the )edication you need to (ollo+ a nu)ber o(
steps to prepare the older person (or )edication. Dour role is to )a,e sure
that the person is co)(ortable and e)otionally ready. There are (i*e things
you need to do:
%. Greet the older person
3. Fncourage participation
3. /ro*ide pri*acy
4. 5a,e the older person co)(ortable
5. 6ee, assistance (ro) other sta(( +hen necessary
%. )reet the older person
!l+ays introduce yoursel( to the older person be(ore going ahead +ith any
procedure.
7ear an identi(ication &I9' badge and al+ays introduce yoursel( by na)e.
Ne*er assu)e that the person ,no+s +ho you are. The older person )ay
ha*e )ore than one aged care +or,er +ho loo,s a(ter the).
Tell the older person +hy you are there and +hat you intend to do. !n
older person +ho does not ,no+ +hat to expect )ight (eel scared and
ob3ect to any (or) o( assistance. They )ay e*en re(use to ta,e their
)edication because they do not trust you or do not understand +hat is
going on. Building trust is an i)portant part o( the relationship bet+een an
aged care +or,er and an older person, especially +hen dealing +ith
)edication. I( the older person trusts you then they +ill ha*e con(idence in
you and rely on you to act in their best interests.
Dou )ight )ention the na)e o( a (a)ily )e)ber or another resident. This
)a,es the) (eel co)(ortable.
@ere are so)e exa)ples o( +ays to greet a person.
E,ample
"Good )orning, 5r. Eendell. 5y na)e is /enelope. @o+ are you
todayI I") here to help you +ith your )edication."
S@ello 5iss #arter. I") #ary. I"ll be loo,ing a(ter you this a(ternoon.
@o+ is your (oot todayI 2irst, I"ll 3ust get your )edication organised."
"Good a(ternoon Brian. It"s Janelle. I sa+ you had your (a)ily *isiting
you this )orning. 9id they )a,e the ca,e you +ere eatingI I") going
to help you +ith your pills no+, so I"ll 3ust get a glass o( +ater."
"@ello 5r.s 6andos. I") >eronica. I +or, +ith 6andra +ho brought your
lunch. I") here to help you +ith your )edication."
3. Encourage participation
Consent )eans gi*ing per)ission (or so)ething or saying you are happy
(or so)ething to happen.
!ged care +or,ers )ust gain the consent o( the older person be(ore going
ahead +ith the )edication. 0e)e)ber that an older person has the right
to choose +hether or not they ta,e their )edication.
It is your role to encourage the older person to ta,e their )edication. 5a,e
sure you tell the person +hat is going to happen and +hat they need to do.
The older person is )ore li,ely to be cooperati*e +hen they understand
+hy they need to ta,e the )edication and ,no+ that you are there to help
the).
6o)eti)es an older person )ight resist ta,ing the )edication. They )ay
si)ply say they don"t +ant to ta,e it. 1thers )ay shout, thro+ things,
*erbally abuse you or use o((ensi*e language. Dour role is to (ind out +hy
they don"t +ant to ta,e the )edication and (ind a +ay to get the) in the
right (ra)e o( )ind to cooperate and agree to ta,ing it. ?isten to +hat they
are saying and explain +hat you are going to do. 6tay cal). 6pea, slo+ly
and reassuringly. 9on"t rush the person or act i)patiently. Eeep your body
language nonAthreatening, that is, don"t (ro+n, sha,e your (inger at the) or
sta)p your (eet. 9on"t )a,e any 3udge)ents. Dou +on"t ,no+ +hy they
don"t +ant to ta,e their )edication until you as, -uestions and (ind out.
Be a+are o( +hy people )ay need encourage)ent to ta,e their
)edication. 1lder people )ay ha*e concerns about the )edication (or a
nu)ber o( reasons, e*en though the doctor )ay ha*e already discussed
this +ith the). 2or exa)ple:
they )ay be concerned about +hat )ight happen +hen they ta,e the
)edication
they )ay +ant to do so)ething their o+n +ay
a change in routine can be unsettling and )a,e the) anxious
they )ay (eel e)barrassed to accept help or (eel bad about their loss
o( independence
they )ay be in pain
there )ay be a lac, o( pri*acy.
!*oid con(rontation and do not persist i( it is )a,ing the situation +orse.
0ecord +hat has happened so your super*isor and the health
pro(essionals can ad*ise +hat to do. Dou )ay ha*e to contact the
super*isor i))ediately i( it is urgent that the person ta,es the )edication
as soon as possible.
Acti*ity
?ist 8 things aged care +or,ers can do to )a,e a person co)(ortable and
ready (or )edications.
7ith the person beside you practice introducing yoursel( to a client.
7hat is a consentI
?ist +ays aged care +or,ers can change an older personsC )ind into
ta,ing )edications.
3. Pro*ide pri*acy
/ri*acy and dignity are *ery i)portant to an older person. 6o)eti)es the
person )ay not +ant you, or anyone else, to be in*ol*ed. This can be a
di((icult situation, especially +hen you ha*e to record that you ha*e seen
the) ta,e their )edication. Dou need to explain to the) that you ha*e
been as,ed by the health pro(essional to record that the )edication has
been co)pleted. It is part o( the policies o( the +or,place that you )ust
(ollo+.
7hile you )ust respect a person"s right to pri*acy, you should be sensiti*e
to the proble) and see ho+ you can +or, around the situation. 2or
exa)ple, i( the person has a *isitor +hen they need to ta,e their
)edication, they )ay not +ant the other person to ,no+ about it or to see
the) ta,e it. Dou )ay need to tell the *isitor to +ait so)e+here else.
Fxplain that you ha*e to tal, to the older person in pri*ate. In this +ay, the
older person +ill still (eel in control.
Dou also need to be a+are o( the )edication you are assisting +ith and
ensure that only the part o( the body that needs crea) or lotion is exposed.
It is i)portant (or older people to retain their dignity.
4. 0a2e the older person comforta"le
Dou need to )a,e sure that the en*iron)ent is co)(ortable (or the older
person be(ore they ta,e their )edication. !n i)portant s,ill (or an aged
care +or,er is to be able to help older people relax or o*erco)e their (ear.
They also need to ,no+ ho+ to help the older person i( they are in pain.
@ere are a (e+ things you can do to help an older person beco)e
physically co)(ortable:
Fnsure the older person is sitting i( they are s+allo+ing )edication. !n
older person )ight cho,e i( they are lying do+n +hen they ha*e to
s+allo+ )edication. !d3ust the older person"s posture or position to
ensure they are sitting se)iAupright &leaning bac, about ;0 degrees' or
a*ailable.
@a*e the area +here the crea) is to be applied (ree (ro) clothes.
5a,e sure the light is su((icient.
+igure # Bed positions

6e)iAupright position pright position
5a,e sure the person is sitting to s+allo+ their )edication.
Acti*ity #
@o+ do you sho+ dignity and pri*acyI
0ole play
?ie on the (loor and put yoursel( in the se)iAupright position and in the
upright position.
Then practice putting so)eone in the se)iAupright position and the upA
right position.
5. See2 assistance from other staff
In so)e instances you )ay need to as, another aged care +or,er to help
you. 2or exa)ple, you )ay need so)eone to help you li(t another person.
Dou )ay need help i( the person decides they don"t +ant to ta,e the
)edication and beco)es physically abusi*e. Dou )ay need to be sure you
are gi*ing )edication to the right person, or in the right +ay. Eno+ the
people you can call on (or help. The (irst person you should consider
as,ing is your super*isor. They can ad*ise you i( you are unsure o(
anything, or need )ore in(or)ation. Dou )ight as, a health pro(essional
(or assistance i( you are unsure about anything to do +ith the route or dose
o( the )edication, or do not understand the instructions they ha*e
pro*ided. Dou )ay as, a (a)ily )e)ber to assist i( you are ha*ing
di((iculty getting the older person to agree to ta,e their )edication. It is
i)portant to be *ery clear in understanding +hat you need to do. It is
i)portant that )edication is gi*en correctly. !l+ays as, (or assistance i(
you need it.
Acti*ity #
?ist 8 things to get an older person co)(ortable and e)otionally ready to
ta,e )edications. Brie(ly explain the i)portance o( each one.

Chec2ing the medication and the identity of the older person
!n aged care +or,er +ho is in*ol*ed in assisting a person to sel(A)edicate
)ust understand their le*el o( authority and (ollo+ the instructions gi*en to
the) by the health pro(essionals. /rocedures )ay di((er bet+een
+or,places. @o+e*er, be(ore allo+ing the person to go ahead and
ad)inister their )edication, the i)portant thing is to chec, and con(ir):
+ho is to recei*e the )edication
+hat )edication is to be gi*en
the a)ount that should be ta,en or applied
+hen it should be ad)inistered
ho+ it should be ad)inistered.
There are 10 steps to ta,e:
%. #hec, the instructions
3. #hec, that the person is the correct one
3. #hec, that the )edication and ad)inistration )ethod is correct
4. #hec, that the )edication is current and in good condition
5. #hec, the a)ount to be ta,en
9. #hec, +hether anything has to be done to the )edication be(ore
being ta,en
:. #hec, the route
;. #hec, +hether there are any +arnings or ad*ice
<. #hec, the ti)e (or ta,ing the )edication is understood
%0. #hec, +hether the person is ta,ing any other )edication
%. Chec2 the instructions
The in(or)ation that tells the aged care +or,er ho+ to help +ith )edication
is gi*en to the) in a nu)ber o( +ays depending on their +or,place and
their 3ob guidelines. 2or exa)ple, you +ill be gi*en a copy o( the person"s
)edical assess)ent (or) or care plan. There )ay be a chart displayed on
the person"s +all that explains the )edication. Instructions +ill be printed
on the dosage ad)inistration aid &9!!' or the )edicine label. Dou +ill be
told +hat to do by your super*isor. In all cases you )ust (ollo+ the
instructions. I( in doubt you )ust i))ediately contact your super*isor.
3. Chec2 that the person is the correct one
The (irst step is to con(ir) that the person you are assisting is the correct
person. I( it is your (irst *isit, as, the) to con(ir) +ho they are. 9oubleA
chec, by loo,ing at their photograph to see that it )atches the one on their
care plan, or loo, at the na)e on the label o( their )edicine. ?oo, (or other
e*idence such as letters addressed to the).
3. Chec2 that the medication and administration method is correct
The next step is to con(ir) the type o( )edication they are to ta,e. This
)ight be capsules, ear drops, eye drops, inhalants, li-uid, gel &a thic,
li-uid li,e 3elly', lotion or crea), nose drops, patches, po+der, tablets or
+a(ers.
The person )ay already ha*e their )edicine ready +hen you arri*e.
1ther+ise as, the) to ta,e it (ro) the cupboard or (ridge. Dou )ay need
to help the) do this. The na)e o( the )edication and the ad)inistration
instructions )ay be printed on a chart. Dou +ill ha*e been gi*en this
in(or)ation (ro) your super*isor. #hec, the person"s na)e on the label or
the 9!!.
4. Chec2 that the medication is current and in good condition
#hec, the expiry date. I( the date has passed, the )edication )ay no
longer be o( bene(it to the person. It could be potentially dangerous (or a
person to ta,e )edication that has passed its useAby date.
!n aged care +or,er should loo, to detect any change in the )edication"s
colour. 2or exa)ple, a change in the colour o( eye drops could )ean that
they ha*e passed the expiry date and +ill no longer be e((ecti*e. It could
also )ean that they ha*e not been stored at the correct te)perature.
9!!s +ill ha*e a description o( the tablets stored in the poc,et. 5edication
instructions )ay tell you +hat colour li-uid )edications are supposed to
be. I( you are unsure, as, your super*isor.
#hec, that the )edication has not separated. 2or exa)ple, crea)s and
e)ulsions are )ade o( oilA and +aterAbased )ixes. The )ixture )ay start
to separate i( it has been stored in a hot place.
7atch +here the person ta,es the )edication (ro). 5edication loses its
e((iciency i( it has been incorrectly stored.
5. Chec2 the amount to "e ta2en
The a)ount o( )edication the person is to ta,e is +ritten on the label. It
)ay also be docu)ented on their care plan or chart, the dosette box or the
pac,age o( the blister pac,. 1*erAtheAcounter )edicines also ha*e
instructions on the container or pac,age. This +ill indicate the nu)ber o(
tablets to be ta,en, the nu)ber o( drops to gi*e and the a)ount o( gel to
apply. 5a,e sure you understand any instructions so you can explain the)
to the older person. 2or exa)ple, a nasal spray )ay say S6pray one pu(("J
a crea) )ay say, "se sparingly". #hec, the person"s supply to )a,e sure
they ha*e su((icient )edication. The (ollo+ing is an exa)ple o( a label on
an ear drop )edication.
E,ample
Instil ; drops in each ear
1nce in )orning, once in a(ternoon
To be applied by tilting head to side, then hold (or 20 seconds to allo+
drops to penetrate
6tore in (ridge
9iscard a(ter ;0 days o( opening
Dou )ust (ollo+ all instructions. Dour role is to rein(orce the instructions o(
the doctor or phar)acist. @o+e*er, i( the older person says they +ant to
use )ore )edication you cannot ta,e a+ay their right to do this. Dou )ust
tell the) again ho+ )uch they should ta,e, )a,e sure they understand
+hat could happen i( they ta,e )ore and then docu)ent ho+ )uch
)edication they actually ad)inister. 2ollo+ the procedures you ha*e been
sho+n, such as contacting your super*isor and telling the), +riting it in the
co))unication boo, or +riting it in the care notes or (eedbac, notes.
9. Chec2 whether anything has to "e done to the medication "efore "eing
ta2en
Instructions are +ritten on the )edication label or care notes about ho+
the )edication is to be gi*en. This o(ten )eans that you )ay ha*e to do
so)ething to the )edication be(ore the person can ta,e it. 2or exa)ple, a
tablet )ay need to be crushed into a po+der, dissol*ed in +ater &such as
berocca or aspirin or dissol*able paraceta)ol' or split in t+o to )a,e it
easier to ta,e. The )edication )ay ha*e to be ta,en +ith (ood or +ith
+ater. ! crea) )ay ha*e to be +ar)ed in your hands be(ore applying, do
not put into a )icro+a*e.
6o)eti)es, the doctor )ay ha*e ad*ised that the instructions )ay be
altered to help the person ta,e the )edicine. 2or exa)ple, they )ay say
that a tablet can be ta,en +ith a (ood li,e 3a), honey, custard or 3elly.
2ollo+ the instructions. 9on"t do anything +ithout (inding out +hether it is
acceptable. 2or exa)ple, a person )ay as, you to crush a tablet.
@o+e*er, so)e )edication should ne*er be crushed as it could cause
)outh ulcers in so)e people, )ight lose its ability to heal or )ay upset the
sto)ach.
I( a person tells you they can"t ta,e the )edication as instructed, you )ust
tell your super*isor and +rite it do+n in the appropriate docu)ent such as
the co))unication boo, andBor clinicalBprogress notes. The in(or)ation
+ill be passed on to the doctor +ho +ill alter the instructions i( necessary.
E,ample
7ame# 5r. Frnie 6treet
D!B# 18B10B1$;8
-oom=Bed# 20 Bed 2
Date and time Progress 7otes
2$B2B200=
0$00hrs
#lient states RIC) ha*ing trouble ta,ing )y tablets as
they are too bigQ. #lient +anted the) bro,en into
s)aller pieces. 9B7 super*isor &!. 5a3ors 0N' and
she ad*ised to put tablets into yoghurt as is and gi*e.
#lient too, tablets +ith no proble)s. A Reese 0eese
&!IN'.
:. Chec2 the route
The label on the )edicine should explains ho+ the )edication is to be
ad)inistered. This )ight be by:
)outh
rubbing into the s,in
drops
applying a patch to the s,in.
E,ample
This is an exa)ple o( a phar)acist label on prescription &script' )edicines:

6o)e )edication )ay be ad)inistered by in3ection or a nebuliser. !ged
care +or,ers must not gi*e in3ections or place )edicine in a nebuliser.
Their role is to obser*e and )a,e sure the )edication instructions ha*e
been co)pleted.
5a,e sure you understand any instructions printed on the label. 2or
exa)ple S!pply directly to a((ected area" )eans that the crea) )ust only
be put on the parts o( the body +here it is needed. S!pply to each nostril"
)eans you ha*e to put drops or spray into both nostrils.
Acti*ity #
2ind out +hat is )eant by the (ollo+ing instructions:
2or external use only
/rescription 5edication
Instil 2 drops into the right eye
2itKroy 2alls #he)ist, 2itKroy 2alls
5s 6heila 5urphy
7aprosyn E7apro,enF 350 mg
80 tablets
a2e % ta"let twice a day with food
9ate dispensedA18B0;B2010 0epeats le(t: 1 #ost: U1%.28
;. Chec2 whether there are any warnings or ad*ice
#on(ir) +hether the )edication instructions gi*e any +arnings or ad*ice
about preparing, ingesting or (ollo+ing up a(ter ta,ing the )edication.
5a,e sure the person understands. Fxa)ples o( instructions or +arnings
are:
6ha,e +ell
5ust be ta,en +ith +ater
se only i( blister seal is intact
9o not ta,e +ith antacids
Eeep a+ay (ro) eyes
9o not apply to open +ounds
9o not do any acti*ity (or a speci(ic ti)e, (or exa)ple do not dri*e (or
t+o hours
9o not ha*e excessi*e exposure to sunlight
5ay cause dro+siness
9o not drin, alcohol +hile ta,ing the )edication
9o not eat (ood (or a speci(ic ti)e, (or exa)ple no (ood (or one hour
a(ter ta,ing the )edication
9o not operate hea*y )achinery or *ehicles
<. Chec2 that the time for ta2ing the medication is understood
#on(ir) the ti)e (or sel(A)edication. The instructions on the label indicate
+hen the )edication should be ta,en. This )ight be:
once a day
+ith (ood
a(ter )eals in the )orning
at hourly inter*als
+hen needed.
6o)eti)es, the instructions only say SThree ti)es daily". sually, the
doctor or phar)acist +ill decide +hen this should be. 1(ten, it is as soon
as they get up in the )orning, be(ore lunch ti)e and be(ore dinner. Eeep
in )ind any other instructions such as Sbe(ore )eals". Dou should )a,e
sure they understand it has to be ta,en be(ore they begin the )edication.
In(or)ation sheets are enclosed in the pac,aging but also the phar)acist
can gi*e +ritten in(or)ation that has the sideAe((ects, contraindications and
reco))ended inta,e o( )edication.
Acti*ity #
Fxplain +hat instructions are on the label abo*e. 7hen do you start the
)edicineI @o+ )any tablets are in the boxI 7hat is the na)e i( the drug
the person is ta,ingI @o+ )uch did the )edication costI 7ho dispensed
the )edicationI
5a,e sure the person understands any abbre*iations on the label. Dou
)ay need to translate these. In )ost cases the )eaning +ill be clear.
@o+e*er, you )ay (ind that so)e instructions are +ritten using initials that
co)e (ro) a ?atin +ord. 2or exa)ple:
+itCroy +alls Chemist6 +itCroy +alls
5s 6heila 5urphy
7aprosyn E7apro,enF 350 mg
80 tablets
a2e % ta"let twice a day with food
9ate dispensedA18B0;B2010 0epeats le(t: 1 #ost: U1%.28
+igure #
A""re*iation 0eaning
-.i.d. (our ti)es a day
b.d. t+ice a day
t.d.s. three ti)es a day
p.r.n. as re-uired or ta,en +hen needed
<B2< e*ery < hours, < hourly
%B2< e*ery % hours, % hourly
stat i))ediately
/1 oral
/FG /ercutaneous enteral gastrosto)y
/> /er *agina
/0 /er rectu)
in3 in3ection
I5 intra)uscular
topical 1n s,in
oral )outh
sublingual nder tongue
NB5 Nil by )outh
N20 Not (or resuscitation
daily 1nce a day at the sa)e ti)e
NGT Naso gastric tube
)ane in the )orning
nocte at night
5edication that is not prescribed to be ta,en at a speci(ic ti)e is ,no+n as
p.r.n. )edication. 5any p.r.n. )edications are (or pain relie( such as
paraceta)ol.
It is i)portant that aged care +or,ers understand the procedures (or these
)edications and (ollo+ the instructions they ha*e been gi*en. They need
to explain these to the older person so the older person understands +hen
they can sa(ely ta,e the).
2or exa)ple, you need to ,no+ ho+ the )edication should be ta,en &+ith
(ood, crushed, not crushed' and the sa(e inter*al bet+een doses the
)ini)u) nu)ber o( hours bet+een )edication such as paraceta)ol it is
reco))ended that no )ore than 8 tablets are ta,en in a 2< hour period.
1lder people ha*e the right to )a,e their o+n decisions about +hen to
ta,e their )edication. @o+e*er, aged care +or,ers ha*e a duty o( care to
see they ta,e their )edication as the doctor has prescribed. Dou )ust let
your super*isor ,no+ i( an older person +ants to ta,e their )edication
)ore (re-uently, as this has the potential to har) the).
Acti*ity #
E,ample
5r. @enry is ta,ing )edication (or pain relie(. The aged care +or,er
explains +hat Sas needed" )eans.
S5r. @enry, you ha*e been prescribed analgesics (or pain. The doctor says
you are to ta,e the) +hen you (eel the pain is *ery bad. I ,no+ the doctor
and phar)acist +ill ha*e explained ho+ to use these pain ,illers, but I
+ould 3ust li,e to con(ir) +ith you that you understand ho+ )any you
should ta,e e*ery day."
SThe prescription says Vno )ore than threeV e*ery 2< hours. This )eans
that you can only ha*e three tablets e*ery day. I( you are (inding your pain
is increasing and +ant to ha*e )ore tablets, you )ust let )e ,no+ and I
+ill arrange (or the super*isor to get in touch +ith your doctor to discuss
this +ith you."
S!l+ays as, (or help i( you do not understand anything."
Fxplain Mas needed" )edication as described in the abo*e exa)ple.
It is use(ul to set up a chart in a pro)inent place to help the person ,no+
+hen to ta,e their )edication. Be sensiti*e about +here you place this
chart. /eople )ay not +ant others to ,no+ +hat )edication they are
ta,ing. !ppropriate places )ay be in their bedroo) or the inside o( a
pantry door.
E,ample
Chart on a personDs wall
Prescription for# )a*in Henry
0edicine Dosage 7um"er of ta"lets=ime of medicine Doctor
0orning 7oon E*ening Bed
!ntibiotic 280)g 1 1 1 B Bailey
#ough
5ixture
18)l A A A 1 B Bailey
!nalgesic 1g 2 tablet +hen needed, )axi)u) % per
day
B Bailey
7hat does )g )ean (ro) abo*e exa)pleI
7hat does )l )eanI
7hat does g )eanI
2ro) the nu)ber o( tabletsBti)e o( )edicine, ho+ )any )illigra)s are in
one analgesic tabletI
Acti*ity
?ist the 10 steps to chec, )edications.
OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO
I( a client is re-uesting pain relie( that is a /0N order +hat do you need to
doI
%0.Chec2 whether the person is ta2ing any other medication
Be(ore you help +ith the )edication, al+ays as, the person +hether they
ha*e ta,en any other )edication that is not listed on their care plan or in
their )edication chart. 2or exa)ple, they )ay ha*e bought o*erAtheA
counter )edicines li,e *ita)ins, paraceta)ol or a soothing crea). Dou
)ay notice o*erAtheAcounter )edicines, or )edicines prescribed by other
people, in the person"s bathroo) or on their ,itchen bench.
!*er8the8counter )edicines can be bought at a phar)acy or a
super)ar,et. They do not need a prescription (ro) a doctor. They )ay not
be sa(e to use +ith other )edicines the doctor prescribes
Dou should con(ir) +ith the older person +hether they are ta,ing any nonA
prescribed )edication li,e *ita)ins, herbal )edicine, tonics or pain relie(
tablets. These )ay react +ith the prescribed )edication. 0e)e)ber that
your 3ob is si)ply to record the )edicine that has been ta,en. Dou )ust
not o((er ad*ice or tell the person they )ust not ta,e it. @o+e*er, you )ust
let other health pro(essionals +ho are in*ol*ed +ith the older person ,no+
+hat they are ta,ing. Dou need to contact your super*isor i))ediately and
docu)ent in the clinicalBprogress notes i( so)eone has decided to ta,e an
o*erAtheAcounter )edicine +hen the care plan states they )ust not.
Acti*ity
7hat is the di((erence bet+een prescription and nonAprescription
)edicationsI
7hat do the (ollo+ing abbre*iations )ean:A
a. /0N:AOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO
b. B9:AOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO
c. /0:AOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO
d. In3:AOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO
e. 5ane:AOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO
7rite the abbre*iations (or the (ollo+ing:A
a. Three ti)es a day:AOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO
b. !t night:AOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO
c. Intra)uscular:AOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO
d. /er *aginal:AOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO
e. F*ery % hours:AOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO

3.3 Clarify specific assistance re?uired to address personal needs of
each client in line with organisation procedures listed in the -ange
Statement and within wor2 role responsi"ilities
5atching the older person as they ta2e their medication
! )a3or responsibility o( an aged care +or,er is to )a,e sure the older
person recei*es the (ull bene(it (ro) their )edication. It is i)portant that
you +atch and super*ise the older person as they ta,e their )edication so
you can be sure all the instructions ha*e been (ollo+ed.
To do this, you )ust )a,e sure the )edication has been ingested
&s+allo+edBta,en into the body' and co)pleted &correct a)ount o(
)edication gi*en and the process (inished'.
2or exa)ple, you need to )a,e sure:
all the tablets ha*e been dissol*ed and s+allo+ed
all the reco))ended )edicine in the box or sachet has been used
all the drops ha*e been ta,en
the correct a)ount o( lotion has been applied.
I( the )edication is not been ingested or co)pleted it +ill not be (ully
e((ecti*e. In so)e cases this )ay be har)(ul to the older person.
The older person )ay hide the )edication or thro+ it a+ay i( they don"t li,e
the taste or i( it is di((icult to s+allo+. 2or exa)ple, you )ay (ind tablets
+rapped in a tissue stu((ed behind a cushion, or traces o( tablet in the sin,
+here they tried to +ash the) a+ay. The person )ay si)ply decide not to
ta,e it. They )ay decide they no longer need to ta,e it. They )ay spit it
out or *o)it it straight bac,. They )ay ha*e )outh proble)s that cause
pain +hen anything is put in the )outh. They )ay not put enough lotion on
the a((ected area.
6uper*ision does not )ean (orcing the older person to ta,e the
)edication. Dou need to ta,e all the steps possible to assist the) in the
)ost e((ecti*e +ay. 6uper*ision can include:
re)inding the person +hat to ta,e
re)inding the person +hy they are ta,ing the )edication
placing the )edication +ithin easy reach or lea*ing it out in a handy
place
obser*ing the person ta,ing the )edication
pro*iding help +hen needed or as,ed (or and +ithin authorised
procedures, li,e cutting the tablet in t+o
encouraging and gi*ing the older person con(idence to )aintain their
independence.
a. 5hat you are e,pected to do when assisting with medication
!n aged care +or,er helps super*ise and )onitor an older person ta,ing
their )edication in the (or) o( tablets, crea)s or li-uids. It is part o( your
responsibilities to )a,e sure the correct person is ta,ing the prescribed
)edication in the correct +ay at the right ti)e.
+igure #
@ere is a list o( 12 responsibilities that are part o( an aged care +or,er"s
role.
-esponsi"ilities E,planation
1. 2ollo+ all instructions gi*en by the
health pro(essional in the older
person"s care plan or care notes.
5a,e sure you understand +hat is +ritten in the
care plan or on the )edication. The in(or)ation
+ill tell you ho+ o(ten each )edication is to be
gi*en and ho+ )uch to gi*e.
2. nloc, the )edication cupboard, i(
per)itted to do so. 6ign (or )edication
(ro) the cupboard i( appropriate.
! nurse +ill generally ha*e this responsibility.
!n aged care +or,er can do this i( a nurse is not
present at the ti)e. Dou )ay need to sign (or the
)edication. In this +ay, aged care (acilities can
,eep trac, o( +hat has been ta,en, +ho too, it
and +hen it +as ta,en.Dour super*isor )ay gi*e
you a ,ey to the )edicine cabinet.
;. Identi(y yoursel(. Dou need to build trust and good co))unication
bet+een yoursel( and the older person.
<. Identi(y the older person. Dou need to ,no+ that you are gi*ing the
)edication to the right person.
8. 5a,e sure the )edication is being
ta,en at the right ti)e.
#hec, the instructions about +hen the
)edication is to be ta,en.
%. /repare the older person (or ta,ing
the )edication. @a*e any )edication
e-uip)ent ready.
5a,e the older person co)(ortable.
nscre+ the lid o( the )edicine bottle. 5a,e sure
the older person"s glasses are handy.
-esponsi"ilities E,planation
=. @elp set out the correct )edication. Dou need to ,no+ that the dosage is correct.
Get the correct nu)ber o( tablets (ro) the dose
ad)inistration aid, +atch the) pour the correct
dosage or s-ueeKe the right a)ount o( lotion.
8. 6ho+ the older person +hat to do. 9e)onstrate ho+ they are to ta,e the
)edication.
$. 7atch the older person ta,e the
)edication.
5a,e sure the older person ta,es all the
)edication. 1bser*e i( they ha*e any di((iculty,
such as proble)s +ith s+allo+ing.
10. 1bser*e any changes in the
person"s condition a(ter they ha*e
ta,en the )edication and bet+een
*isits. 9ocu)ent +hat has happened.
7rite any changes or reactions in your care
notes. 0eport any changes to your super*isor.
11. 2ollo+ all occupational health and
sa(ety guidelines to pre*ent the spread
o( in(ection and )aintain a clean and
hygienic en*iron)ent.
7ash hands be(ore helping to ad)inister the
)edication.
7ear glo*es +hen appropriate. 9ispose o( +aste
products correctly.
6tore the )edicine appropriately.
12. 0ecord e*erything that has
happened +ith the ad)inistration o(
the )edication A the )edicine they
too, or did not ta,e, their condition and
any reactions they ha*e.
F*eryone in*ol*ed in the care o( the older person
)ust ,no+ +hat care has been gi*en.
Acti*ity #
?ist the 12 responsibilities o( an aged care +or,ers role +hen assisting
+ith )edications.
?ist % +ays to assist a client to ta,e their )edications.
?ist ; things clients )ight do +ith their )edications instead o( ingesting
the).
7hat do you do i( you (ind )edications on the (loorI
". 5hat you must not do
1ne o( the roles o( an aged care +or,er is to distribute and ad)inister
prescribed )edications under strict super*ision in a residential care (acility.
Dou need to understand the li)itations o( this role and your le*el o(
authority. ! )ista,e +ith )edication can ha*e serious conse-uences,
including death.
@ere is a list o( things you should not do:
!n aged care +or,er is not authorised to )a,e any decisions about the
)edication, o((er )edical ad*ice or change the )edication in any +ay,
e*en i( the older person has a reaction to the )edicine or they as, you
to gi*e the) )ore.
nder no circu)stances is an aged care +or,er allo+ed to gi*e an
in3ection. This )ust al+ays be carried out by a registered nurse or
doctor.
!ged care +or,ers should not carry out any in*asi*e procedures, (or
exa)ple inserting rectal or *aginal )edication.
!n aged care +or,er )ust not (orce an older person to ta,e their
)edicine.
!n aged care +or,er )ust not +ithhold &re(use to gi*e' an older person
their )edicine.
!n aged care +or,er )ust not assist an older person to ad)inister the
+rong )edicine.
Dou can help the older person to sel(A)edicate but you )ust not
ad)inister the )edicine yoursel(. It is against the la+ (or aged care
+or,ers to ad)inister )edication. Be a+are that )any older people
need to (eel they ha*e control o*er their li*es. 7hen they ad)inister
their o+n )edicine they ,eep their independence and retain their sel(A
estee) and dignity.
c. 5ho you must report to
Dour super*isor is the person +ho is directly responsible (or you and the
+or, you do. They gi*e you your instructions. They )ay delegate certain
(unctions to you, such as handing out )edication or changing dressings, i(
you ha*e been trained and are co)petent to per(or) the tas,. Dour
super*isor +ill )a,e the decision about +hether to call a nurse, doctor or
an a)bulance i( you ha*e contacted the) +hen you are concerned about
an older person"s condition. 0e)e)ber, you )ust co)ply +ith
organiKational policies and procedures.
It is your responsibility to tal, to your super*isor i( you are unsure about
anything or ha*e any concerns. Tell the) i( you do not (eel sa(e and
co)petent in per(or)ing a tas, delegated to you. !s, (or (urther support
and training.
!l+ays re)e)ber:
I( you are not sure +hat to do, don"t do it.
!s, (or assistance (ro) the senior colleague andBor super*isor
0ead the appropriate docu)entation.
d. How to record what you ha*e done
Dou are legally re-uired to docu)ent and report all your obser*ations
about the older person, such as the )edicine they too, or did not ta,e,
their condition and any reactions they ha*e. Dou )ay be re-uired to
co)plete care notes or an incident report. 9i((erent organisations +ill use
di((erent types o( docu)ents, so )a,e sure you are (a)iliar +ith the (or)s
you are expected to co)plete.
Acti*ity
7here +ould you locate in(or)ation about regarding the personal needs o(
clientsCI
?ist ; things that are not in an aged care +or,ers role responsibilities.
7hy is docu)entation i)portantI
3.3 Correctly identify and greet each client and prepare them for
medication
+ollowing procedures to identify the older person
1ne o( the (irst steps in ad)inistering )edication, or helping a person to
sel(Aad)inister their )edication, is to con(ir) that the person you are
assisting is the correct person. Dou )ust (ollo+ procedures (or identi(ying
the older person you are helping, e*en i( you ,no+ the older person +ell
and thin, it is a +aste o( ti)e.
Ne*er gi*e the )edication i( an older person (ails to identi(y the)sel*es
correctly. It is a serious )ista,e to help an older person +ith their
)edication i( you are not sure they are the correct person. Dou )ight
cause death or a serious in3ury to the person. 0eport to your super*isor
that you ha*e been unable to identi(y the person. 9o this i))ediately,
because it )ay be essential that the older person recei*es )edication at
that ti)e.
Dour +or,place should ha*e clear directions to (ollo+ (or identi(ying the
older person. 6teps to identi(y an older person There are (our steps you
should (ollo+:
%. !s, the older person to identi(y the)sel*es
3. ?oo, at a photograph
3. ?oo, at the older person"s details
4. #on(ir) the identity +ith another sta(( )e)ber
!ged care +or,ers )ust as, the older person to identi(y the)sel*es.
Gi*e the older person the opportunity to identi(y the)sel*es. 2or exa)ple,
a(ter introducing yoursel(, you could say, SI") loo,ing (or Ina 0obertson."
This o((ers the person the opportunity to identi(y the)sel*es. 5a,e sure
you include the surna)e because there )ay be t+o or )ore people +ith
the sa)e (irst na)e.
Be care(ul during this process. !lthough you )ight thin, that older people
can identi(y the)sel*es, they could be con(used, they )ight ha*e a
hearing de(icit or they )ay be unable to spea, Fnglish +ell. These people
)ay respond +ith an inappropriate ans+er +hen as,ed to identi(y
the)sel*es.
2or exa)ple, i( you say S!re you 5r.s 0obertsonI", the older person )ight
nod to agree or 3ust say yes. 6he )ay not ha*e heard you or she )ight
ha*e de)entia and is not able to identi(y hersel(. 6he )ay ha*e said yes
because she thought that"s +hat you +anted her to say.
E,ample
M@ello, )y na)e is Eatrina, and you are...I" &9o not as, S!re you 5r.s
6)ithI"'
S#ould you please identi(y yoursel( be(ore I help you +ith your
)edication."
Preparing a person for medications
/repare any e-uip)ent re-uired.
Introduce yoursel(.
?oo, at the care plan to see pre(erences o( ta,ing )edications.
5a,e sure the person is co)(ortable by sitting the) in a se)iAupright
position or upright position or sitting out o( bed and in a chair.
Tell the client +hat you are doing and +hy they need the )edication.
#on(ir) the type o( )edication they are ta,ing such as capsules, ear
drops, inhalants, li-uid, lotionBcrea), nose drops, patches, po+der,
tablets or +a(ers.
?oo, at )edication chart as it gi*es the na)e o( the )edications,
ad)inistration instructions, route, ti)e, a)ount and (re-uency o( the
)edication.
I( using a 9!! &dose ad)inistration aid' chec, that the label has the
personCs na)e on it.
#hec, the )edication expiry date.
9onCt rush the person to ta,e their )edications.
Fnsure they ha*e a drin, ready to assist +ith s+allo+ing )edications
as i( le(t in the )outh too long they can lea*e a disgusting taste in their
)outh.
Build trust +ith the client.
Fncourage the older person.
5a,e sure there is su((icient light to read the label.
5a,e sure their reading glasses are nearby or they ha*e a )agni(ying
glass to help the).
Fnsure the person is sitting i( they are s+allo+ing )edication &an older
person should ne*er be lying do+n +hen they ha*e to s+allo+
)edication'.
!d3ust the older person"s posture or position to ensure they are sitting
a*ailable.
@a*e the area +here crea) is to be applied (ree (ro) clothes.
Acti*ity
@o+ +ould you correctly identi(y a clientI
?ist 8 +ays aged care +or,ers need to prepare to gi*e )edications.
?ist 8 +ays aged care +or,ers can prepare clients (or )edications.
3.4 Chec2 client medications according to the procedures identified in
the organisation guidelines defined in the -ange Statement
Chec2ing medications
5edication is prepared and pac,aged by the phar)acist in a *ariety o(
+ays. 2or exa)ple, they )ay be gi*en to the older person in their original
container such as a pac,et or bottle. @o+e*er, to help the person ,no+
ho+ )uch to ta,e, the )edication is o(ten pac,aged in prescribed
a)ounts. The pills are organised into co)part)ents (or each day and (or
the ti)e they are to be ta,en. This type o( pac,aging is re(erred to as a
dose ad)inistration aid &9!!'. It is a sa(e and easy +ay to ad)inister
)edication.
Note that the (ollo+ing )edication should not be pac,ed in a dose
ad)inistration aid:
p.r.n. )edication &)edication that is gi*en to the older person to ta,e
+hen they (eel they need it'
5edications sensiti*e to heat that could be a((ected i( heat sealing is
used
The dose ad)inistration aid used depends on the dispensing phar)acy,
the re-uire)ents o( the older person and the re-uire)ents o( the
organisation. 1lder people )ight experience di((iculty in ta,ing their
)edication (ro) a speci(ic type o( aid and should be assessed and o((ered
the )ost appropriate aid a*ailable. The regulations and legislation related
to the use o( dose ad)inistration aids )ay di((er in *arious states and
territories. It is the phar)acist +ho is responsible and accountable (or the
pac,aging o( )edications but you still need to chec, the) as there still
)ay be errors.
Dose administration aids
1nly a health pro(essional can ad)inister )edication (ro) the original
pac,aging. !ged care +or,ers cannot ad)inister )edication (ro) bottles
or pac,s, only (ro) the dose ad)inistration aid.
Dou should be (a)iliar +ith the di((erent types o( 9!!s. These include:
a. #o)part)entalised boxes
". Blister &or bubble' pac,s
c. 6achets
a. Compartmentalised "o,es
! dosette "o, is a co))on +ay o( pac,aging pills to organise people"s
)edication. The re(illable plastic box is di*ided into co)part)ents. The
days o( the +ee, and ti)es to ta,e the pills are printed at the top o( the
box. 5edicines (or each day are placed in the box. It is easy to see +hat
pill to ta,e and +hen to ta,e it. !ll the older person has to do is ta,e out
the )edicine (or the correct day. They do not ha*e to re)e)ber ho+ )any
pills to ta,e. This has already been done (or the). ! plastic sliding lid
co*ers all the tablets. The older person"s na)e and photo is usually placed
on the box. 5any ser*ices pre(er not to use dosette boxes no+, as they
are easy to accidentally open, and )edication )ay beco)e )ixed up or
lost.

". Blister Eor "u""leF pac2s
! blister pac, is si)ilar to a dosette box. It is a container +here all the
tablets that need to be ta,en at a certain ti)e o( day are sealed together
into a section o( the pac, &a poc,et or bubble'. The bac, o( each bubble
lists the date and ti)e they are to be ta,en. There is also a description o(
the tablets that should be in each bubble. The containers are prepared by
a phar)acist. 7hen it is ti)e to ta,e the )edication, the tablets are si)ply
pushed through the (oil bac,ing o( the pac, into a )edicine cup or the
older person"s hand, ready to be ta,en. It is i))ediately ob*ious i( a pac,
has been ta)pered +ith because the (oil +ill be bro,en. Blister pac,s are
not reAusable.

c. Sachets
6ingleAdose sachets are prepared by a )edical practitioner, registered
nurse or phar)acist. They usually contain po+ders in the correct a)ount
(or a single dose.

John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1;0 o( 282
Acti*ity #
@a*e a loo, at t+o types o( dose ad)inistration aids. In your o+n +ords,
+rite a brie( description, ho+ the pills are organised and labelled (or the
older person.
0a2ing sure the older person recei*es the right medication
It is i)portant thing to chec, and con(ir) that a person"s )edication is
correct be(ore helping to ad)inister it. Generally, the phar)acist )a,es up
the doctor"s prescription and deli*ers it to the aged care (acility. The
+or,place +ill ha*e clear, docu)ented guidelines about ho+ to chec, that
the )edication is correct +hen it arri*es (ro) the phar)acy and be(ore it is
gi*en to the older person. /rocedures )ay di((er bet+een +or,places.
2or exa)ple, the )edication )ay ha*e been ta,en (ro) a loc,ed cabinet
by your super*isor, and it )ay be your responsibility to collect the
)edication. Dou )ay ha*e )edication (or a nu)ber o( di((erent people on
a trolley. ! nu)ber o( di((erent people )ay ta,e the sa)e types o(
)edication. There are )any situations in +hich you +ill need to chec, and
reAchec, that the right person is getting the right )edication.
F*en though the )edication +ill ha*e been chec,ed by the phar)acist and
then by a -uali(ied person at the (acility, the aged care +or,er )ust still
chec, )edication be(ore the older person ta,es it.
There are (our things you need to chec,:
%. #on(ir) +hat the )edication is
3. 5a,e sure the )edication )atches the docu)entation
3. #hec, the )edication is not da)aged, conta)inated or expired
4. #hec, the dose ad)inistration aids are intact
%. Confirm what the medication is
#on(ir) the type o( )edication the older person is to ta,e. This )ight be
capsules, ear drops, eye drops, inhalants, li-uid, lotion or crea), nose
drops, patches, po+der, tablets or +a(ers. The )edication )ay include
)edicines that are prescribed by a doctor as +ell as nonAprescribed
)edicines that can be bought o*er the counter, (or exa)ple cough
)ixtures, pain,illers and antihista)ines. 5edication could also include
co)ple)entary treat)ent such as herbal )edicines, ho)eopathic
)edicines, health (ood supple)ents and nutritional supple)ents.
3. 0a2e sure the medication matches the documentation
Dou need to be sure that the )edication to be gi*en )atches +hat is
+ritten on any docu)entation that is supplied. #hec, the instructions that
ha*e been gi*en to the older person. The na)e o( the )edication and the
ad)inistration instructions +ill be printed on the label o( the )edication or
on the older person"s )edication care chart. Dou +ill ha*e been gi*en this
in(or)ation (ro) your super*isor.
0e)e)ber to chec, the older person"s na)e on the label o( the dose
ad)inistration aid.
Chec2 the la"el
The label )ust be legible and printed in clear +riting. It should clearly
indicate the (ollo+ing:
The na)e o( the older person
The na)e o( the )edication
The strength
The dose to be ta,en
The route
The ti)es at +hich it should be ta,en
#hec, (or any special considerations. 2or exa)ple, there )ay be +arnings
or ad*ice such as S6ha,e +ell", S5ust be ta,en +ith (ood", MEeep a+ay (ro)
eyes", or M6tore in the (ridgeQ.
E,ample
5r. John 9eath
Amo,il EAmo,icillinF 500mg
To be ta,en orally.
a2e one capsule 3 times a day6 with meals until all capsules
completed.
5arning# Do not open6 crush or "rea2 capsule.
9ate:A 1=B0;B200$
Acti*ity #
7hat is the +arning (ro) the exa)pleI 7hy is this +arning thereI
Chec2 the dose administration aid
The dose ad)inistration aid )ay ha*e the person"s photograph as +ell as
their na)e, the )edication and +hen it should be ta,en and any allergies a
person has. Allergies are sensiti*ities or physical reactions such as
rashes, *o)iting, s+elling or di((iculty breathing due to contact +ith
substances that are usually har)less. 6o)e allergies can be i))ediately
li(eAthreatening.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1;; o( 282
E,ample
Prescription for# 6te*en /earson Date of "irth# ;B8B2$
Date# /rescribed 2; !ugust 200= Allergies# NE!
0edicine Dose Description 0orning 7oon E*ening Bed Doctor
!nalgesic
/araceta)ol
1000)g 2 )ediu)A
siKe round
+hite tablets
1 A A 1
? Bosco
? Bosco
!ntiA
e)etic
5axolon
10)g 1 s)all
+hite
round
tablets
+ith
5axolon
on one
side and a
brea, line
on the
other

1 1 A 1
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1;< o( 282
Chec2 the care instructions
5a,e sure that the )edication you ha*e 3ust chec,ed )atches the
in(or)ation on the older person"s )edication chart, clinicalBprogress notes
andBor care plan. #hec, the person"s photograph, na)e, the )edication
and the ti)e it )ust be gi*en. #hec, the strength, dose and route. #hec, i(
the person has any allergies listed on their care plan.
Acti*ity #
In the exa)ple belo+, co)plete the )issing parts in the )edication chart.
ip
#hec, the docu)entation (our ti)es:
%. 7hen (irst pic,ing up the )edication container
3. #hec,ing the label against the )edication chart or list
3. 7hen )edication is re)o*ed (ro) the container
4. Be(ore the older person ta,es it
Chec2 the medication is not damaged6 contaminated or e,pired
It is i)portant to chec, that the )edication is not da)aged, conta)inated
&so)ething that does not belong but has been introduced into the
)edicine' or expired &passed its useAby date'. 5edicine that is da)aged,
conta)inated or expired is unsuitable to use and )ust not be
ad)inistered.
5edicine is unsuitable to use i( so)ething has happened that )ight )a,e
it di((erent to +hat +as prescribed. 2or exa)ple, i( it is stored at the +rong
te)perature, the )edicine )ight be da)aged by che)ical changes. I( the
lid is le(t o(( (or too long, bacteria )ight conta)inate the )edicine. I( the
expiry date has passed, the )edicine )ay ha*e deteriorated in -uality or
undergone other che)ical changes. !ny o( these changes )ight )a,e the
)edicine ine((ecti*e or dangerous.
#hec, the expiry date. I( the date has passed, the )edication )ay no
longer be a bene(it to the person. It could be potentially dangerous (or a
person to ta,e )edication that has passed its useAby date. It )ay )ean
the )edication is sent bac, to the phar)acy chec, +ith your super*isor
and organiKational policies and procedures.
!n aged care +or,er should loo, to detect any change in the )edication"s
colour. 2or exa)ple, a change in the colour o( eye drops could )ean that
they ha*e passed the expiry date and +ill no longer be e((ecti*e. It could
also )ean that they ha*e not been stored at the correct te)perature.
5edication loses its e((iciency i( it has been incorrectly stored. There )ay
be a description o( the )edication ,ept +ith dose ad)inistration aids.
5edication instructions )ay tell you +hat colour li-uid )edications are
supposed to be. I( you are unsure, as, your super*isor.
#hec, that the )edication has not separated. 2or exa)ple, crea)s and
e)ulsions are )ade o( oilA and +aterAbased )ixes. The )ixture )ay start
to separate i( it has been stored in a hot place.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1;% o( 282
Chec2 the dose administration aids are intact
Dou )ust chec, the pac,aging *ery care(ully. 5ost )edications ha*e a
+arning telling people not to use it i( the pac,aging is bro,en. I)portant
points to consider +hen chec,ing the pac,aging include:
#hec, that the pac,aging is sealed properly to pre*ent conta)ination.
9o not allo+ an older person to ta,e any )edication not pac,ed in its
original pac,aging or in a dose ad)inistration aid as dispensed by the
phar)acist.
9o not gi*e )edication dispensed by anyone other than the
phar)acist."
#hec, the na)e and photo on the dose ad)inistration aid.
#hec, the expiry dates.
#hec, that )edication is correctly re)o*ed (ro) the pac,aging i( the
older person sel(A)edicates.
#hec, that the dose (or the pre*ious shi(t is re)o*ed &ta,en'.
#hec, the current and (uture doses are still in the container.
I( anything is unclear, inco)plete, inappropriate or unreasonable it )ust be
reported to the super*isor or health pro(essional +ithout delay. !ccording
to speci(ic organisation, state or territory guidelines, so)e )edication, (or
exa)ple 6chedule 8 &68' drugs, )ust be chec,ed +ith another person.
6chedule 8 drugs are drugs that are either dangerous or addicti*e, such as
/ethidine, 5orphine or >aliu). They need to be doubleAchec,ed by health
pro(essionals because o( the da)age that could be done i( they +ere
ad)inistered inappropriately. There should be t+o health pro(essionals
present +hen these drugs are unloc,ed, prepared, countered,
signedBcountersigned and ad)inistered because these drugs are )ore
li,ely to be )isused or stolen.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1;= o( 282
Acti*ity # -esearch
0esearch the )a3or 6chedule drugs, description and 2 exa)ples o(
)edications in each group. /ut ans+ers in the table belo+.
Classification=
Schedule
Description E,ample
Classification=
Schedule
Description E,ample
?ist < things to chec, be(ore gi*ing )edications and brie(ly explain each
one.
Is it necessary to (ollo+ organiKational policies and procedures +hen
chec,ing client )edicationsI Fxplain your ans+er.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1;$ o( 282
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1<0 o( 282
3.5 E,plain the administration procedure to the client in line with
re?uirements and organisation procedures and ensure their needs are
met
he aged care wor2erDs role
!ged care +or,ers need to be a+are o( your le*el o( authority. The
responsibilities an aged care +or,er +ill ha*e in assisting +ith )edication
are -uite li)ited. Dou )ust be a+are o( the things you are and are not
allo+ed to do in assisting older people +ith )edication. Dou )ust only do
+hat you ha*e been trained and instructed to do. Dou )ust not do
anything you are unsure about. !s, your super*isor i( you are not sure.
!n aged care +or,er )ust:
ne*er gi*en an in3ection or place )edication in a nebuliser.
ne*er initiate any treat)entJ this is the tas, o( the doctor or, in so)e
cases, the registered nurse.
only assist the older person to re)o*e tablets (ro) the dose
ad)inistration aid +hen it is pac,ed by a phar)acist. The aged care
+or,er )ust be assessed as co)petent be(ore assisting an older
person to re)o*e )edication (ro) this aid.
I( the older person says they +ant to use )ore )edication you cannot ta,e
a+ay their right to do this. Dou )ust tell the) again ho+ )uch they should
ta,e, )a,e sure they understand +hat could happen i( they ta,e )ore and
then docu)ent ho+ )uch )edication they actually ad)inister. 2ollo+ the
procedures you ha*e been sho+n, such as contacting your super*isor and
telling the), +riting it in the co))unication boo, or +riting it in the
careBprogress notes or (eedbac, notes.
Assisting with 0edication
/ro*ide the help re-uired to assist the older person ta,e their )edication.
#hec, your 3ob description, organiKational policies and procedures,
)edication chart or careBprogress notes that tell you +hat you ha*e to do.
In so)e cases, the careBclinical notes and care plans +ill say ho+ you )ay
ha*e to pro*ide additional assistance. 2or exa)ple:
Bertha has arthritis in her hands and cannot open the lids on the 3ars.
Fd+ard is slightly *isually i)paired and e*en +hen +earing glasses is
not al+ays accurate in reading the )easuring glass.
1ther things you )ay need to do:
open bottles and re)o*e tablets
)easure the a)ount re-uired
crush or di*ide tablets +here indicated by the phar)acist &see Tip
belo+'
help plug in a nebuliser to a po+er point &re)e)ber, you )ust not
place the )edication in the nebuliser'
help the older person to (it a )as,
get the )edicine and open the co)part)entalised box, blister pac, or
sachet that has been prepared by a phar)acist
get )edication (ro) a (ridge and bring it to roo) te)perature be(ore
ad)inistering, +hen appropriate
+ar) )edication in hands be(ore using, +hen appropriate dissol*e
)edicine in +ater
ensure that (luids, or so(t (ood li,e 3elly, are a*ailable to )a,e it easier
to ta,e the tablet and assist +ith s+allo+ing
I( an older person is sel(A)edicating, sho+ the) ho+ to prepare (or their
)edication. Gi*e the) tips to help the). This +ill help the) (eel
independent and gi*e the) control o*er +hat they are doing. 2or exa)ple,
sho+ the person ho+ to:
chec, ho+ )uch they ha*e to ta,e on the label or chart
hold the )easuring glass at eye le*el +hen (illing it
ta,e tablets one at a ti)e P don"t rush to ta,e the).
9on"t +orry i( you )a,e a )ista,e +hen preparing. 6tay cal). 6tart again
(ro) the beginning i( you are able to. In(or) your super*isor i( you are
unable to pro*ide )edication to the person due to a preparation )ista,e.
0e)e)ber, i( you )a,e a )ista,e during preparation you )ay not be able
to gi*e it to the older person and noti(y your super*isor (or ad*ice about
+hat to do next.
Dou +ill be as,ed to assist in helping an older person +ith the (ollo+ing
)edication:
a. tablets
". li-uid )edicines
c. topical )edication
d. eye treat)ents
e. ear drops
f. patches
g. p.r.n. )edication
@ere are so)e tips and techni-ues. 1bser*e +hat experienced aged care
+or,ers do. !s, your super*isor to explain anything you don"t understand.
aF a"lets
7here possible older people should be in an upright or se)iAupright
position +hen ta,ing oral )edication &ta,en *ia the )outh'
The (ollo+ing procedures should be (ollo+ed (or oral )edication:
0e)o*e the tablet (ro) its pac,aging into a )edicine cup
and hand to the older person +ith a glass o( +ater.
I( the older person can"t hold a cup, use the cup to introduce one tablet
at a ti)e into the older person"s )outh.
!lternati*ely, the tablet can be placed on a spoon at the bac, o( the
tongue to sti)ulate the s+allo+ing re(lex.
Tipping the head slightly (or+ard +ill also help +ith s+allo+ing.
!llo+ su((icient ti)e (or the older person to s+allo+ the tablet.
6olid )edication should be gi*en +ith su((icient +ater to pre*ent
irritating the throat, oesophagus and sto)ach.
6o)e tablets )ay be )ixed +ith s)all a)ounts o( custard or 3a) to
disguise the taste. Dou need to ha*e per)ission to do this.
9o not place tablets in (ood, because the older person )ight not (inish
their )eal.
1lder people )ay ha*e di((iculty s+allo+ing so)e )edications. #hec,
+hether you can alter the )edication to )a,e it easier (or the) to ingest
the )edication. 2or exa)ple, opening capsules and di*iding or crushing
tablets )ay assist the older person in s+allo+ing the )edication. @o+e*er,
re)e)ber that so)e (or)ulas should not be altered because:
it can reduce the e((ecti*eness o( the )edication
it can degrade the )edication +hen it is exposed to light
it can cause the )edication to be released at the +rong ti)e &called
pre)ature absorption'
it )ight result in a bitter taste or texture.
!ged care +or,ers should ne*er crush )edication unless authorised by a
phar)acist or doctor. This authorisation should be in +riting. F-uip)ent
used to crush )edication can be a )ortar and pestle or tablet crusher. !n
i)portant point to re)e)ber is to re)o*e all the po+dered )aterial (ro)
other )edicationJ e-uip)ent should be +ashed and dried a(ter each use.
1ther+ise, the )edication e*en though it is a s)all a)ount this +ill be
)ixed +ith other crushed )edications and )ay lead to serious
conse-uences (or the person.
5ixed, crushed )edication )ust be gi*en as soon as possible a(ter
crushing to pre*ent che)ical interaction. 7hen capsules and tablets are
gi*en together, the tablets should be crushed be(ore adding the content o(
the capsule. Ne*er crush the content o( a capsule.
"F (i?uid medicines
6o)e )edication is supplied as a li-uid. This )ay be the only +ay it is
a*ailable or it )ay be because a li-uid has been re-uested (or a person
+ho has di((iculty s+allo+ing a tablet. 6o)e li-uid )edicines include:
cough )ixtures, li-uid antibiotics, pred)ix and paraceta)ol.
5ost li-uid )edicines co)e in a bottle and each dose )ust be care(ully
)easured out.
@ere are so)e tips (or )easuring a li-uid:
#hec, the instructions care(ully P )a,e sure the a)ount to be
pro*ided is +ritten clearly, (or exa)ple 1.0 )l or 10 )l.
?oo, care(ully at the )edicine cup P (ind the )ar,er (or the a)ount
you need to )easure out.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1<; o( 282
@old the )edicine cup so that the correct )ar, is le*el +ith your eye.
/our the )edicine up to the correct )ar,.
#hec, the instructions again (or the correct a)ount and chec, that this
is the a)ount you ha*e )easured.
1nce the person has ingested the )edicineAchec, the cup to )a,e
sure they ha*e not le(t any behind. It is i)portant that the person ta,es
the +hole dose.
cF opical medication
Topical )edication includes crea)s and lotions. They )ay be prescribed
and nonAprescribed such as sorbolene crea), cortisone lotions, antibiotics
and so on.
The (ollo+ing points are i)portant +hen ad)inistering topical )edication:
Identi(y the correct area to apply the treat)ent.
se glo*es to pre*ent the )edication being absorbed into your s,in.
9o not rub the )edication inJ pat it instead.
1nly use the a)ount prescribed. !pplying )ore is +aste(ul and not
necessary.
Be care(ul i( you need )ore crea) to not conta)inate the clean crea)
in the container.
dF Eye treatments
The (ollo+ing points are i)portant to re)e)ber +hen assisting an older
person to instill eye drops or oint)ent:
I( eye drops stored in the (ridge get the) out and +ar) to roo)
te)perature or +ar) bet+een the hands. 9o not put into a )icro+a*e.
se glo*es
Identi(y the correct eye to instill the )edication into &i( only one eye'.
#lean the eyeBs be(ore the procedure usually cotton +ool balls +ith
sodiu) chloride in it, s-ueeKe excess, clean (ro) inner part o( eye out
to+ards the ear, once, discard and do as )any ti)es as re-uired or as
ordered. Note do not rub cotton +ool ball bac,+ards and (or+ards.
#orrectly position the older person get the person co)(ortable and
loo,ing up at the ceiling
/ull do+n the lo+er eyelid.
Instil the correct nu)ber o( drops into the )iddle o( the inside area o(
the lo+er eyelid.
9o not touch the eye +ith the point o( the container.
@a*e a tissue ready (or the person so the drops donCt run do+n the
person (ace on into their ear.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1<< o( 282
eF Ear drops
The (ollo+ing points are i)portant to re)e)ber +hen assisting +ith ear
drops:
#hec, the instructions care(ully.
se glo*es
Fnsure there are no obstructions in the +ay P tuc, the person"s hair
behind their earJ re)o*e hearing aidsJ re)o*e cotton +ool or other
obstructions.
@a*e a tissue ready (or 3ust in case
!s, the person to tilt their head to the side so that the ear to be treated
is (acing up.
@old the top o( the ear and gently pull it up and bac, to +iden the ear
opening.
Instill the drops +ithout touching the applicator or bottle to the ear.
9o not insert bottle nec,s or droppers into the ear canal.
Instruct the person to ,eep their head tilted (or about 20 seconds
I( instructed, assist the older person to place a s)all +ad o( cotton
+ool loosely into their ear to pre*ent the )edicine running out
pre)aturely. 9o not push the cotton +ool into the ear canal.
fF Patches
/atches re(ers to stic,Aon )edication, designed to deli*er )edication
e*enly o*er 2< hours through the s,in and into the *eins. It does the sa)e
3ob as tablets ta,en three or (our ti)es a day.
The (ollo+ing points are i)portant +hen ad)inistering patches:
/atches should be applied to a clean, dry, hairless area on the s,in
+ith the stic,y side in contact +ith the s,in.
9o not apply directly a(ter a sho+er as the older person"s s,in +ill still
be too )oist.
/atches are usually placed on the chest, shoulders and upper ar)s
need to loo, at the reco))endations by the drug co)pany or as
directed by the doctor.
!*oid applying patches to areas +ith cuts or rashes.
9o not rub patchesJ instead, press (ir)ly (or about ten seconds.
!lternate sides o( the person"s body should be used.
6o)eti)es you )ay need to +rite the date and ti)e the patch is
applied on the patch
Be care(ul not to touch the )edicated part o( the patch as you )ay
absorb the )edication and ha*e sideAe((ects (ro) it
gF P-7 medication
0e)e)ber that )edication prescribed as /0N should only be gi*en on an
"as needed" basis, that is, only in circu)stances as directed by a doctor
and phar)acist and in accordance +ith organisational procedures.
#hec, i( there are clear directions (ro) the doctor on /0N )edication. 2or
exa)ple:
the circu)stances under +hich /0N )edication can be gi*en
the procedures to underta,e +hen gi*ing /0N )edication
a sa(e inter*al bet+een /0N doses
the )axi)u) dose in 2< hours, (or exa)ple no )ore than six to eight
tablets in 2< hours such as paraceta)ol
circu)stances +hen the doctor )ust be noti(ied.
!l+ays chec, +ith your super*isor i( you are unsure about +hen /0N
tablets should be ta,en.
Note the (ollo+ing:A
The actual dose gi*en )ust be recorded
The person ad)inistering each dose is responsible (or chec,ing that the
)axi)u) daily dosage +ill not be exceeded.
E,ample
This is an exa)ple o( a /0N order
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1<% o( 282
Acti*ity
?ist 2 things aged care +or,ers are N1T allo+ed to do +hen assisting +ith
sel( )edication.
?ist 8 types o( assistance an older person )ay re-uire.
?ist = types o( assistance an aged care +or,er )ay need to help an older
person.
In your o+n +ords, choose < (ro) the pre*ious ans+er and gi*e a brie(
description o( each one.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1<= o( 282
I( you are assisting an older person to sel(A)edicate, let the) ,no+ that
you trust the) and are con(ident in their ability to ta,e their )edication.
Tell the) you +ill sho+ the) +hat to do in case they ha*e (orgotten or are
e)barrassed and don"t +ant you to +atch. Dou )ay ha*e to explain or
re)ind an older person each ti)e you *isit. 1lder people )ay su((er
)e)ory loss that is not related to an illness but is si)ply a degenerati*e
process due to old age. This )ay a((ect their ability to re)e)ber. They
need to be reassured about +hat to do. 0epeating the instructions +ill gi*e
the) the con(idence to ,no+ +hat to do and help the) to (eel in control.
Dou )ay need to assist a person by:
Acti*ity# -ole play
/ractice gi*ing )edications to each other, one person being the client and
the other being the care gi*er. Things to practice include:A
Introducing yoursel( to the client explaining +hat you are doing and so on
/ractice gi*ing di((erent types o( )edications to both cooperati*e and nonA
cooperati*e clients. The di((erent types o( )edications include:
tablets
li-uid )edicines
topical )edication
eye treat)ents
ear drops
patches
/0N )edication
3.9 Prior to gi*ing medication6 o"ser*e the client to chec2 for any
physical or "eha*ioural changes that may indicate a need to report to
super*isor or health professional in accordance with organisation
policies and procedures
)etting permission to proceed
!ged care +or,ers need per)ission to assist older people to ta,e their
)edication. The aged care +or,er"s role is to super*ise and help the older
person ta,e their prescribed )edicine under super*ision (ro) a health care
pro(essional.
Be (a)iliar +ith the guidelines in your +or,place that outline the authority
you ha*e and the steps you should (ollo+ be(ore you assist an older
person +ith their )edication. 2or exa)ple, a registered nurse or the
person in charge )ay delegate the responsibility (or assisting +ith the
ad)inistering o( )edication to trained and co)petent aged care +or,ers.
! registered nurse or endorsed enrolled nurse +ill ad)inister )edication in
)ost highAcare (acilities. !n aged care +or,er )ay assist to ad)inister
)edication to an older person in a lo+Acare (acility or in the co))unity.
It is the aged care +or,er"s responsibility to -uestion any instruction that
see)s unclear, inappropriate or unreasonable. Dou should direct this
-uery to your super*isor or the tea) leader on duty. I( they are not
a*ailable you should contact the older person"s doctor or the phar)acist
+ho prepared the )edication.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1<$ o( 282
Authorisation to proceed
Be(ore you can help +ith the )edication you need per)ission (ro) your
super*isor. nder no circu)stances )ust you ad)inister the )edication
on your o+n +ithout per)ission. Dour super*isor +ill gi*e you per)ission
once they are con(ident that you ha*e done the (ollo+ing things:
T 0ead the older person"s care plan and )edication chart and understand
+hat )edication is to be gi*en.
T Dou ha*e identi(ied the older person by their photograph or na)e on the
dose ad)inistration aid or their )edication chart.
T Dou ha*e chec,ed that the dose ad)inistration aid is pac,ed (or the
correct dosage, the correct day and the correct ti)e.
T I( there is no dose ad)inistration aid, you ha*e chec,ed the in(or)ation on
the label o( the )edication to ,no+ the dosage and ad)inistration
instructions.
T Dou ha*e chec,ed that the older person has agreed to ta,e the
)edication. 0e)e)ber that the older person has the right to re(use
)edication and you +ill need their per)ission or a re-uest (ro) the) to
assist the) in ta,ing their )edication.
!"ser*ing changes in the older person
!ged care +or,ers )ust )a,e sure that older people are capable o( ta,ing
the )edication be(ore it is gi*en to the). 2or exa)ple, the client )ight be
*o)iting and the )edication +ill not be ingested properly. !n i)portant
responsibility is to regularly chec, the older person"s ability to understand
+hat they ha*e to do to ta,e their )edication.
There are )any reasons the condition o( the older person )ay ha*e
changed. 2or exa)ple:
their existing health condition )ay ha*e +orsened
the doctor )ay ha*e changed their )edication
the person )ay ha*e )ixed their )edications
the person )ay ha*e (orgotten or chosen not to ta,e their )edications
&i( they sel(A)edicate'
the person )ay ha*e de*eloped another condition, such as the (lu
the person )ay be unable to sleep, +hich )a,es it harder (or the) to
thin, clearly
stress(ul e*ents in the person"s li(e )ay be a((ecting their abilities, (or
exa)ple the death o( a lo*ed one, (inancial di((iculties, (a)ily proble)s
or the onset o( de)entia.
Dou need to ,no+ ho+ to help the older person tell you i( they are ha*ing
di((iculties. Dou also need to ,no+ +hat to do i( you spot a change in their
beha*iour or condition. ! change in their ability to ta,e their )edication
could indicate that they are ha*ing trouble in other areas o( their li(e. It )ay
)ean the le*el o( assistance )ay ha*e to be increased.
ypes of changes
Dou need to loo, (or any changes in the older person"s condition that )ight
a((ect their ability to ta,e their )edication. Dou should pay particular
attention to:
their )ental state, (or exa)ple: 9o they see) con(usedI
their )obility, (or exa)ple: #an they +al, as (ar as they used toI
their breathing, (or exa)ple: Is their breathing noisier or (aster than
usualI their beha*iour, (or exa)ple: 9o they see) )ore depressed
than usualI
The (ollo+ing are conditions that )ay occur. In all o( these cases, you
)ust (ollo+ procedures and noti(y your super*isor. In so)e circu)stances
you )ay need to call an a)bulance or per(or) e)ergency (irst aid
procedures i( -uali(ied and as,ed to do so &(or exa)ple cardiopul)onary
resuscitation W#/0X'. In such instances your organisational policies and
procedures +ill ha*e clearly de(ined guidelines to (ollo+. It is your
responsibility to (ollo+ the).
+igure # Physical changes
Condition 5hat to loo2 for
#hanges to air+ay cho,ing
not able to s+allo+
#hanges to breathing slo+ed
(ast
(aint
#irculation unexpected dro+siness
colour change
rapid pulse
(aint pulse
0ash continual scratching
redness
In(la))ation redness
heat &older person is hot to touch'
s+elling
pain
6+elling s+ollen hands, throat or nasal passages
@eadache
&)ay indicate high
blood pressure'
cannot (ocus +ell
is lightAsensiti*e
can"t get up (ro) their bed
@earing loss cannot hear
ringing in the earBs
)atter co)ing (ro) the earBs
cannot understand instructions
Blurred *ision cannot read labels
unsteady on their (eet
9iKKiness
&)ay indicate lo+
blood pressure'
losing balance
(eeling (aint
eye +ea,ness
inability to )aintain nor)al seated balance
6lurring o( speech
&)ay indicate stro,e'
cannot spea, clearly
+ords 3u)bled
cannot )a,e the)sel*es understood
Nausea dry retching
pale
has the urge to *o)it
>o)iting *o)iting as soon as )edication is ta,en
*o)it in the toilet bo+l or on their clothes
9iarrhoea loose bo+el )otions
5obility stu)bling
+igure # Beha*ioural changes
#on(usion cannot decide +hat to do
cannot re)e)ber +hen to ta,e the )edicine
cannot re)e)ber the right dose
does not (ollo+ instructions
hoards tablets
9isorientation the older person doesn"t ,no+ +here they
are or +hat is happening to the)
Not sleeping is )ore tired than usual
is al+ays dro+sy
5ood changes is )ore irritable than usual
re(uses to ta,e the )edication
6ho+ing signs o( stress does not sleep
is angry
physical changes, such as a rash
6ubstance abuse or
)isuse
#o)bining )edications, ta,ing alcohol +ith
)edication
I( any o( the abo*e signs are obser*ed, do not continue. 0eport to the
super*isor or doctor and +ait (or direction and guidance. These signs )ay
ha*e serious conse-uences (or the older person. 2or exa)ple:
I( their hands ha*e beco)e s+ollen they )ay ha*e di((iculty opening
their )edication and be unable to ta,e it.
I( they (eel diKKy they )ay (aint and hurt the)sel*es.
I( their *ision has been a((ected they )ay not be able to read the
)edicine label or chart clearly.
6lurred speech )ay be an indicator o( a stro,e.
I( they are *o)iting they +ill not be able to ,eep their )edicine do+n.
!ll these instances can be dangerous, +hich is +hy it is crucial that you
noti(y your super*isor as soon as you identi(y a change in the person"s
condition.
0onitor the older personDs condition.
Dou need to )onitor the older person"s condition e*ery ti)e you *isit. Dou
can do this in a nu)ber o( +ays.
!"ser*e them
7atch the older person (or signs that their condition has changed since
you last sa+ the). 2or exa)ple: !re they s+eatingI 9o they loo,
con(usedI !re they scratching the)sel*esI 9o they ha*e a di((erent s,in
toneI !re they slurring their speech )ore than usualI
(isten to them
The older person )ay tell you that they (eel di((erent or (eel concerned that
their )edication is )a,ing the) (eel +orse. Fncourage the) to tal, to you.
Get the) to describe exactly ho+ they (eel. It is your 3ob to record this
clearly so the doctor can (ollo+ it up.
As2 ?uestions
@elp the older person to be speci(ic about the +ay they (eel or loo,. !s,
-uestions such as, S!re you concerned that the ne+ )edication is )a,ing
you sic,I" !s, direct -uestions so you can pinpoint ho+ they (eel and +hat
)ight be causing it, such as:
7here is the painI
9o you +ant to *o)itI
7hen did you start to itchI
7here does your head acheI
7hen did the pain startI
@a*e you eaten todayI
@a*e you had enough sleepI
@a*e you had a (allI
@a*e you eaten so)ething you don"t usually eatI
Dou )ay (ind that the person"s physical beha*iour has changed and they
ha*e beco)e +ithdra+n, angry, depressed, uncooperati*e or (rustrated. I(
they are sel(A)edicating, as, the) +hether they ha*e ta,en their
)edication today. !s, the) to sho+ you +hat )edication they ha*e ta,en.
The )ore you (ind out, the )ore in(or)ation you +ill be able to tell your
super*isor. Dou need to report the older person"s condition i))ediately i(
there is any doubt that the older person cannot ta,e their )edication sa(ely
and according to the instructions. Dour super*isor or the older person"s
doctor +ill assess the person to see +hether the person is able to ta,e
their )edication or is able to sel(A)edicate.
0e)e)ber you are not )a,ing a diagnosis. Dou are si)ply recording +hat
the person tells you about ho+ they (eel and +hat you ha*e obser*ed.
E,ample
@elen attends 5r. 2rost"s roo) to gi*e hi) his )orning )edication. 7hen
she arri*es she (ind that he cannot re)e)ber her na)e, is unsure o(
+here he is, has +et his trousers and is *ery angry and aggressi*e +hen
she as,s hi) i( he (eels all right. @elen ,no+s these things are *ery
unusual (or 5r. 2rost, as he is usually a *ery astute, polite and -uiet )an.
6he ,no+s that these are probably signs that so)ething is +rong +ith hi).
6he ,no+s that she should not gi*e hi) his )edication until she has
reported these changes to her super*isor, and a doctor has seen hi). 6he
reassures 5r. 2rost and tries to )a,e hi) co)(ortable be(ore calling her
super*isor.
In this exa)ple, the aged care +or,er had a duty o( care to report these
changes in condition and beha*iour, be(ore gi*ing )edication +hich )ay
)a,e the person +orse. They )ust not gi*e )edication i( they thin, there
is so)ething +rong. !t this stage they do not ,no+ +hat the proble) is A it
)ay be to do +ith the )edication, but it could also be an in(ection, stro,e
or the onset o( a disease or disorder. !n aged care +or,er is not -uali(ied
and is not authorised to diagnose the proble) or initiate (urther treat)ent.
They should i))ediately noti(y their super*isor. Their super*isor +ill tell
the) the correct procedure to (ollo+.
Acti*ity #
0ead the case study, then ans+er the -uestions.
Case study
!licia arri*es and (inds 5r.s 2erguson sitting do+n. 6he is usually li*ely
and tal,ati*e. Today she see)s -uiet, pale and cla))y. 6he says she has
been *o)iting and cannot ,eep anything do+n. 6he (eels nauseous and
cold.
%. 7rite (our -uestions you )ight as, 5r.s 2erguson.
3. 7hy do you need to as, these -uestionsI
3. 9escribe +hat you should do next.
3.: -ecognise circumstances when appropriate action is to report
o"ser*ed client health status rather than proceeding with
administration of medication and see2 ad*ice of super*isor or health
professional
7otifying your super*isor if there is a difficulty with the self8medication
! super*isor andBor health pro(essional is noti(ied o( any di((iculty +ith sel(A
)edication &such as client re(usal to ta,e so)e or all )edications,
inco)plete ingestion or )issing doses' according to the organisation"s
procedures and protocols.
7hene*er there is a di((iculty +ith sel(A)edication you )ust (ollo+ the
guidelines set do+n by your e)ployer. 5ost +or,places ha*e strict policies
and procedures concerning )edication. Dou )ust understand that an aged
care +or,er )ust not gi*e )edical ad*ice or assu)e they ,no+ +hat has
caused the di((iculty. Dour 3ob is to obser*e and report +hat you ha*e
seen.
ypes of difficulties
There are a nu)ber o( things that )ight happen to a((ect the person"s sel(A
)edication schedule. The (ollo+ing table lists so)e di((iculties and ho+ the
di((iculty )ight occur.
+igure # Difficulty
Difficulty How the difficulty might occur
!n error in dosage ! person )ay accidentally ta,e the +rong
dosage +hen the aged care +or,er is not there
to super*ise, (or exa)ple in the early )orning.
5issed )edication ! person )ay go out (or the day and (orget
to ta,e their )edication +ith the).
They )ay be unable to open the top o( the
bottle.
?ost )edication ! person )ay lose their )edication i( it (alls out
o( the dosette box and rolls a+ay or (alls into
the rubbish bin by )ista,e. The person )ay
then decide to ta,e the next day"s dosage.
The person re(uses to
ta,e the )edication
! person )ay re(use to ta,e their )edication
because:
they (eel sic,
they thin, the tablet is too big
they ha*e di((iculty s+allo+ing
they don"t li,e the taste o( it
they are annoyed +ith ha*ing to ta,e it
they belie*e they don"t need it any )ore
they are angry.
The person doesn"t
ingest the )edication
The person )ay:
ha*e di((iculty in s+allo+ing +hole or
di*ided tablets
spit it out
not co)plete the ingestion
*o)it.
#onta)inated
)edication
The aged care +or,er )ay (ind that the
)edication is past its useAby date or has been
incorrectly stored and is not suitable to use. !
tablet +ill be conta)inated i( the person has
ta,en it out o( the blister pac, and it (alls into
the rubbish bin.
Beha*iour The person )ight be in pain or be *ery
distressed and be unable to ta,e the
)edication.
These situations )ust be reported i))ediately because it )ay be crucial
that the person ta,e the prescribed dosage o( their )edication +ithin the
prescribed ti)e. 2or exa)ple, a )issed tablet or application o( lotion )ay
ha*e a serious e((ect on the person"s condition and their ability to heal.
How you find out a"out a difficulty
To (ind out i( there is a di((iculty you )ay need to:
as, the person -uestions
loo, (or e*idence in their en*iron)ent
obser*e their beha*iour.
2or exa)ple, so)eti)es a person +ill ha*e ta,en their early )orning
)edication be(ore you ha*e arri*ed. Dou )ust as, the) +hether they ha*e
ta,en it. They )ay tell you that they opened their pac, and the pill (ell onto
the (loor and disappeared under a cupboard. They )ay say that they didn"t
(eel li,e ha*ing it. They )ay tell you they +ent to an appoint)ent and
(orgot to ta,e it +hen they returned. They )ay say that the top +as on too
tightly and they couldn"t open it.
Dou )ay need to as, the) speci(ic -uestions to get an ans+er. !s, the
sa)e -uestions in a *ariety o( +ays. 2or exa)ple:
@a*e you ta,en all your tablets todayI
@o+ )any tablets ha*e you ta,enI
7hat ha*e you ta,enI
Dou )ay need to loo, around their ho)e or roo) to see +hether there is
any )edication in their rubbish bin, or on the (loor. Dou )ay (ind that they
are consistently applying )ore lotion than necessary and the tube is nearly
e)pty.
7hen you are ready to assist the) +ith sel(A)edicating you )ay (ind that
they re(use to ta,e the tablet, despite your encourage)ent. I( they
ad)inister the )edication, they )ight *o)it it, only ha*e hal( o( a tablet or
lea*e )ost o( it in the glass.
Procedures to report the difficulty
!ny action or assistance an aged care +or,er pro*ides +hen there is a
di((iculty +ith sel(A)edication )ust be in accordance +ith their 3ob
description and +or,place procedures. I( you are unsure o( your role and
responsibilities chec, +ith your super*isor.
Dou )ust al+ays contact your super*isor i))ediately, explain the situation
and +ait (or their instructions. I( you are +or,ing in a co))unity residential
setting you can contact the super*isor on duty (ace to (ace or by
telephone. I( you are +or,ing in a person"s ho)e, you need to telephone
the).
The super*isor +ill gi*e you (eedbac, and explain the (ollo+ up action that
needs to occur. 2or exa)ple, your super*isor )ay tell you not to do
anything until they ha*e noti(ied the doctor or phar)acist and recei*ed
ad*ice (ro) the). Then they +ill call you bac, and ad*ise +hat to do. In
other situations they )ay respond straighta+ay and tell you to gi*e the
person another tablet.
2ollo+ the instructions and guidance you are gi*en. 0e)e)ber that you
are not the one to )a,e a decision about +hat to do next. 2or exa)ple,
you )ust not decide to gi*e the person the next dosage in place o( the one
they )issed, or gi*e the) an extra tablet i( they *o)ited one up. The
health pro(essionals in*ol*ed +ith the person +ill decide the course o(
action to ta,e. The in(or)ation the super*isor recei*es (ro) you about the
situation )ay lead to an ad3ust)ent o( the person"s care plan or a change
in their )edication. The course o( action should be properly docu)ented in
the careBprogress notes.
.nowing who to contact if a difficulty arises
It is i)portant to ,eep a list o( +ho you should call i( a di((iculty arises. The
list should be easily accessible so you can contact the appropriate person
+ithout +asting any ti)e. In )ost cases the super*isor +ill contact other
people, but in so)e circu)stances they )ay as, you to do this. ! contact
list )ay contain the na)e and telephone nu)ber o(:
your super*isor
the case )anager
a)bulance
(a)ily
nearest hospital
phar)acist
doctor
It is use(ul i( the older person also has a copy o( this list. Their list should
include the aged care support agency"s &your +or,place"s' contact nu)ber.
Dou )ust tell the older person that you are going to contact your
super*isor (or ad*ice. Dou need to explain to the super*isor exactly +hat
has happened so they can )a,e a decision. 2or exa)ple, is it crucial that
the person ta,e the dosage that +as )issedI Is it all right to substitute
another pillI 6hould the +or,er encourage the person to co)plete the
)edication e*en i( they re(useI 6hould the doctor be in(or)edI
!(ter you ha*e contacted your super*isor, explain to the older person +hat
is going to happen so they (eel that they are in control.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1%0 o( 282
E,ample
?iKKie, an aged care +or,er, is helping 9orothy +ith her pills (or a chest
in(ection. 9orothy is (iercely independent, so all ?iKKie does is encourage
her to ta,e the pill at the correct ti)e. Today, 9orothy (u)bles and the pill
(alls out o( the dosette pac,, rolls under the table and disappears do+n a
crac, in the (loorboards. S1h dear," 9orothy says, SI suppose I"d better ta,e
the one (or to)orro+, instead."
?iKKie tells her that she cannot do this. 6he explains that she +ill call the
super*isor and as, (or their ad*ice. 6he tells 9orothy not to do anything
until she (inds out +hat to do.
The super*isor tells ?iKKie that it is all right (or 9orothy to ta,e to)orro+"s
pill. 6he says that she +ill call the phar)acist and they +ill (ill a ne+
dosette box and deli*er it that day.
?iKKie tells 9orothy +hat +ill happen.
In this situation, the aged care +or,er did the correct thing and contacted
their super*isor. The next pill )ay ha*e had a di((erent dosage than +as
re-uired at the ti)e and )ay ha*e caused a proble) (or the older person.
Acti*ity
7hat +ould you do in the (ollo+ing situations:A
6ituation 7hat +ould you doI
5edication (alls
onto the (loor
#lient re(uses to
ta,e their
)edication
The 99! has
been ta)pered
+ith
The client is not
the)sel*es
-eporting difficulties or errors
!nything that does not go according to plan )ay ha*e serious
conse-uences (or the older person. 7hen this happens you need to ,no+
+hat action you should ta,e. This includes ,no+ing +hat to do i))ediately
and ,no+ing +ho to call on to help you or gi*e you ad*ice. 2or exa)ple,
should the person ta,e the dosage that they )issedI Is it all right (or the
aged care +or,er to substitute another pillI 6hould the aged care +or,er
encourage the person to co)plete the )edication e*en i( they re(useI
6hould the doctor be in(or)edI
2ollo+ the guidelines set do+n by your e)ployer. 0e)e)ber that you
)ust not gi*e )edical ad*ice or assu)e you ,no+ +hat has caused the
di((iculty. Dour 3ob is to obser*e and report +hat has happened.
/rocedures )ay di((er bet+een organisations so )a,e sure you (ind out
+hat you are )eant to do. @ere are so)e general guidelines.
7otify your super*isor
Be (a)iliar +ith the structure o( your organisation and e*eryone"s roles and
responsibilities. This +ill let you ,no+ +ho +ill best be able to help you.
Eeep a list o( +ho you should call i( a di((iculty arises. The list should be
easily accessible so you can contact the appropriate person +ithout
+asting any ti)e.
In )ost cases the super*isor +ill contact other people such as a doctor or
phar)acist, but in so)e circu)stances they )ay as, you to do this.
! contact list )ay contain the na)e and telephone nu)ber o(:
5anagerB91N
your super*isor
the older person"s case )anager &(or ho)e and co))unity care'
a)bulance & 000 or 112 (ro) )obile phones'
(a)ily
nearest hospital
phar)acist.
The (irst person you should noti(y is your super*isor. Fxplain to the
super*isor exactly +hat has happened so they can )a,e a decision. They
+ill contact the doctor i( they (eel this is necessary. They )ay tell you to
contact an a)bulance i( the situation is urgent.
.eep the older person informed
!(ter you ha*e contacted your super*isor, explain to the older person +hat
is going to happen so they (eel that they are in control. 1((er support and
reassurance to the client.
-ecord what has happened
0ecord +hat has happened in the careBprogress notes, incident (or),
co))unication boo, or on a (eedbac, (or) so e*eryone can see +hat has
occurred and the action you too,. 5a,e sure the in(or)ation is +ritten
clearly, logically and accurately so e*eryone +ho reads the notes is clear
about +hat happened. They can then )a,e an in(or)ed decision about
+hat to do. 5a,e sure you sign and date the docu)entation as a health
pro(essional )ay need to get in touch +ith you.
Dou )ay ha*e to co)plete an error or incident report (or). These *ary
(ro) place to place. 5a,e sure you ,no+ ho+ to co)plete the one at your
+or,place. !n errorBincident report should include the (ollo+ing
in(or)ation:
Na)e and date o( birth o( the older person
Na)e o( sta(( )e)ber in*ol*ed
Na)es o( people the incident +as reported to
9ate and ti)e o( incident
9etails o( incident
!ctions ta,en
1utco)e (or older person
6ignature o( person reporting the incident
Acti*ity
In any +or,place, +hat )ust e)ployees co)ply +ithI
?ist ; things that can go +rong +hen assisting +ith sel(A)edication.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1%; o( 282
?ist +ho should be noti(ied i( errors or proble)s arise +hen assisting +ith
)edicationsI
7hat is the purpose o( an incident reportI
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1%< o( 282
;. !ssistBsupport client +ith
ad)inistration o( )edication
3.%
0e)ind and pro)pt client to ta,e )edication at correct ti)e
3.3
!ssist clients +ith ad)inistration o( )edications as re-uired in
accordance +ith legislation, organisation policies and the le*el
o( support needed as identi(ied in their care B support plan
3.3
6uper*ise and obser*e clients +hen ta,ing )edication and
con(ir) +ith the) their ingestion or co)pletion
3.4
#o)plete docu)entationBrecord o( )edication ad)inistration
3.5
1bser*e client (or any changes in their condition listed in the
0ange 6tate)ent and see, assistance (ro) a health
pro(essional, super*isor, )edical o((icer or e)ergency
ser*ices as indicated in the organisationCs policies
3.9
9iscard +aste products according to organisation procedures
andBor )anu(acturerCs instructions
3.% -emind and prompt client to ta2e medication at correct time
#hec, the indicated ti)es to ensure that the )edication is gi*en at the
right ti)e. The ti)es should be clearly docu)ented on the container or
)edication chart and in )edication notesBcharts. #on(ir) the ti)e (or sel(A
)edication. The instructions on the label indicate +hen the )edication
should be ta,en. This )ight be:
once a day
+ith (ood
a(ter )eals
in the )orning
at hourly inter*als
+hen needed.
Dour super*isor +ill explain anything you need to ,no+. 2or exa)ple,
so)e drugs are altered by (ood and should be gi*en at least one hour
be(ore )eals. 6o)e )edications should not be gi*en together and can
re-uire up to a t+oAhour inter*al bet+een )edications. ! patch should not
be applied to +et s,in, so )a,e sure the person has sho+ered and is dry
be(ore continuing. 5ost drugs gi*en +ithin ;0 )inutes o( the prescribed
ti)e are considered to be on ti)e. 1thers such as insulin and so)e
antibiotics )ust be ta,en at precisely the right ti)e.
6o)eti)es, the instructions only say "Three ti)es daily". sually, the
as they get up in the )orning, be(ore lunch ti)e and be(ore dinner. Eeep
in )ind any other instructions such as "be(ore )eals" .Dou should )a,e
sure they understand it has to be ta,en be(ore they begin to eat.
Fxplain +hat instructions such as "(ourAhourly" )ean. 7hen do you start
the (our hoursI 9o you count the hours at night as +ellI
5a,e sure the person understands any abbre*iations on the label. Dou
)ay need to translate these. In )ost cases the )eaning +ill be clear.
@o+e*er, you )ay (ind that so)e instructions are +ritten using initials that
co)e (ro) a ?atin +ord.
Acti*ity #
!s ter)inology has been done pre*iously co)plete the table:A
!bbre*iation 5eaning
-idBNI9
bdBB9
tdsBT96
prnB/0N
)ane
nocte
/0N )edication. 5any /0N )edications are (or pain relie(. It is i)portant
that aged care +or,ers understand the procedures (or these )edications
and (ollo+ the instructions they ha*e been gi*en. They need to explain
these to the older person so the older person understands +hen they can
sa(ely ta,e the). 2or exa)ple, you need to ,no+ ho+ the )edication
should be ta,en &+ith (ood, crushed, not crushed' and the sa(e inter*al
bet+een doses &the )ini)u) nu)ber o( hours bet+een )edication'.
1lder people ha*e the right to )a,e their o+n decisions about +hen to
ta,e their )edication. @o+e*er, aged care +or,ers ha*e a duty o( care to
see they ta,e their )edication as the doctor has prescribed. Dou )ust let
your super*isor ,no+ i( an older person +ants to ta,e their )edication
)ore (re-uently, as this has the potential to har) the).
F*en i( the person is sel(A)edicating it is i)portant that any )edication
they ta,e is recorded on a )edication chart and in their care notes. sually
the older person +ould need to re-uest that their )edication is brought to
the) (ro) a loc,ed cupboard. I( not, )a,e sure they ,no+ that they )ust
tell sta(( +hen they are sel(A)edicating +ith a /0N )edication, so this can
be recorded.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1%% o( 282
Acti*ity
!s an aged care +or,er, ho+ +ould you re)ind and pro)pt a client to ta,e
their )edications at the correct ti)eI
7hat other things could be used to re)ind and pro)pt clients to ta,e
)edications at the correct ti)eI
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1%= o( 282
3.3 Assist clients with administration of medications as re?uired in
accordance with legislation. !rganisation policies and the le*el of
support needed as identified in their care= support plan
&nderstanding the legislation and regulations
F*erything you do as an aged care +or,er is go*erned by legislation, all
the rules and procedures that are +ritten by the go*ern)ent about ho+ to
deal +ith )edication. Dou )ust (ollo+ the). It is against the la+ to ignore
the), +hether you +or, in an aged care (acility or are part o( a @o)e and
#o))unity #are &@!##' progra). !ll aspects o( your +or, are regulated
under:
the !ged #are !ct 1$$=
the !ccreditation 6tandards de*eloped by the !ged #are 6tandards
and !ccreditation !gency
the @o)e and #o))unity #are !ct and 6tandards
the 9isability 6er*ices !ct
the 7rongs !ct
@o)e and #o))unity #are !ct
Guiding /rinciples (or 5edication 5anage)ent in the #o))unity 200%
5edication 5anage)ent in 0esidential !ged #are 2acilitiesAde*eloped
by the !ustralian /har)aceutical !d*isory #ouncil
state and territory regulations
+or,place policies and procedures.
These !cts &is a piece o( legislation +ritten by the go*ern)ent and
describes +hat people )ust do', regulations and guidelines are there to
ensure that )edication is al+ays gi*en to older people correctly and sa(ely.
They are *ery large docu)ents, so you do not ha*e to ,no+ the) in detail.
@o+e*er, you should understand that the procedures you )ust (ollo+ in
your +or,place ha*e been +ritten to )eet these !cts and regulations. I(
you (ollo+ the procedures, then you are (ollo+ing all the la+s. It is the
responsibility o( your +or,place to ensure that you are trained and -uali(ied
(or the tas,s they as, you to do.
Acti*ity # -esearch
nder all aspects o( your +or, is regulated by &abo*e dot points'. #hoose
2 and in hal( a page (or each one, gi*e a brie( description o( each one. This
can be done in a dot point (or)at.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1%$ o( 282
Assist the older person to ta2e their medication as prescri"ed
It is essential that all older people recei*e and ta,e their )edication as
prescribed by their doctor and dispensed by the phar)acist. 5edication
has the potential to cause har) i( it is not prescribed, dispensed and
ad)inistered correctly. !ged care +or,ers play an i)portant role in helping
older people to use )edication correctly and sa(ely.
It is i)portant that the aged care +or,er understands their 3ob role and
le*el o( authority and (ollo+s the policies and procedures set out by their
+or,place. In no circu)stances are they to o((er )edical ad*ice or gi*e
assistance +here they are not authorised or -uali(ied to do so.
The older people you are assisting +ill ha*e a range o( conditions and
abilities. The le*el o( assistance re-uired +ill *ary. !ssistance +ith
)edication could include:
handing the dose ad)inistration aid box to the older person
opening sachets and blister pac,s
)easuring and pouring li-uids
preparing nebulisers
instilling drops
applying lotions
applying patches.
!n i)portant part o( assisting +ith )edication is to +rite do+n the
)edication the person too, and i( they had any reaction. 0ecording +hat
the person does is an essential part o( an aged care +or,er"s
responsibilities. #o)prehensi*e docu)entation +ill ensure that all
)e)bers o( the health care tea) are in(or)ed about the person and their
)edication.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1=0 o( 282
Preparing and gi*ing the medication
!ged care +or,ers )ust (ollo+ at all ti)es the legislation and +or,place
policies and procedures (or ad)inistering )edication. Dou ha*e a duty o(
care to )a,e sure you do not place the person in any danger or cause
the) har).
Be(ore you help ad)inister the )edication you need to )a,e sure you
understand +hat you ha*e to do and chec, that e*erything is in order
be(ore you proceed. Dour +or,place )ay ha*e a chec,list to help you
+hen you (irst start your 3ob as an aged care +or,er. @ere is an exa)ple
o( a chec,list.
E,ample
Preparation chec2list
/ast a )andatory theory )edication test
1bser*ed in(or)ally by experienced sta((
#o)petent &(or)al obser*ation' in gi*ing out )edication to clients
I understand )y responsibilities and le*el o( authority (or assisting +ith
)edication.
I ha*e chec,ed that the person is the person I ha*e to assist.
I understand the type o( )edication the person is ta,ing.
I understand any conditions or +arnings attached to the )edication, (or
exa)ple S6ha,e +ell", S5ust be ta,en +ith +ater".
I ,no+ +hether anything has to be done to the )edication be(ore it is
ta,en.
I ha*e chec,ed the dose ad)inistration aid is intact.
/ersonal hygiene procedures are in place.
7hen you and the organisation are con(ident that you ha*e co)pleted the
necessary co)petency then you can proceed, the next steps are to
prepare the e-uip)ent and the )edication, and gi*e it to the person
according to the prescription instructions.
/repare (or ad)inistering the )edication Be(ore you can help ad)inister
the )edication you need to:
/repare the e-uip)ent
/repare the )edication
%. Prepare the e?uipment
5edication is )anu(actured in di((erent shapes, siKes and (or)ats and
your +or,place should ha*e policies and procedural guidelines to assist
+ith the preparation o( *arious types o( )edication or treat)ents. Dou
)ust (ollo+ the instructions you ha*e been gi*en such as do not crush,
gi*e be(ore )eals, ha*e t+ice a day or store in the (ridge.
!t no ti)e )ust you decide (or yoursel( +hat to do or alter the a)ount o(
)edication (ro) that speci(ied on the label or chart this is decided by the
doctor andBor the phar)acist. !ll actions and decisions )ust be ta,en
+ithin your 3ob role and responsibilities. 7hene*er you are in doubt you
)ust contact your super*isor.
5a,e sure all the necessary e-uip)ent is handy. This )a,es it easy to get
the )edication ready (or the older person and can help to pre*ent
)ista,es. The older person +ill be )ore relaxed i( e*erything is a*ailable
and ready (or the). Fnsure all e-uip)ent is clean and ready to use. This is
i)portant to pre*ent crossAin(ection and to help you per(or) the procedure
in an organised, e((icient )anner.
F-uip)ent you need )ight include:
docu)entation you need to (ollo+A)edication charts
)edication such as lotions, li-uids, tablets, capsules, ear, eye or nose
drops
dose ad)inistration aids such as co)part)entalised boxes, blister
pac,s or sachets that ha*e been prepared by a phar)acist
e-uip)ent to prepare the )edication such as rubbish bag, glo*es, pill
cutters, glasses, )ortar and pestle, glo*es, 3a), a 3ug o( +ater and
)easuring cups.
+igure # E?uipment
@ere is a list o( e-uip)ent and +hen you )ight need to use it.
E?uipment needed 5hen to use the e?uipment
5edication charts To identi(y the older person and chec, indi*idual
)edication
To record )edication, date and ti)e ta,en as per
organisational guidelines
Eeys To open a cupboard or trolley +here the )edication
is stored
!prons To +ear during procedures to protect clothing
9isposable glo*es To +ear +hen you apply topical treat)ents
To +ear +hen you are in contact +ith body To
dispense )edication (ro) original (luid
5edicine cups To dispense )edication (ro) original container 3ust
prior to the older person ta,ing it
6poons in the correct
)easure)ent
To )ix )edication +ith s)all a)ounts o( (ood
To hand to older person to ta,e )edication
Tu)blers, glasses,
paper cups
To gi*e +ater to older person to s+allo+ oral
)edication
7ater 3ug To ,eep +ater to ser*e older person
/ill crusherB )ortar
and pestle
To crush )edication (or an older person +ho (inds it
hard to s+allo+
5easuring cups To )easure li-uid )edication
Tablet di*ider or pill
cutter
To cut tablets in hal( (or an older person +ho (inds it
hard to s+allo+ larger tablets
/aper to+els and
tissues
To dry any e-uip)ent
To +ipe any spills
Nebuliser To add )oisture or air to )edication &)ostly used (or
bronchodilators or )ucolytic )edication (or exa)ple
>entolin'
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1=; o( 282
E?uipment needed 5hen to use the e?uipment
#ontainers (or used
e-uip)ent
To store all used e-uip)ent prior to +ashing, (or
exa)ple teaspoons
#ontainers (or used
paper goods and
disposable ite)s
To dispose o( used e-uip)ent and paper goods
Trolleys I( )edication is deli*ered to )ore than one older
person and stored in the trolley, the trolley +ill be
ta,en (ro) roo) to roo)
+igure # 0edication rolley
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1=< o( 282
Acti*ity
2ro) the e-uip)ent list, add to the picture 5edication Trolley &abo*e' the
e-uip)ent re-uired to co)plete assisting +ith )edications )ore e((iciently.
I( you run out o( space around the picture continue list on the lines belo+.
3. Prepare the medication
Instructions are +ritten on the )edication label or care notes about ho+
the )edication is to be gi*en. This o(ten )eans that you )ay ha*e to do
so)ething to the )edication be(ore the person can ta,e it. 2or exa)ple, a
tablet )ay need to be crushed into a po+der, dissol*ed in +ater or split in
t+o to )a,e it easier to ta,e. The )edication )ay ha*e to be ta,en +ith
(ood or +ith +ater. ! crea) )ay ha*e to be +ar)ed be(ore applying.
6o)eti)es, the doctor )ay ha*e ad*ised that the instructions )ay be
altered to help the person ta,e the )edicine. 2or exa)ple, they )ay say
that a tablet can be ta,en +ith a (ood li,e 3a), honey, custard or 3elly.
2ollo+ the instructions. 9on"t do anything +ithout (inding out +hether it is
acceptable. 2or exa)ple, a person )ay as, you to crush a tablet.
@o+e*er, re)e)ber that so)e )edication should ne*er be crushed,
opened or di*ided as it could cause )outh ulcers in so)e people, )ight
lose its ability to heal or )ay upset the sto)ach. The )edication )ay be
designed to dissol*e slo+ly in the person"s sto)ach, or the co*ering )ay
protect the person"s )outh and throat (ro) a harsh )edication. 1nly crush
or cut a capsule or tablet +hen there is a clear instruction (ro) the health
pro(essional to do so.
I( a person tells you they can"t ta,e the )edication as instructed, you )ust
tell your super*isor and +rite it do+n in the appropriate docu)ent such as
the co))unication boo, and careBprogress notes. The in(or)ation +ill be
passed on to the doctor +ho +ill alter the instructions i( necessary. @ere is
an exa)ple.
+igure # Progress 7otes
7ame# 5r. Frnie 6treet
D!B# 18B10B1$;8
-oom=Bed# 20 Bed 2
Date and time Progress 7otes
2$B2B200=
0$00hrs
#lient states RIC) ha*ing trouble ta,ing )y tablets as
they are too bigQ. #lient +anted the) bro,en into
s)aller pieces. 9B7 super*isor &!. 5a3ors 0N' and
she ad*ised to put tablets into yoghurt as is and gi*e.
#lient too, tablets +ith no proble)s. A Reese 0eese
&!IN'.
Prepare to gi*e the medication according to instructions
2ollo+ the instructions as listed on the dose ad)inistration aid and the
older person"s care chart. !n aged care +or,er )ust be trained be(ore
they can help ad)inister )edication. 2or exa)ple, you need to ,no+ ho+
to help the older person put in ear drops, apply lotion or ta,e capsules.
There )ay be special techni-ues you ha*e to be a+are o(, such as placing
a cotton+ool ball in the ear to pre*ent the drops lea,ing out. 0e)e)ber
that an aged care +or,er )ust ne*er gi*e an in3ection, place )edicine in a
nebuliser or insert anything into the rectal or *aginal areas. 5a,e sure you
understand your +or,place"s policies and procedures and any legislation
speci(ic to your state or territory.
!s, your super*isor i( you are in doubt about any instructions +ritten on
the dose ad)inistration Aaid, )edication label or care chart.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1=% o( 282
The (ollo+ing is a list o( )edicines and so)e guidelines (or their
ad)inistration. Note that this table is (or in(or)ation and training purposes
only.
+igure # 0edicines and )uidelines
0edicine E,ample Preparation and specific guidelines
Fye drops !Kopt 5ost eye drops )ust be ,ept belo+
28Y#.
se the Sno touch" techni-ue. 9o not
touch the eye +ith the tip o( the bottle.
Fye drops expire one )onth a(ter
opening L the date +hen the bottle is
opened
Far drops 7axol
#iproxin
Gently pull the ear up and bac, to )a,e
the opening as +ide as possible. Instil
the correct nu)ber o( drops to+ards the
bac, o( the ear canal.
The older person should be ad*ised to
re)ain in the !liciae position (or at least
(i*e )inutes.
Nasal sprays Beconase 6pray into nostrils as indicated on the
label.
Tablets 9igoxin
?abetolol
Naproxen
9ispense into a )edicine cup and hand
to older person +ith a glass o( +ater.
!lternati*ely, place tablet on bac, o(
tongue to sti)ulate the s+allo+ing
re(lex. !llo+ ti)e (or s+allo+ing. !ll
tablets should be s+allo+ed +hole
unless other+ise ad*ised by the
phar)acist.
! )ortar and pestle or electronic
crusher could be use to crush, i(
indicated. Tablets can be split i( too big
to s+allo+.
#apsules !)oxyl
/araceta)ol
#apsules should be s+allo+ed +hole
+ith +ater.
I( indicated, it can be opened and )ixed
+ith (ood.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1== o( 282
0edicine E,ample Preparation and specific guidelines
?i-uids #ough
)ixtureA
Benadryl,
9uroATuss
/red)ix
6ha,e gently.
5easure into a )easuring cup or spoon
and assist older person to drin,.
Inhalers /u((er,
nebuliKerA
*entolin
6ha,e the capsule.
Fnsure nebuliser, bo+l and )as, are
clean.
1lder person should be in a sittingAup
position.
/atches Transider)A
nitro
6,in )ust be cleaned +ith +ater and
dried properly.
5ust be applied to a dry, clean, nonA
hairy area.
!pply the stic,y side to the s,in. /ress
(ir)ly and do not rub.
!pply to alternate sides.
/o+ders ral
5eta)ucil
This )ight be in po+dered (or) and
should be dissol*ed in +ater.
To pre*ent lu)ps a sha,er )ight be
re-uired.
6uppositories Glycerin
suppositories
5icrolax
Naprosyn
/araceta)ol
sually aged care +or,ers are not
expected to per(or) this tas,. #hec, the
guidelines in your +or,place.
Topical
)edication
&)edication
used on the
s,in'
Bepanthen
crea)
#ortisone
crea)s
1int)ent should be patted onto the s,in
A do not rub.
Glo*es )ust be +orn to pre*ent
absorption through the s,in.
6cheduled
drugs
/ethidine
Te)aKepa)
Fndone
In so)e states or territories there )ight
be a re-uire)ent (or t+o people to
chec, be(ore an older person ta,es a
6chedule 8 drug.
7a(ers &oral
disintegrating
1lanKapine /lace +a(er on the tongue. It +ill
dissol*e in the )outh and can be
s+allo+ed +ith sali*a.
)edication'
Acti*ity # -ole Play
#hoose 2 any types o( )edication such as tablets and po+ders, (ro) the
abo*e table. /ractice ho+ you +ould:A
Introduce yoursel(
/repare the necessary e-uip)ent
Gi*e those )edications
6tate the docu)entation to be co)pleted
!nd so on to your partner and *ice *ersa.
3.3 Super*ise and o"ser*e clients when ta2ing medication and confirm
with them their ingestion or completion
Super*ising the medication
)ost e((ecti*e +ay. 7hate*er the situation and +hate*er strategy you use,
you need to super*ise to )a,e sure the correct a)ount has been
success(ully ta,en.
Dour role is to obser*e and )a,e sure the )edication has been
co)pleted. Dou should )a,e reasonable e((orts to assist the).
6uper*ision can include the (ollo+ing techni-ues:
Fxplain the process (or ta,ing )edication and +hy it is i)portant (or
the older person. This )ay i)pro*e their understanding and
cooperation. 0e)ind the person +hat )edication to ta,e and +hy they
are ta,ing it. Dou can o((er to contact health pro(essionals (or (urther
ad*ice. This allo+s the older person to )a,e a decision based on +hat
their doctor tells the).
Fncourage and gi*e the older person con(idence to )aintain their
independence. !n older person is )ore li,ely to cooperate +hen they
(eel they are in control o( the situation and ha*e a say in their o+n
health care )anage)ent. 0e)e)ber that the older person has the
right to re(use treat)ent.
1bser*e the person ta,ing the )edication. 9on"t lea*e the) until you
are satis(ied the )edication has been (ully ingested or the treat)ent
co)pleted. 2or exa)ple, i( so)e po+der is still le(t in the glass, rinse
the glass +ith a little )ore +ater and as, the) to co)plete ta,ing it.
7atch (or the s+allo+ing re(lex in the person"s throat. This is generally
a good indicator that the person has s+allo+ed the tablets.
1((er ade-uate (luids. The proble) )ay be as si)ple as not ha*ing
ade-uate +ater in their )outh to help s+allo+ tablets.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1=$ o( 282
/ro*ide help +hen needed or as,ed (or and +ithin authorised
procedures, li,e cutting the tablet in t+o or o((ering the person one
tablet at a ti)e.
Gi*e the )edication +ith (ood i( they disli,e the taste o( the tablet, or
o((er the) so)ething they li,e to eat or drin, i))ediately a(ter they
ha*e ta,en all the )edication &i( authorised by the doctor'.
0espect(ully as, the) i( you can chec, their )outh, i( you suspect they
ha*en"t s+allo+ed the )edication. 1lder people )ay be con(used and
(orget that a tablet should be s+allo+ed. They )ay not ,no+ +hat to
do +ith it in their )outh. Dou can as, the) -uestions such as "@a*e
you s+allo+ed your tabletI"The -uestions the aged care +or,er as,s
the) )ight trigger their )e)ory. !s, the older person to open their
)outh i( you are not sure and chec,. This should be done in a sensiti*e
and unobtrusi*e )anner.
I( )edication is not ingested as prescribed, or the aged care +or,er has
reason to belie*e that any o( the abo*e situations )ay occur on a regular
basis, it should be reported to the super*isor or doctor and docu)ented
+ithout delay.
! )a3or responsibility o( an aged care +or,er is to )a,e sure the person
recei*es the (ull bene(it (ro) their )edication. It is i)portant that you +atch
and super*ise the older person as they ta,e their )edication so you can
be sure all the instructions ha*e been (ollo+ed.
I( the )edication has not been ingested or co)pleted it +ill not be
e((ecti*e. In so)e cases this )ay be har)(ul to the older person.
The older person )ay hide the )edication or thro+ it a+ay i( they don"t li,e
the taste or i( it is di((icult to s+allo+. 2or exa)ple, you )ay (ind tablets
+rapped in a tissue stu((ed behind a cushion, or traces o( tablet in the sin,
+here they tried to +ash the) a+ay. The person )ay si)ply decide not to
ta,e it. They )ay decide they no longer need to ta,e it. They )ay spit it
out or *o)it it straight bac,. They )ay ha*e )outh proble)s that cause
pain +hen anything is put in the )outh. They )ay not put enough lotion on
the a((ected area.
)ost e((ecti*e +ay. 6uper*ision can include:
re)inding the person +hat to ta,e
re)inding the person +hy they are ta,ing the )edication
placing the )edication +ithin easy reach or lea*ing it out in a handy
place
obser*ing the person ta,ing the )edication
pro*iding help +hen needed or as,ed (or and +ithin authorised
procedures, li,e cutting the tablet in t+o
encouraging and gi*ing the older person con(idence to )aintain their
independence.
Tips to )a,e sure the )edication has been ta,en include:
7atch (or the s+allo+ing re(lex in the person"s throat. This is generally
a good indicator that the person has s+allo+ed the tablets.
0espect(ully as, the) i( you can chec, their )outh, i( you suspect they
ha*en"t s+allo+ed the )edication.
I( so)e po+der is still le(t in the glass, rinse +ith a little )ore +ater.
Gi*e the )edication +ith (ood i( they disli,e the taste o( the tablet.
1((er the person one tablet at a ti)e.
1((er the) so)ething they li,e to eat or drin, i))ediately a(ter they
ha*e ta,en all the )edication &i( authorised by the doctor'.
7hate*er the situation and +hate*er strategy you use, you need to
super*ise to )a,e sure the correct a)ount has been success(ully ta,en.
5atching the older person after they ha*e ta2en the medication
It"s i)portant that aged care +or,ers +atch the older person a(ter they
ha*e ta,en their )edication to obser*e any changes in their condition or
any reactions they ha*e to the )edication.
7hen prescribing the )edication, the doctor ta,es into account the
li,elihood o( the )edication a((ecting the person and prescribes )edication
that should ha*e no ad*erse e((ects. 2or exa)ple, i( a person has a +ea,
heart the doctor +ould not prescribe anything that +ould +orsen this
condition.
@o+e*er, occasionally there )ay be instances o( unexpected reactions to
a particular )edicine. ! reaction )ay ta,e hours, days or e*en +ee,s to
happen. 6o)eti)es it )ay occur i))ediately or *ery soon a(ter the
person has ta,en the )edication. 2or exa)ple, a person )ay *o)it,
beco)e diKKy, lose consciousness or ha*e a seiKure. 6o)eti)es it )ay
ta,e )uch longer and the changes )ay be s)all ones. Dou should
obser*e the older person e*ery ti)e you *isit to +atch (or any changes in
their condition.
7hen prescribing the )edication, a doctor +ill explain to the older person
+hy they are ha*ing the )edication and +hether there )ay be any
possible sideAe((ects. They )ight ad*ise the person +hat to loo, out (or
+hen they ta,e the )edication.
The aged care +or,er )ay be a+are that the older person is also ta,ing
o*erAtheAcounter supple)ents such as *ita)ins or )inerals. They should
docu)ent this clearly in the care notes or noti(y their super*isor. 6o)e
nonAprescribed supple)ents )ight react +ith the prescription )edication.
2or exa)ple, a person )ay be on tablets to lo+er their blood pressure and
at the !liciae ti)e be ta,ing a supple)ent that )ay ha*e the potential to
raise their blood pressure.
&nderstanding a personDs progress notes
!n aged care +or,er has a responsibility to ,no+ about the potential sideA
e((ects o( any )edication they are helping the older person to ta,e. 5a,e
sure you are (a)iliar +ith the person"s care plan, )edication (or) or notes
that ha*e been )ade by health pro(essionals about possible sideAe((ects or
reactions. In addition to explaining the purpose o( the )edication and +hen
it should be ad)inistered, the in(or)ation should also include:
un+anted sideAe((ects to +atch out (or
ho+ long be(ore sideAe((ects )ay be expected to occur
possible interactions +ith other )edication the person is ta,ing
storage conditions.
2or exa)ple:
5iss Fdith /arrass )ay be allergic to the penicillin. 7atch (or a rash
appearing <A% hours a(ter ta,ing the )edication.
Far drops should not be too cold. I( they are too cold +hen applied to
the ear they )ay cause pain, diKKiness or nausea. #hec, that the
storage te)perature is correct.
(oo2ing for changes
! ,ey responsibility is to be obser*ant and +atch (or any changes in a
person"s condition a(ter they ha*e ta,en the )edication. The role o( the
aged care +or,er in these circu)stances is +ritten clearly into their 3ob
role and the policies and procedures o( the +or,place.Dou )ust
understand and (ollo+ these instructions. The (ollo+ing is a list o( changes
to +atch (or:
#hanges to air+ay, (or exa)ple cho,ing
Breathing that has slo+ed or is too (ast
0ash
6+elling
@eadache
6,in tone
6lurring o( speech
Nausea and *o)iting
Blurred *ision
#on(usion
7eight (luctuations
Bo+el )o*e)ents
!llergy
#hanges in beha*iour such as beco)ing angry, irritable, lethargic,
energetic
!nything that appears abnor)al about the older person
!nything else that the doctor or health pro(essional has ad*ised you to
+atch out (or
Chec2ing the personDs condition
!n aged care +or,er +ho *isits regularly is in a good position to see
+hether the older person is experiencing any sideAe((ects caused by the
)edication they are ta,ing. There are lots o( +ays you can do this.Dou can
identi(y changes in a person"s condition by:
tal,ing to the) and as,ing the) ho+ they (eel
obser*ing their colour, )obility, )ental and *erbal responses, and
physical signs
tal,ing to others associated +ith the), li,e (a)ily )e)bers or a
neighbour
chec,ing the person"s care plan, )edication chart and progress notes.
7hen you ha*e identi(ied that there are changes, there are a nu)ber o(
things you should as, yoursel(:
7hat response is neededI
#an I deal +ith thisI
6hould I consult )y super*isor or other health pro(essionalI
7hat i)pact +ill this ha*e on the person"s routineI
F)ergencies such as loss o( consciousness, dangerous beha*iour or
seiKures should al+ays be reported straighta+ay. They )ust be dealt +ith
according to policies and procedures. 2or exa)ple, apply (irst aid, get help
(ro) other sta(( and super*isor and )ay be call e)ergency ser*ices.
Dou )ust +atch to see +hether an older person has any sideAe((ects a(ter
ta,ing their )edication. ?oo, at the anaphylaxis reactions belo+.
+igure # Anaphyla,is reactions
-esponding according to procedures
Dou )ust (ollo+ the guidelines pro*ided by your +or,place (or responding
to a reaction to )edication. !n aged care +or,er )ust not gi*e any
)edical ad*ice or opinion. Dou )ust not atte)pt to treat the person unless
you are instructed to do so and ha*e the appropriate (irst aid training.
5a,e sure you docu)ent any *erbal instructions you recei*e.
Dou )ust i))ediately contact your super*isor, +ho +ill tell you +hat to do.
Dou )ay be instructed to:
call an a)bulance
call a (a)ily )e)ber
call a doctor
clear air+ays
place pillo+s to support the person"s head
co*er the) +ith a blan,et
do nothing.
In a critical situation, (or exa)ple the older person is unconscious or
ha*ing a seiKure, al+ays call an a)bulance (irst, by dialling 000 or i( using
a )obile phone 112. It is al+ays better to call an a)bulance e*en i( you
disco*er later that it is not needed.
0eassure the older person. #al) the person do+n. Tell the) +hat you are
going to do. 2or exa)ple, tell the) that you +ill call your super*isor, or call
an a)bulance. Eeep the) in(or)ed at all ti)es by explaining +hat you are
doing and +hat +ill happen as a result. 5a,e sure they are co)(ortable.
#lean up any )ess that has been )ade.
Dou )ay need to be (lexible and change the day"s routine i( necessary.
5a,e sure you ,no+ +hat the procedures are relating to the ad)inistration
o( )edication in changed circu)stances. 2or exa)ple, is it 1E i( the
person does not ta,e all their )edication that dayI #ertain )edication
routines )ay not be (lexible and you +ill need to rely on ad*ice (ro) the
health pro(essionals. 2or exa)ple, the ti)ing o( so)e )edications is
crucial as they )ay ha*e been prescribed to be gi*en at set inter*als. !ny
interruption to this cycle could a((ect the person"s health.
Documenting the situation
2ollo+ +or,place procedures to docu)ent +hat has occurred. These *ary
(ro) place to place. Dou )ay ha*e to co)plete an incident report or +rite
up the situation in the person"s care notes, co))unication boo, or on a
(eedbac, (or). 7hate*er the )ethod used, the i)portant thing is that the
in(or)ation is +ritten clearly and accurately so e*eryone +ho reads the
notes is clear about +hat happened. They can then )a,e an in(or)ed
decision about +hat to do. 5a,e sure you sign and date the
docu)entation. ! health pro(essional )ay need to get in touch +ith you.
Acti*ity
@o+ +ould you super*ise and obser*e clients ta,ing )edicationsI
?ist +ays to con(ir) that a client has ingested or co)pleted their
)edicationsI
3.4 Complete documentation= record of medication administration
!n essential responsibility o( an aged care +or,er is to report and record
exactly +hat they ha*e obser*ed +hen the older person ta,es their
)edication. Dour records +ill be read by your super*isor, the older
person"s doctor and other aged care +or,ers.
It is part o( legal re-uire)ents to docu)ent +hat you ha*e obser*ed. Dour
obser*ations )ay be included in a court case i( die older person has a
negati*e reaction to the )edication +hich causes har) to the older
person.
1rganisational procedures and (or)s )ay di((er bet+een +or,places, but
all +or,ers )ust record:
+hat )edication the older person too,
ho+ )uch they too,
the ti)e they too, it
the day they too, it
+hether the )edication +as ingested or co)pleted success(ully
the support they ga*e to encourage the ad)inistration o( the
)edication
any reaction the person had to the )edication
any (urther co))ents or obser*ations they need to )a,e.
!ccurate record ,eeping or docu)entation is essential so there is a
per)anent record o( +hat too, place. !ll +or,ers and health pro(essionals
in*ol*ed +ith the older person"s care )ust understand +hat )edication
has been gi*en and +hether there +ere any sideAe((ects.
Acti*ity
7hy is accurate docu)entation i)portantI
2ro) your experience, list < possible ra)i(ications o( (ailing to accurate
co)plete )edication charts.
0edication Charts
F*idence that )edication is ta,en as prescribed should be recorded and
signed by the person +ho assisted +ith the ad)inistration. It is also
i)portant to docu)ent i( the )edication +as not gi*en or co)pleted or i(
there +as an error. 2or exa)ple:
the older person re(used )edication
the older person is currently in hospital
the older person only partially co)pleted the )edication then stopped
the )edication +as )issing (ro) its pac,aging.
5a,e sure you are (a)iliar +ith the types o( docu)entation you are
re-uired to co)plete. This )ight include a )edication ad)inistration (or)
and progress notes.
7hen loo,ing at orders on a )edication chart it is i)perati*e to loo, at the
fi*e -s these are:A
The right D-&)
The right D!SE
The right -!&E
The right '0E
The right PA'E7=C('E7
I( the 8 rights are not co)pleted on the )edication chart +hat do you doI
9o not gi*e the )edications and noti(y the super*isor i))ediately and
docu)ent in the progress notes.
@ere are 2 exa)ples o( entries on a )edication chart.
+igure # Entries on a medication chart.
Acti*ity
7hat are the 8 rightsI
@o+ docu)ent belo+, on the )edication chart, that you ga*e /araceta)ol
on the 2B8B0$ at <p).
7hat is )issing (ro) the abo*e )edication chartI
#ontinuing (ro) the pre*ious -uestion, +ould you still gi*e the )edicationI
Fxplain your ans+er.
7hat do the lines )ean on the )edication chart belo+I
7hy is it i)portant o( recording )edication ad)inistration in align)ent +ith
organiKational policies and proceduresI
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1$0 o( 282
3.5 !"ser*e client for any changes in their condition listed in the -ange
Statement and see2 assistance from a health professional6
super*isor6 medical officer or emergency ser*ices as indicated in the
organisation>s policies
(oo2ing for Changes
role and the policies and procedures o( the +or,place. Dou )ust
understand and (ollo+ these instructions.
The (ollo+ing is a list o( changes to +atch (or:
#hanges to air+ay, (or exa)ple cho,ing
Breathing that has slo+ed or is (ast
0ash
6+elling
@eadache
6,in tone
6lurring o( speech
Nausea and *o)iting
Blurred *ision
#on(usion
7eight (luctuations
Bo+el )o*e)ents
!llergy
#hanges in beha*iour such as beco)ing angry, irritable, lethargic,
energetic
!nything that appears abnor)al about the older person
!nything else that the doctor or health pro(essional has ad*ised you to
+atch out (or
Chec2ing the condition of a person
!n aged care +or,er +ho *isits regularly is in a good position to see
+hether the older person is experiencing any sideAe((ects caused by the
)edication they are ta,ing. There are lots o( +ays you can do this. Dou
can identi(y changes in a person"s condition by:
tal,ing to the) and as,ing the) ho+ they (eel
obser*ing their colour, )obility, )ental and *erbal responses, and
physical signs
tal,ing to others associated +ith the), li,e (a)ily )e)bers or a
neighbour
chec,ing the person"s care plan.
7hen you ha*e identi(ied that there are changes, there are a nu)ber o(
things you should as, yoursel(:
7hat response is neededI
#an I deal +ith thisI
6hould I consult )y super*isor or other health pro(essionalI
7hat i)pact +ill this ha*e on the person"s routineI
F)ergencies such as loss o( consciousness, dangerous beha*iour or
seiKures should al+ays be reported straighta+ay. They )ust be dealt +ith
according to policies and procedures. 2or exa)ple, apply (irst aid, contact
super*isor and )aybe call e)ergency ser*ices.
-esponding to a personDs reaction to their medication
Dou ha*e an i)portant role in the care o( an older person. Dou )ay be the
only person they see apart (ro) their doctor. Because o( this it is essential
that you +atch the) +hen they ta,e their )edication &or as, -uestions i(
they ha*e already ad)inistered it' and ta,e note o( any reaction they ha*e
to the )edication. It is i)portant that you obser*e the person as they
ad)inister their )edication so you can see +hether they are ta,ing the
correct dosage. Dou can also see i( they ha*e a reaction to the )edication.
Dour 3ob is to identi(y, report, record and address a person"s reaction to
their )edication.
! person"s reaction to )edication )ay include:
*o)iting the )edication
e3ecting the )edication, (or exa)ple spitting it out
re(using to ta,e it
ha*ing a change in their condition li,e (ainting or (eeling sic, or diKKy
i))ediately a(ter ad)inistration.
Eno+ +hat your +or,place procedures are and +hat you are re-uired to
do to deal +ith any reactions. !s discussed pre*iously, your (irst steps are
to noti(y your super*isor, )a,e sure the older person is co)(ortable, (ollo+
any instructions you are gi*en, then record exactly +hat has ta,en place.
!(ter you ha*e discussed the situation +ith your super*isor and ta,en the
appropriate action, you need to +rite exactly +hat has happened, describe
+hat you ha*e done and +hat (ollo+Aup is re-uired so e*eryone else
in*ol*ed in the person"s care understands the situation.
2ollo+ your +or,place procedures and co)plete the correct (or). This
)ight be a care note, a co))unication boo,, an incident report (or), an
ad*erse drug reaction (or). Be (a)iliar +ith the style and the a)ount o(
in(or)ation re-uired. Dou should +rite clearly, accurately and in brie(
sentences. Eeep to the point. 9o not )a,e any suggestions or personal
state)ents. 2or exa)ple, +rite "!gnes has a rash", not SI thin, !gnes has a
rash because she ate oysters that al+ays disagree +ith her, though it
could be the ne+ )edication". Generally, any ,no+n allergies are recorded
on the person"s care plan and +ould ha*e been ta,en into account by the
doctor +hen prescribing the )edication.
The (ollo+ing table gi*es a su))ary so)e conditions and +hat to obser*e
(or as a +or,er.
+igure # Physical changes
#hanges to air+ay cho,ing
not able to s+allo+
#hanges to breathing slo+ed
(ast
(aint
#irculation unexpected dro+siness
colour change
rapid pulse
(aint pulse
0ash continual scratching
redness
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1$; o( 282
Physical changes continuedG
In(la))ation redness
heat &older person is hot to touch'
s+elling
pain
6+elling s+ollen hands, throat or nasal passages
@eadache
&)ay indicate high
blood pressure'
cannot (ocus +ell
is lightAsensiti*e
can"t get up (ro) their bed
@earing loss cannot hear
ringing in the earBs
)atter co)ing (ro) the earBs
cannot understand instructions
Blurred *ision cannot read labels
unsteady on their (eet
9iKKiness
&)ay indicate lo+
blood pressure'
losing balance
(eeling (aint
eye +ea,ness
inability to )aintain nor)al seated balance
6lurring o( speech
&)ay indicate stro,e'
cannot spea, clearly
+ords 3u)bled
cannot )a,e the)sel*es understood
Nausea dry retching
pale
has the urge to *o)it
>o)iting *o)iting as soon as )edication is ta,en
*o)it in the toilet bo+l or on their clothes
9iarrhoea loose bo+el )otions
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1$< o( 282
5obility stu)bling
+igure # Beha*ioural changes
#on(usion cannot decide +hat to do
cannot re)e)ber +hen to ta,e the )edicine
cannot re)e)ber the right dose
does not (ollo+ instructions
hoards tablets
9isorientation the older person doesn"t ,no+ +here they
are or +hat is happening to the)
Not sleeping is )ore tired than usual
is al+ays dro+sy
5ood changes is )ore irritable than usual
re(uses to ta,e the )edication
6ho+ing signs o( stress does not sleep
is angry
physical changes, such as a rash
6ubstance abuse or
)isuse
#o)bining )edications, ta,ing alcohol +ith
)edication
Acti*ity
?ist (irst ; things you +ould do i( the older person is ha*ing a reaction to
)edication they ha*e 3ust consu)ed.
?ist 8 changes that )ay occur to an older person post )edications.
?ist people you )ay see, assistance (ro).
@o+ do you ,no+ +hat to do i( you obser*e changes in a clientsC
conditionI Is this +ritten any+hereI I( so, +hereI
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1$% o( 282
3.9 Discard waste products according to organisation procedures and= or
manufacturer>s instructions
Safely throwing away any waste material
To reduce the ris, o( conta)ination you )ust al+ays dispose o( any +aste
)aterials associated +ith the )edication. The +aste that you deal +ith
depends on the type o( )edication and the support you gi*e to the older
person. 6o)eti)es there +on"t be )uch +aste except (or e)pty glass
bottles or plastic tubes o( )edicine. In other cases you )ay deal +ith
*o)it, soiled clothes, sharps, blood and other body (luids as +ell as
discarded pac,aging )aterial, disposable plastic cups and glo*es.
7aste )ight include:
e)pty bottles and bottle tops
e)pty pac,ages
e)pty sachets
e)pty boxes
e)pty blister pac,s
e)pty plastic tubes
cotton +ool
adhesi*e dressing plastic and used dressing
disposable glo*es
soiled )aterial.
In a residential care setting there +ill be +aste disposal containers (or
speci(ic products, li,e sharps containers, bins (or general +aste,
conta)inated +aste bins that ha*e blood, bodily (luids, and recycle bins (or
cardboard, paper and glass.
In a person"s ho)e you )ay ha*e to gi*e the) special containers (or
+aste. I( not, you should as, per)ission to use the person"s o+n recycle
and rubbish bins. !l+ays loo, around to chec, +hether any +aste is le(t
lying around +hen you begin your *isit and 3ust be(ore you lea*e.
#lear guidelines should be a*ailable in your +or,place to explain ho+ to
dispose o( )edications. It is also i)portant to (ollo+ state or territory
guidelines in relation to disposal o( phar)aceutical +aste.
2ollo+ these rules:
Fxpired )edication is usually sent bac, to the phar)acy.
#onta)inated )edication, (or exa)ple a tablet that (ell on the (loor,
can be placed in the sharps container (or incineration or discarded +ith
clinical +aste.
6chedule 8 drugs )ust be returned to the phar)acy or en*iron)ental
health unit as per speci(ic state or territory guidelines.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1$= o( 282
sed, conta)inated or expired patches )ust be (olded in hal(, stic,y
sides together, and discarded +ith clinical +aste. 7hen this is not
possible they should be sent bac, to the phar)acy (or sa(e disposal.
I( you are not sure ho+ to correctly dispose o( a particular )edication,
chec, +ith the phar)acist.
Dou should ne*er discard )edication in the garbage bin, do+n the toilet or
do+n the sin,. @ere are so)e reasons +hy:
There are serious health ris,s in*ol*ed +hen expired )edication is
thro+n out +ith the garbage. #hildren and pets could get hold o( it.
The )edication can tric,le through to +ater supplies +hen it ends up in
land(ills.
2lushing do+n the toilet )ay ,ill help(ul bacteria in the en*iron)ent
and could har) a-uatic li(e in the ocean.
7aste +ater treat)ents do not re)o*e )edication residue.
Disposing of 5aste
9isposable ite)s such as plastic cups, tissue paper and cotton +ool can
cause signi(icant har) to the en*iron)ent and it is there(ore essential that
they are disposed o( in the correct +ay. 2ollo+ +or,place procedures.
@ere are so)e suggestions:
9isposable cups, spoons, cotton +ool, gauKe and paper to+els should
be discarded in the rubbish bin.
!ny containers +ith )edication residue should be discarded in the
clinical +aste bins. 1rganisations are obliged to pro*ide these and
should ha*e a contract (or their sa(e re)o*al under 1@Z6.
6harp e-uip)ent, (or exa)ple insulin syringes, )ust be placed in a
sharps container )ade o( thic, i)penetrable plastic.
Disposal of contaminated6 unused or e,pired medications
Getting rid o( +aste incorrectly can ha*e serious conse-uences, including
detri)ental e((ects on the en*iron)ent and the people +ithin it. I(
)edication goes into general rubbish, children and pets could get hold o( it.
7hen disposed o( into land(ill, it can tric,le through to ri*ers, la,es and
+ater supplies. There are strict en*iron)ental and sa(ety guidelines (or the
disposal o( )edical +astes, so it is i)portant that you (ollo+ the policies
and procedures that apply in your +or,place.
#onta)inated drugs or expired )edication )ust be returned to the
phar)acy (or sa(e disposal. 6o)e en*iron)ental health units +ill ha*e
speci(ic guidelines in relation to thisJ (or exa)ple, there )ay be a
re-uire)ent (or 6chedule 8 drugs to be dealt +ith in a di((erent
)anner. #hec, +ith your super*isor i( your organisation has any
speci(ic guidelines (or the disposal o( 6chedule 8 drugs. !l+ays chec,
+ith the phar)acist i( you are not sure.
The older person )ay not ingest a tablet properly. They )ay spit it out,
or it )ay (all out o( their )outh. These tablets should be disposed o( in
the sharps container to be re)o*ed +ith the clinical +aste.
sed patches )ust be (olded in hal(, sides stuc, together and placed
in the clinical +aste container.
+igure # Sharps Containers

Disposal of medication containers
6o)e dose ad)inistration aids are suitable (or )ultiple uses and
should be returned to the phar)acist +hen e)pty.
1ther containers that ha*e the older person"s details printed on the)
should be sent bac, to the phar)acist or shredded onsite to protect the
pri*acy o( older people.
!ll used )edicine bottles, tubes and other containers should be
+ashed then placed into the regular rubbish bin.
In a co))unity setting the older person has the right to decide +hether
they +ant to place )edication containers in the ordinary garbage bin
and +hether they +ant to re)o*e the label prior to doing so.
Ne*er thro+ a+ay outAo(Adate )edicines in the rubbish. They )ust be
returned to the phar)acy.
0ethods of disposal
2ollo+ these )ethods to )a,e sure all +aste products are disposed o(
sa(ely and hygienically:
0inse bottles or plastic containers be(ore putting in a recycle bin.
I( you co)e across any sharps such as raKor blades, insulin needles
gi*en by a *isiting nurse, or needles used in )easuring blood sugar
le*els, place the) in a sharps container.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 1$$ o( 282
<. !ssistBsupport )edication
ad)inistration according to
prescriptionBinstructions
4.%
/repare )edications and ad)inister to the client or support
their sel( ad)inistration according to the speci(ic re-uire)ents
o( the (or) o( )edication, in strict accordance +ith de(ined
legislation and organisation procedures and +ritten
prescription instructions
4.3
I)ple)ent all necessary chec,s to ensure the right
)edication is gi*en at the right ti)e, to the right person, in the
right a)ount, *ia the right route
4.3
!ssist the client to ta,e the )edications as re-uired, in
accordance +ith their needs and docu)ented procedures
4.4
6uper*ise and obser*e the client +hen ta,ing the )edication
and con(ir) +ith the client their ingestion or co)pletion
4.5
I)ple)ent docu)ented procedures (or )edication not being
ad)inistered or absorbed, such as through expellingB*o)iting,
re(usal or da)age to )edication and report to super*isor
andBor health pro(essional
4.9
0ecord all re-uired details o( )edication ad)inistration and
other details in the appropriate docu)ents according to the
legislation and organisationCs procedures
4.:
1bser*e the client (or any possible )edication e((ects listed in
the 0ange 6tate)ent and report to a super*isor or health
pro(essional
4.;
#ollect used e-uip)ent, discarded )edications B applicators
and rubbish and place in appropriateB designated receptacle
according to instructions
4.% Prepare medications and administer to the client or support their self
administration according to the specific re?uirements of the form of
medication6 in strict accordance with defined legislation and
organisation procedures and written prescription instructions
AndH
4.3 'mplement all necessary chec2s to ensure the right medication is
gi*en at the right time6 to the right person6 in the right amount6 *ia the
right route
Chec2ing the medication
By no+ you should understand the i)portance o( chec,ing and doubleA
chec,ing to ensure that the right )edication is gi*en to:
the right person
at the right ti)e
in the right a)ount
*ia the right route.
he right medication
Be(ore an older person ta,es their )edication, the label )ust be chec,ed
(our ti)es:
1. 7hen (irst pic,ing up the )edication container
2. 7hen chec,ing the label against the )edication chart or list
;. 7hen )edication is re)o*ed (ro) the container
<. Be(ore the older person ta,es it
The content o( the dose ad)inistration aid or )edication pac,et should
also be chec,ed against the drugs listed in the )edication chart, i( a chart
is in use. The label on the )edication )ust be legible, easy to read and in
big print. I( there is any doubt, do not continueJ get assistance (ro) the
super*isor, doctor or phar)acist.
Acti*ity
The tablet you re)o*e (ro) the dose ad)inistration aid loo,s di((erent to
the one you re)o*ed the day be(ore. 7hat should you doI
he right time
#hec, the indicated ti)es to ensure that the )edication is gi*en at the
right ti)e. The ti)es should be clearly docu)ented on the container or
)edication chart and in )edication notesBcharts. This )ight be:
once a day
+ith (ood
a(ter )eals
in the )orning
at hourly inter*als
+hen needed.
Dour super*isor +ill explain anything you need to ,no+. 2or exa)ple,
so)e drugs are altered by (ood and should be gi*en at least one hour
be(ore )eals. 6o)e )edications should not be gi*en together and can
re-uire up to a t+oAhour inter*al bet+een )edications. ! patch should not
be applied to +et s,in, so )a,e sure the person has sho+ered and is dry
be(ore continuing. 5ost drugs gi*en +ithin ;0 )inutes o( the prescribed
ti)e are considered to be on ti)e. 1thers such as insulin and so)e
antibiotics )ust be ta,en at precisely the right ti)e.
>arious abbre*iations are used to indicate ti)es +hen )edication should
be ta,en. Dou +ill need to learn +hat these are. There is a list o( co))on
abbre*iations in !spire"s +or,boo, @andling aged care in(or)ation.
I( the person is sel(A)edicating )a,e sure they understand any
abbre*iations on the label. Dou )ay need to translate these. In )ost cases
the )eaning +ill be clear. @o+e*er you )ay (ind that so)e instructions are
+ritten using initials that co)e (ro) a ?atin +ord.
+igure # Prescri"ed times
The (ollo+ing are exa)ples o( prescribed ti)es.
a) 5orning
p) F*ening
nocte Night ti)e
)ane 5orning
p.r.n. 7hen needed
-.i.d. < ti)es a day
t.d.s. or t.i.d. ; ti)es a day
b.i.d. T+ice a day
6o)eti)es, the instructions only say SThree ti)es daily". sually, the
as they get up in the )orning, be(ore lunch and be(ore dinner. Eeep in
)ind any other instructions such as SBe(ore )eals". Dou should )a,e sure
they understand it has to be ta,en be(ore they begin to eat.
Dou need to understand so you can explain to the older person +hat
instructions such as "(ourAhourly" )eans. 7hen do you start the (our hoursI
9o you count the hours at night as +ellI
p.r.n. )edication. 5any p.r.n. )edications are (or pain relie(. It is i)portant
that aged care +or,ers understand the procedures (or these )edications
and (ollo+ the instructions they ha*e been gi*en. They need to explain
these to the older person so the older person understands +hen they can
sa(ely ta,e the). 2or exa)ple, you need to ,no+ ho+ the )edication
should be ta,en &+ith (ood, crushed, not crushed' and the sa(e inter*al
bet+een doses &the )ini)u) nu)ber o( hours bet+een )edication'. 1lder
people ha*e the right to )a,e their o+n decisions about +hen to ta,e their
)edication. @o+e*er, aged care +or,ers ha*e a duty o( care to see they
ta,e their )edication as the doctor has prescribed. Dou )ust let your
super*isor ,no+ i( an older person +ants to ta,e their )edication )ore
(re-uently, as this has potential to har) the).
Fxplaining Sas needed" )edication is described in the (ollo+ing exa)ple.
E,ample
5r. @enry is ta,ing )edication (or pain relie(. The aged care +or,er
explains +hat Sas needed" )eans.
S5r. @enry, you ha*e been prescribed analgesics (or pain. The doctor says
you are to ta,e the) +hen you (eel the pain is *ery bad. I ,no+ the doctor
and phar)acist +ill ha*e explained ho+ to use these pain,illers, but I
+ould 3ust li,e to con(ir) +ith you that you understand ho+ )any you can
ta,e e*ery day."
SThe prescription says Vno )ore than threeV e*ery 2< hours. This )eans
that you can only ha*e three tablets e*ery day. I( you are (inding your pain
is increasing and +ant to ha*e )ore tablets, you )ust let )e ,no+ and I
+ill arrange (or the super*isor to get in touch +ith your doctor to discuss
this +ith you."
F*en i( the person is sel(A)edicating it is i)portant that any )edication
they ta,e is recorded on a )edication chart and in their care notes. sually
the older person +ould need to re-uest that their )edication is brought to
the) (ro) a loc,ed cupboard. I( not, )a,e sure they ,no+ that they )ust
tell sta(( +hen they are sel(A)edicating +ith a p.r.n. )edication, so this can
be recorded.
The (ollo+ing exa)ple sho+s ho+ )edication is recorded in an older
person"s care notes.
E,ample
In(or)ation in an older person"s care notes
Prescription for# )a*in Henry
0edicine Dosage 7um"er of ta"lets Doctor
0orning 7oon E*ening Bed
!ntibiotic 120)g 1 1 1 B Bailey
#ough
5ixture
28)l A A A 1 B Bailey
!nalgesic 1 tablet +hen needed, )axi)u) ; per day B Bailey
Acti*ity #
7rite do+n, tell your trainer or roleAplay:A+ith a partner +ho ta,es the part
o( an older person, +hat Sas needed" )eans +hen printed on a label.
Acti*ity #
5hat do you thin2@
@a*e a discussion +ith your class, or +ith +or, colleagues. 9iscuss the
(ollo+ing idea, 7rite do+n your conclusions.
7hy is it i)portant to record +hen so)eone has ta,en a p.r.n. )edicationI
7hat do you thin,I 7hat do others thin,I
he right person
To ensure that the right person gets their )edication, an aged care +or,er
)ust con(ir) their identity be(ore assisting the) to ta,e their )edication.
0e)e)ber that an older person )ay appear )entally alert and still
respond incorrectly e*en to -uestions in relation to their o+n identity.
!s you learnt earlier, an older person can be identi(ied:
by as,ing the) their na)e and chec,ing this against the )edication
label and chart
by chec,ing their photo i( a*ailable on the )edication chart and dose
ad)inistration aid
by chec,ing +ith a second person i( you are still not sure.
Acti*ity #
In your o+n +ords +rite do+n, or tell your trainer, +hy you should not
chec, the older person"s identity si)ply by as,ing SGood )orning, are you
5rs. BaileyI".
he right amount
9rugs +ill only be e((ecti*e i( the correct dosage is gi*en. Too )uch or too
little can cause serious har). 2or exa)ple, an aged care +or,er )ay ha*e
identi(ied the correct older person and helped the) to recei*e the right
)edication, but gi*en the +rong dose. This can happen i( you read the
dosage incorrectly. 2or exa)ple, 188 )l instead o( 18.8 )l.
Bad hand+riting or printing can also result in )edication errors. 2or
exa)ple, you )ay (ind it hard to read +hat the doctor or phar)acist has
+ritten. The printing )ay ha*e a price stic,er placed o*er it. I( you are e*er
in doubt, do not proceed. #ontact the super*isor, doctor or phar)acist. I(
an error occurs, you )ust in(or) your super*isor i))ediately and an
incident (or) should be (illed out and the details o( the error should be
recorded in the older person"s notes.
Acti*ity #
7hat do you thin,I
(ollo+ing ideas:
@o+ i)portant is it to get the right dosage o( )edicationI
OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO
Is it )ore i)portant to get the right dosage (or so)e )edications than
othersI 7hat do you thin,I 7hat do others thin,I
he right route
There are a nu)ber o( +ays to recei*e )edication, such as through the
)outh, rubbing into the s,in, putting drops in or applying a patch to the
s,in. The label explains ho+ the )edication is to be ad)inistered. !ged
care +or,ers )ust be a+are o( the correct route to use to deli*er the
)edication. 6o)eti)es, the instructions +ill be in an abbre*iated (or) that
your super*isor )ay need to explain to you. 5a,e sure you understand
any instructions printed on the label. 2or exa)ple S!pply directly to
a((ected area" )eans that the crea) )ust only be put on the parts o( the
body +here it is needed. S!pply to each nostril" )eans you ha*e to put
drops into both nostrils.
The (ollo+ing table lists the di((erent routes and exa)ples o( the type o(
)edication ta,en *ia those routes. !l+ays as, your super*isor i( there is
anything you are unsure o(.
+igure # -outes of Administration
-oute Another
description
A""re*iation ype of
medication
5outh 1ral p.o. Tablets
6,in Topical ung 1int)ents
nder the
tongue
6ublingual s.l. Tablets or
+a(ers
nder the s,in 6ubcutaneous s.c. In3ections, (or
exa)ple insulin
In a )uscle IntraA)uscular i.). In3ections
Fyes 9rops
Fars 9rops
Nose Nasal 9rops or sprays
7ote#
6o)e )edication )ay be ad)inistered by in3ection or a nebuliser. !ged
care +or,ers )ust not gi*e in3ections or place )edicine in a nebuliser.
Their role is to obser*e and )a,e sure the )edication instructions ha*e
been co)pleted.
4.3 Assist the client to ta2e the medications as re?uired6 in accordance
with their needs and documented procedures
Assisting an older person to ta2e prescri"ed medication
Dou )ust (ollo+ all instructions +hen assisting an older person to ta,e
their )edication. Dour role is to rein(orce the instructions o( the doctor or
phar)acist. The doctor, phar)acist and aged care +or,er all (or) part o( a
tea) and there(ore it is essential to report anything that you )ight thin, is
not sa(e or correct (or the older person you are caring (or.
In so)e instances your 3ob +ill si)ply be to +atch and )a,e sure the
person is ta,ing the correct )edication at the right ti)e in the right +ay.
0e)e)ber, you )ust allo+ an older person to )aintain their dignity and
independence as long as possible. 6o)eti)es you +ill ha*e to pro*ide
)ore assistance, such as unscre+ing a bottle top. I( the person has a
disability or is unable to ta,e their o+n )edication because o( a )edical
condition, you +ill be responsible (or ta,ing the capsule out o( the dose
ad)inistration aid and handing it to the older person to ta,e.
+ollowing doctorDs orders
It is a legal re-uire)ent that doctor"s orders are (ollo+ed (or prescribed
)edication.
7ritten doctor"s orders )ust include the:
older person"s na)e
older person"s diagnosis
)edication, including dose, route and (re-uency
date o( authorisation
signature o( doctor.
+ollowing the prescription
! doctor is accountable (or the correct prescription, +hile the phar)acist is
responsible (or (illing and dispensing this prescription correctly. !ged care
+or,ers )ust (ollo+ the prescription on the label o( the )edication
containers.
6o)e +or,places )ay ha*e a )edication chart +here the doctor repeats
their prescription.Dou )ust sign your na)e next to the )edication that +ill
be gi*en. @ere is an exa)ple.
4.4 Super*ise and o"ser*e the client when ta2ing the medication and
confirm with the client their ingestion or completion
! )a3or responsibility"o( an aged care +or,er is to )a,e
sure the person recei*es the (ull bene(it (ro) their
)edication. It is i)portant that you +atch and super*ise
the older person as they ta,e their )edication so you can
be sure all the instructions ha*e been (ollo+ed.
To do this, you )ust )a,e sure the )edication has been ingested or
completed. I( the )edication has not been ingested or co)pleted it +ill not
be (ully e((ecti*e. In so)e cases this )ay be har)(ul to the older person.
Dou need to )a,e sure:
all the tablets ha*e been dissol*ed and s+allo+ed
all the reco))ended )edicine in the box or sachet has been used
all the drops ha*e been ta,en
the correct a)ount o( lotion has been applied
the patch is securely in place.
!n aged care +or,er should ne*er assu)e that the older person has
success(ully ta,en their )edication. Dou )ust ne*er be in too )uch o( a
hurry and +al, a+ay be(ore you are sure they ha*e (inished the
)edication.
5hat can go wrong@
There are a nu)ber o( things that older people do that can )a,e it di((icult
(or the aged care +or,er. @ere are so)e exa)ples.
The older person thro+s a+ay, hoards or hides the )edication. 6o)e
older people pretend to ta,e their )edication once you ha*e helped
the) to re)o*e it (ro) the pac,age. They ne*er ta,e it. 6o)e )ight
e*en pretend to ta,e it but hide it in their hand or under their tongue.
!ged care +or,ers o(ten report that they ha*e (ound tablets hoarded in
an older person"s dra+er or +rapped in a tissue stu((ed behind a
'ngest )eans to
ta,e (ood or li-uid
into the body.
Ingested )eans
that the li-uid,
tonic, tablets or
capsules ha*e
been co)pletely
s+allo+ed.
Completed )eans
that the correct
a)ount o(
)edication &such
as drops, crea)'
has been applied
and the process is
(inished.
cushion. Dou )ight (ind traces o( tablet in the sin, +here they tried to
+ash the) a+ay.
The older person *o)its the )edication up be(ore it has ti)e to be
ingested.
The older person si)ply re(uses to ta,e the )edication.
4.5 'mplement documented procedures for medication not "eing
administered or a"sor"ed6 such as through e,pelling= *omiting6
refusal or damage to medication and report to super *isor and= or
health professional
It is i)portant that aged care +or,ers +atch the older person a(ter they
ha*e ta,en their )edication to obser*e any changes in their condition or
any reactions they ha*e to the )edication. 7hen prescribing the
)edication, the doctor ta,es into account the li,elihood o( the )edication
a((ecting the person and prescribes )edication that should ha*e no
ad*erse e((ects. 2or exa)ple, i( a person has a +ea, heart the doctor
+ould not prescribe anything that +ould +orsen this condition. 7hen
prescribing the )edication, a doctor +ill explain to the older person +hy
they are ha*ing the )edication and +hether there )ay be any possible
sideAe((ects. They )ight ad*ise the person +hat to loo, out (or +hen they
ta,e the )edication. 5a,e sure you are (a)iliar +ith their )edication chart,
+hich should list any allergies the older person has.
1lder people and aged care +or,ers should also be a+are o( any +arnings
or conditions printed on, the pac,aging o( )edication. 2or exa)ple, S9o
not consu)e alcohol +ith this )edication" or S9o not dri*e +hen ta,ing this
)edication". These +arnings and conditions are listed because in so)e
circu)stances a particular )edication )ay interact +ith another
)edication, an existing condition &such as high blood pressure, allergies',
(ood or alcohol and cause a dangerous reaction (or the older person. The
aged care +or,er and older person should be )ade a+are o( this by the
phar)acist.
5hat might happen
7hene*er )edication is ta,en there is al+ays the possibility o( an
unexpected reaction to a particular )edicine. This includes:
8. 6ideAe((ects
%. !d*erse reactions
=. !llergic reactions
8. F((ects (ro) ta,ing )ore than one )edication
a. Side8effects
! sideAe((ect is a possible response to a )edication. 2or exa)ple, a
person )ay beco)e dro+sy as a result o( an antihista)ineJ a speci(ic
)edication )ight cause headaches in so)e people. /ossible sideAe((ects
are listed in the drug in(or)ation sheet or on the dispensed container, (or
exa)ple S5ay cause dro+siness". 5ost )edications ha*e the potential (or
sideAe((ects, but not all sideAe((ects are serious. The reaction to )edication
can range (ro) )ild &a slight headache' to *ery serious &,idney (ailure,
seiKures and death'.
". Ad*erse reactions
!n ad*erse reaction is an unexpected response to a
)edication and )ay occur as a result o( drug interaction
or (ood interacting +ith drugs. 1*erAtheAcounter or nonA
prescribed substances li,e herbal )edicine, ca((eine and
alcohol ha*e the potential to a((ect the i)pact o(
prescribed drugs and )ay result in an ad*erse reaction
,no+n as drug interaction. The e((ect o( one or both
drugs )ay be increased or decreased. 6o)e drugs are
used purposely in co)bination to pre*ent or )ini)ise
sideAe((ects. !ged care +or,ers should see, guidance
(ro) the doctor or phar)acist be(ore assisting an older
person to ta,e o*erAtheAcounter substances.
c. Allergic reactions
!n allergic reaction occurs +hen a drug triggers the
release o( antibodies in the body and causes a )ild or
se*ere reaction. The onset can be (ast, (or exa)ple
resulting in anaphylactic shoc,. This )eans a (ull body
reaction to a substance that the person is allergic to.
The person )ust ha*e been exposed to the substance
be(ore. The body goes into an So*erreaction" +hich can
lead to death. 6y)pto)s include di((iculty breathing,
loss o( consciousness due to sudden lo+ering o( blood
pressure and in se*ere cases heart (ailure. ! reaction
)ay be delayed and occur o*er a period o( ti)e. !n
exa)ple is der)atitis, an itchy dry rash that occurs
+hen the s,in has been in contact A usually repeatedly
+ith a substance that the person is allergic to, (or
exa)ple a soap, crea) or +ashing po+der. The allergic e((ects and
reactions +ill *ary depending on the type o( )edication and each older
person. 2or exa)ple Aanti Ain(la))atories can cause cra)ps, codeine can
cause constipation and an o*erdose o( )edication can cause dro+siness
or con(usion.
d. Effects from ta2ing more than one medication
The aged care +or,er )ay be a+are that the older
person is also ta,ing o*erAtheAcounter supple)ents
such as *ita)ins or )inerals. They should docu)ent
this clearly in the care notes or noti(y their super*isor.
6o)e nonAprescribed supple)ents )ight react +ith
the prescription )edication. 2or exa)ple, a person
)ay be on tablets to lo+er their blood pressure and at
the !liciae ti)e be ta,ing a supple)ent that )ay ha*e
the potential to raise their blood pressure. The older person"s )edication
should be re*ie+ed by their doctor on a regular basis to pre*ent
polypharmacy and to ensure that the lo+est possible dose is ta,en to
)ini)ise the possibility o( sideAe((ects or ad*erse reactions.
Drug interaction is the
result o( di((erent drugs
interacting +ith each
other, +ith che)ical
agents, or +ith
co)ponents o( the
older person"s diet.
These results can
either be good or bad.
!n allergic reaction
is a physical reaction
such as a rash,
*o)iting, di((iculty
breathing, or
s+elling, due to
contact +ith
substances that are
usually har)less.
6o)e allergies can
be i))ediately li(eA
threatening.
Polypharmacy
)eans a person is
ta,ing )any di((erent
,inds o( prescribed
)edications at the
!liciae ti)e.
0onitoring the older person
!n aged care +or,er has a responsibility to ,no+ about the potential sideA
e((ects o( any )edication they are helping the older person to ta,e and any
possible ad*erse reactions. 5a,e sure you are (a)iliar +ith the person"s
care plan, )edication (or) or notes that ha*e been )ade by health
pro(essionals about possible sideAe((ects or reactions. In addition to
explaining the purpose o( the )edication and +hen it should be
ad)inistered, the in(or)ation should also include:
un+anted sideAe((ects to +atch out (or
ho+ long be(ore sideAe((ects )ay be expected to occur
possible interactions +ith other )edication the person is ta,ing
storage conditions.
+or e,ample#
S5r. @arper )ay be allergic to the penicillin. 7atch (or a rash appearing <A
% hours a(ter ta,ing the )edication."
SFar drops should not be too cold. I( they are too cold +hen applied to the
ear they )ay cause pain, diKKiness or nausea. #hec, that the storage
te)perature is correct."
role and the policies and procedures o( the +or,place. Dou )ust
understand and (ollo+ these instructions.
Side8effects and reactions to loo2 for
!n aged care +or,er is not expected to assess the cause o( the reaction
but is re-uired to )onitor the older person and i))ediately report and
record any signs presented. #hanges to +atch (or include:
changes to air+ay, (or exa)ple cho,ing
change in pulse
breathing that has slo+ed or is (ast
change in s,in colour
rash
in(la))ation or redness
s+elling
s+eating
headache
(eelings o( diKKiness
slurring o( speech
nausea and *o)iting
4.9 -ecord all re?uired details of medication administration and other
details in the appropriate documents according to the legislation and
organisation>s procedures
!n essential responsibility o( an aged care +or,er is to record exactly +hat
they ha*e obser*ed +hen the older person sel(A)edicated. 1rganisational
procedures and (or)s )ay di((er bet+een +or,places, but all +or,ers )ust
record:
ho+ )uch they too,
)edication
any reaction the person had to the )edication
!ccurate recordA,eeping is essential so there is a per)anent record o(
+hat too, place. !ll +or,ers and health pro(essionals in*ol*ed +ith the
older person"s care )ust &understand +hat )edication has been gi*en and
+hether there +ere any sideAe((ects.
The (ollo+ing is an exa)ple o( a )edication ad)inistration (or) you +ill
need to co)plete. 2or the purpose o( this training exa)ple, no speci(ic
)edicines are na)ed.
+igure # 0edication Administration form.
Na)e o( client: John @enderson 9ate o( birth: ;B $B ;=
9ate: ;B 8B 0=
5edication
na)e
!)ount Ti)e
gi*en
Ingestion
co)pletedB
not
co)pleted
Na)e and signature o(
+or,er
!ntibiotic x 1 $.;0 a) #o)pleted 5aud Gold(inch
M. Goldfinch
!ntacid 28)l $.;8 a) #o)pleted 5aud Gold(inch
M. Goldfinch
!nalgesic x 2 p.r.n. $.<8 a) Not
co)pleted
5aud Gold(inch
M. Goldfinch
The (ollo+ing is an exa)ple o( the care notes the aged care +or,er should
+rite (or 5r. @enderson.
+igure # Care 7otes
Care notes
Date and time 7ame# 5r. John @enderson D!B# 0;B 0$B 1$;=
; !ug 200=
10.;0 a)
Comments# 5r. @enderson too,
all prescribed )edication except
the analgesic tablets. @e did not
+ant to ta,e it. @e said he +as
not in pain. 6trategies used to
encourage hi) (ailed.
6uper*isor noti(ied at 10.18 a)
today.
+ollow8up# 6uper*isor ad*ised
not to crush the tablets but to
place in yoghurt. @a*e done this.
5r. @enderson too, the tablet.
5aud Gold(inch
M. Goldfinch
-ecording the details of medication administration
!n essential responsibility o( an aged care +or,er is to report and record
exactly +hat they ha*e obser*ed +hen the older person ta,es their
)edication. Dour records +ill be read by your super*isor, the older
person"s doctor and other aged care +or,ers.
It is part o( legal re-uire)ents to docu)ent +hat you ha*e obser*ed. Dour
obser*ations )ay be included in a court case i( the older person has a
negati*e reaction to the )edication +hich causes har) to the older
person.
1rganisational procedures and (or)s )ay di((er bet+een +or,places, but
all +or,ers )ust record:
ho+ )uch they too,
)edication
any reaction the person had to the )edication.
!ccurate recordA,eeping is essential so there is a per)anent record o(
+hat too, place. !ll +or,ers and health pro(essionals in*ol*ed +ith the
older person"s care )ust understand +hat )edication has been gi*en and
+hether there +ere any sideAe((ects.
Acti*ity #
(ollo+ing ideas:
%. @o+ does accurate and co)prehensi*e docu)entation o( the
)edication ad)inistered help ensure that )edication is ad)inistered
correctly to the older personI 7hat do you thin,I 7hat do others
thin,I
3. 7hy should an aged care +or,er ha*e to record the details o( all
)edication ad)inisteredI 7hy or +hy notI
Documenting the details of the medication
F*idence that )edication is ta,en as prescribed should be recorded and
signed by the" person +ho assisted +ith the ad)inistration. It is also
i)portant to docu)ent i( the )edication +as not gi*en or co)pleted or i(
there +as an error. 2or exa)ple:
the older person re(used )edication
the older person is currently in hospital
the older person only partially co)pleted the )edication then stopped
the )edication +as )issing (ro) its pac,aging.
4.: !"ser*e the client for any possi"le medication effects listed in the
-ange Statement and report to a super*isor or health professional
Dou ha*e an i)portant role in the care o( an older person. Dou )ay be the
only person they see apart (ro) their doctor. Because o( this it is essential
that you +atch the) +hen they ta,e their )edication &or as, -uestions i(
they ha*e already ad)inistered it' and ta,e note o( any reaction they ha*e
to the )edication. It is i)portant that you obser*e the person as they
ad)inister their )edication so you can see +hether they are ta,ing the
correct dosage. Dou can also see i( they ha*e a reaction to the )edication.
Dour 3ob is to identi(y, report, record and address a person"s reaction to
their )edication.
! person"s reaction to )edication )ay include:
*o)iting the )edication
e3ecting the )edication, (or exa)ple spitting it out
re(using to ta,e it
ha*ing a change in their condition li,e (ainting or (eeling sic, or diKKy
i))ediately a(ter ad)inistration.
Eno+ +hat your +or,place procedures are and +hat you are re-uired to
do to deal +ith any reactions. !s discussed pre*iously, your (irst steps are
to noti(y your super*isor, )a,e sure the older person is co)(ortable, (ollo+
any instructions you are gi*en, then record exactly +hat has ta,en place.
!(ter you ha*e discussed the situation +ith your super*isor and ta,en the
appropriate action, you need to +rite exactly +hat has happened, describe
+hat you ha*e done and +hat (ollo+Aup is re-uired so e*eryone else
in*ol*ed in the person"s care understands the situation.
2ollo+ your +or,place procedures and co)plete the correct (or). This
)ight be a care note, a co))unication boo,, an incident report (or), an
ad*erse drug reaction (or). Be (a)iliar +ith the style and the a)ount o(
in(or)ation re-uired. Dou should +rite clearly, accurately and in brie(
sentences. Eeep to the point. 9o not )a,e any suggestions or personal
state)ents. 2or exa)ple, +rite "!gnes has a rash", not SI thin, !gnes has a
rash because she ate oysters that al+ays disagree +ith her, though it
could be the ne+ )edication". Generally, any ,no+n allergies are recorded
on the person"s care plan and +ould ha*e been ta,en into account by the
doctor +hen prescribing the )edication.
4.; Collect used e?uipment6 discarded medications= applicators and
ru""ish and place in appropriate= designated receptacle according to
instructions
Cleaning and disposing of e?uipment and ru""ish
To reduce the ris, o( conta)ination you )ust al+ays dispose o( any +aste
)aterials associated +ith the )edication. The +aste that you deal +ith
depends on the type o( )edication and the support you gi*e to the older
person. 6o)eti)es there +on"t be )uch +aste except (or e)pty glass
bottles or plastic tubes o( )edicine. In other cases you )ay deal +ith
*o)it, soiled clothes, sharps, blood and other body (luids as +ell as
discarded pac,aging )aterial, disposable plastic cups and glo*es.
In a residential care setting there +ill be +aste disposal containers (or
speci(ic products, li,e sharps containers, bins (or )aterial +ith blood on
the), and recycle bins (or cardboard, paper and glass. These )ay be
located on the )edication or treat)ent trolleys, in )edication roo)s or in
residents" roo)s.
!l+ays loo, around to chec, +hether any +aste is le(t lying around +hen
you begin your *isit and 3ust be(ore you lea*e.
F-uip)ent that needs to be cleaned (or later use )ight include:
bo+ls
drin,ing glasses
spoons
aprons
crusher &)ortar and pestle'
nebuliser )as,
trolley.
0ubbish )ight include:
e)pty bottles and bottle tops
e)pty pac,ages, sachets, boxes, blister pac,s and plastic tubes
used cotton+ool
adhesi*e dressing plastic and used dressing
disposable glo*es
used needles
soiled )aterial.
Procedures for handling dirty e?uipment and ru""ish
Dour +or,place should ha*e docu)ented procedures and guidelines that
explain +hat you )ust do to in relation to cleaning and storing e-uip)ent
and disposing o( rubbish.
@ere are so)e exa)ples o( the e-uip)ent used in the ad)inistration o(
)edication. 2ollo+ these )ethods to )a,e sure all +aste products are
cleaned or disposed o( sa(ely and hygienically.
8. #o)ply +ith organisationCs
procedures (or handling the
range o( issuesB contingencies
+hich )ay arise
5.%
0eport to super*isor andBor health pro(essional all concerns
+ith the ad)inistration o( )edication &such as: client re(usal to
ta,e so)e or all )edications, inco)plete ingestion, )issed or
)issing doses' according to organisation procedures and
protocols
5.3
Identi(y, report, record and address indi*idualCs reactions to
)edication according to organisation guidelines and health
5.3
#learly identi(y conta)inated or out o( date )edication and
i)ple)ent organisationCs procedures (or ensuring sa(e and
appropriate disposal
5.4
Identi(y, report and record changes in indi*idualCs condition,
including +ithin essential ti)e(ra)es +here rele*ant,
according to organisation guidelines
5.5
Identi(y procedures to address B respond to changes in the
clientCs condition or needs according to the organisationCs
guidelines
5.9
/ro)ptly report to the super*isor or health pro(essional any
inconsistencies obser*ed +ith the )edication or client and
ta,e action in accordance +ith the organisationCs procedures
or health pro(essionalCs instructions
5.:
9ocu)ent all inconsistencies and address according to
organisation guidelines and procedures
5.% -eport to super*isor and= or health professional all concerns with the
administration of medication Esuch as# client refusal to ta2e some or
all medications6 incomplete ingestion6 missed or missing dosesF
according to organisation procedures and protocols
7hen an older person re(uses to ta,e their )edication or the )edication is
not co)pleted you need to report the situation i))ediately. 2ollo+ your
organisation"s procedures.Dou )ay ha*e to co)plete progress notes,
incident report (or)s or )edication charts.
Dou need to (ind out +hy the person re(uses to ta,e the )edication or +hy
the )edication is not co)pleted. 7hen you ,no+ this, you can +or, on a
solution. 0e)e)ber that the older person has the right to re(use any
treat)ent.
6o)e o( the reasons a person )ay re(use to ta,e their )edication or the
)edication is not co)pleted include:
not li,ing the taste
not being able to s+allo+ the )edication
deciding they don"t need the )edication
not +anting to get better
ha*ing a condition that causes the) to be uncooperati*e
being in pain.
An older person refuses to ta2e their medication
7hat can an aged care +or,er do about an older person +ho re(uses to
ta,e their )edicationI @ere are so)e strategies.
/rogra)s should ha*e the (ollo+ing in(or)ation regarding all )edications
being ta,en by all indi*iduals ser*ed, +hether or not there has been a
history o( re(usal. 0e)e)ber, re(usal is not the only reason that a dose
)ight be )issed. These -uestions should be as,ed each ti)e a ne+
)edication is prescribed and sta(( should as, the physician or phar)acist
to also explain this in(or)ation directly to the indi*idual regardless o( their
ability to co))unicate.
%. 7hat are the i)plications i( the indi*idual )isses a dose o( this
)edicationI 7hat +ill result i( they )iss se*eral dosesI &2or so)e
drugs the i)plications are *ery serious, (or others, no cause (or alar).'
3. !t +hat point should the progra) contact the physician due to )issed
dosesI &i.e. a(ter one, three in sa)e day, ten in one )onth or i( certain
sy)pto)s return, etc.I'
3. 7hat are the acceptable ti)e (ra)es (or getting the indi*idual to ta,e
their )edicationI 2or exa)ple, can you still gi*e it to the) )ore than
one hour a(ter the dosage ti)eI Is it i)portant that doses be a certain
period o( ti)e apart &i.e. no t+o doses any closer together than (our
hours'I It is especially i)portant to as, about ti)e (ra)es (or gi*ing
anticon*ulsant, psychotropic or antibiotic )edicationJ as, i( you can
gi*e t+o doses together i( one is )issed. I( yes, as, i( the e*ening is
the best ti)e to do this.
1ther tips: Be upbeat +hen approaching the indi*iduals about ta,ing their
)edication. 6tate in a )atter o( (act +ay VIt"s ti)e to ta,e your )edicineV
rather than V9o you +ant to ta,e your )edicineIV
'nter*ention for !ccasional -efusal
%. !s, the) 7@D they don"t +ant to ta,e itH This is *ery i)portant
because (or so)e indi*iduals, re(usal is their +ay o( letting you ,no+
that the )edication has negati*e side e((ects such as ner*ousness,
nausea, dro+siness, bad taste etc. In one case an indi*idual re(used
because another sta(( person had 3ust gi*en hi) his )edication but
(ailed to docu)ent the doseJ he pre*ented an o*erdose. 2or indi*iduals
+ho ha*e li)ited co))unication s,ills you )ay need to be *ery
obser*ant to deter)ine +hy they are re(usingJ loo, (or patterns in ti)e
o( dose &i.e. are you interrupting a (a*orite acti*ityI', location, particular
sta(( &i.e. does the indi*idual only re(use on VBobby"s shi(tVI', gestures
and body language. I( you can deter)ine 7@D they +on"t ta,e the
)edication, alternati*es )ay beco)e clear. 2or exa)ple i( they don"t
li,e the taste, )aybe a breath )int a(ter+ards or a spoon o( pudding
+ould sol*e the proble). I( the )edication )a,es the) (eel bad in
so)e +ay, alternati*es could be discussed +ith the physician.
3. 2ind out i( they understand +hat the )edication is (or. I( they do not
understand, re)ind the) o( the purpose and as, the) again to ta,e it.
3. 2ind out i( they understand the i)plications o( not ta,ing their
)edication &+hich you (ound out (ro) the physician or phar)acist as
suggested'. I( they do not understand, re)ind the) o( the i)plications
and as, the) again to ta,e it. &In addition to physical sy)pto)s,
i)plications )ay include the need to call the physician and report the
)issed dose.'
4. 7ait a short ti)e, and the) encourage the) again be(ore the
acceptable ti)e (ra)e expires. Generally the ti)e (ra)e is one hour
unless the physician ga*e )ore speci(ic instructions.
5. I( they continue to re(use, docu)ent the )issed dose and state the
reason &indi*idual re(used', along +ith other rele*ant in(or)ation i(
,no+n &i.e. they indicated nausea'. In addition, contact the physician
under circu)stances as agreed +hen )edication +as prescribed
andBor i)ple)ent any steps (or )issed doses.
!ther ips# Be *ery )atter o( (act in your in co))unication style +ith the
indi*idual about ta,ing )edication. 9o not beg, threaten, bribe or (orce the
indi*idual. 9o not say VI"ll get in troubleV or VDou"ll get in troubleV.
+re?uent or Persistent Pattern of -efusal
I( the abo*e strategies ha*e not been success(ul, and i)plications o(
)issed doses 3eopardiKe the indi*idual"s health, the Interdisciplinary Tea)
should )eet to:
%. #ollect and docu)ent obser*ations and ,no+ledge o( the reason the
indi*idual continues to re(use the )edication. &#onsider physical as
+ell as beha*ioral barriers because )aybe they ha*e trouble
s+allo+ing the )edicine.'
3. #ollect and docu)ent strategies that ha*e already been tried.
3. Identi(y -uestions (or the physician. &i.e. !re there alternati*e
)edications to treat the condition in ter)s o( type, route, a)ount,
schedule, etc.I 7hat are the health i)plications o( continued )issed
doses andBor discontinuation o( treat)entI !re there +ays to alle*iate
negati*e side e((ectsI'
4. I( the i)plications o( continued )issed doses andBor discontinued
treat)ent +ill 3eopardiKe the indi*idualCs health, the tea) should clari(y
the guardianship status (or the indi*idual, deter)ine i( it co*ers
treat)ent decisions, and consider i( a change in status should be
pursued. It )ay be a good idea to consider other legal ra)i(ications (or
the indi*idual, ser*ice pro*ider and others.
5. #onsider *arious alternati*es to address the situation, (or exa)ple:
#hanges to )edication regi)en
#hanges in approach +ith the indi*idual
Ta,ing the )edication in (ood &+ithout hiding itH'
/atient education
Incenti*es (or cooperation
0e(erral to a specialist
Nursing ser*ices
#onsultation (ro) an 1T, 6?/ andBor 9ietician
9. !l+ays include a protocol (or +hat the sta(( should do i( re(usals
continue to occur A +hich should be +or,ed out +ith the physician.
!ther tips# In*ite the physician to attend so that all the alternati*es can be
re*ie+ed at the )eeting. F*en i( they can only participate by phone it is
help(ul. I( the physician is not able to attend, a tea) )e)ber should
discuss the groupCs -uestions +ith the physician be(ore (inal decisions are
)ade. /erhaps i( the physician is pro*ided -uestions ahead o( ti)e, he
could send a nurse or other representati*e +ith the in(or)ation. I( the
physician is not responsi*e to the tea)"s concerns, consider gaining a
second opinion.
!ther 0edical Concerns
1ther )edically related situations )ay arise +hich the tea) should )eet
to address. 2or exa)ple i( the indi*idual re(uses to cooperate +ith lab tests
&especially blood le*el chec,s', re(uses to ,eep doctor"sBdentist"s
appoint)ents, are accessing )ultiple physicians in order to gain extra
)edication due to a substance abuse proble), or because existing
treat)ent has not been success(ul in controlling their condition &i.e.
diabetes, seiKures, etc.'. The tea) process listed abo*e is rele*ant (or
these types o( situations as +ell.
5.3 'dentify6 report6 record and address indi*idual>s reactions to
medication according to organisation guidelines and health
professional>s instructions
9rug allergies are a group o( sy)pto)s caused by allergic reaction to a
drug &)edication'.
Causes
!d*erse reactions to drugs are co))on, and al)ost any drug can cause
an ad*erse reaction. 0eactions range (ro) irritating or )ild side e((ects
such as nausea and *o)iting to li(eAthreatening anaphylaxis.
Anaphyla,is
!naphylaxis is a se*ere, +holeAbody allergic reaction. !(ter being exposed
to a substance li,e bee sting *eno), the person"s i))une syste)
beco)es sensitiKed to that allergen. 1n a later exposure, an allergic
reaction )ay occur. This reaction is sudden, se*ere, and in*ol*es the
+hole body.
Tissues in di((erent parts o( the body release hista)ine and other
substances. This causes the air+ays to tighten and leads to other
sy)pto)s.
6o)e drugs &poly)yxin, )orphine, xAray dye, and others' )ay cause an
anaphylacticAli,e reaction &anaphylactoid reaction' +hen people are (irst
exposed to the). This is usually due to a toxic reaction, rather than the
i))une syste) response that occurs +ith VtrueV anaphylaxis.
+igure # Anaphyla,is
! true drug allergy results (ro) a series o( che)ical steps +ithin the body
that produce the allergic reaction to a )edication. 1ne ti)e &o(ten the (irst
ti)e you ta,e the drug', your i))une syste) launches an incorrect
response that is not noticeable. The next ti)e you ta,e the drug, an
i))une response occurs, and your body produces antibodies and
hista)ine.
5ost drug allergies cause )inor s,in rashes and hi*es. 6eru) sic,ness is
a delayed type o( drug allergy that occurs a +ee, or )ore a(ter exposure
to a )edication or *accine.
/enicillin and related antibiotics are the )ost co))on cause o( drug
allergies. 1ther co))on allergyAcausing drugs include:
6ulphur drugs
!nticon*ulsants
Insulin preparations &particularly ani)al sources o( insulin'
Iodinated &containing iodine' xAray contrast dyes &these can cause
allergyAli,e anaphylactoid reactions'
5ost side e((ects o( drugs are not due to an allergic reaction. 2or exa)ple,
aspirin can cause nonallergic hi*es or trigger asth)a. 6o)e drug reactions
are considered Vidiosyncratic.V This )eans the reaction is an unusual
e((ect o( the )edication, not due to a predictable che)ical e((ect o( the
drug. 5any people con(use an unco)(ortable, but not serious, side e((ect
o( a )edicine &such as nausea' +ith a true drug allergy, +hich can be li(e
threatening.
Symptoms
!naphylaxis, or se*ere allergic reaction &see belo+'
@i*es &a less co))on type o( rash'
Itching o( the s,in or eyes &co))on'
6,in rash &co))on'
6+elling o( the lips, tongue, or (ace
7heeKing
Symptoms of anaphyla,is include#
!bdo)inal pain or cra)ping
#on(usion
9iarrhea
9i((iculty breathing +ith +heeKe or hoarse *oice
9iKKiness
2ainting, lightAheadedness
@i*es o*er di((erent parts o( the body
Nausea, *o)iting
0apid pulse
6ensation o( (eeling the heart beat &palpitations'
E,ams and ests
!n exa)ination o( the s,in and (ace )ay sho+ hi*es, rash, or
angioedoe)a &s+elling o( the lips, (ace, or tongue'. 9ecreased blood
pressure, +heeKing, and other signs )ay indicate an anaphylactic
reaction.
6,in testing )ay con(ir) allergy to penicillinAtype )edications. Testing )ay
be ine((ecti*e &or in so)e cases, dangerous' (or other )edications. !
history o( allergicAtype reaction a(ter use o( a )edication is o(ten
considered proo( enough o( drug allergy AA no (urther testing is re-uired.
The sa)e applies to other substances that are not considered drugs but
are used in hospitals, such as xAray contrast dyes.
reatment
The treat)ent goal is to relie*e sy)pto)s and pre*ent a se*ere reaction.
Treat)ent )ay include:
!ntihista)ines to relie*e )ild sy)pto)s such as rash, hi*es, and
itching
Bronchodilators such as albuterol to reduce asth)aAli,e sy)pto)s
&)oderate +heeKing or cough'
#orticosteroids applied to the s,in, gi*en by )outh, or gi*en
intra*enously &directly into a *ein'
Fpinephrine by in3ection to treat anaphylaxis
The o((ending )edication and si)ilar drugs should be a*oided. 5a,e
sure all your health care pro*iders AA including dentists and hospital
personnel AA ,no+ about any drug allergies that you or your children
ha*e.
Identi(ying 3e+elry or cards &such as 5edicA!lert or others' )ay be
reco))ended.
1ccasionally, a penicillin &or other drug' allergy responds to
desensitiKation, +here increasing doses o( a )edicine are gi*en to
i)pro*e a person"s tolerance o( the drug. This should only be done by
an allergist.
!utloo2 EPrognosisF
5ost drug allergies respond readily to treat)ent. ! (e+ cases cause
se*ere asth)a, anaphylaxis, or death.
/ossible #o)plications
!naphylaxis &li(eAthreatening'
!sth)a
9eath
Pre*ention
There is generally no +ay to pre*ent de*elop)ent o( a drug allergy.
I( your client has a ,no+n drug allergy, a*oiding the )edication is the best
+ay to pre*ent an allergic reaction. Dour client )ay also be told to a*oid
si)ilar )edicines. 2or exa)ple, i( they are allergic to penicillin, they should
also a*oid a)oxicillin or a)picillin.
!s discussed pre*iously throughout this unit docu)entation is essential
and drug allergies andBor sensiti*ities )ust be docu)ented also (or
exa)ple on the drug ad)inistration chart belo+.
+igure # Drug Administration Chart
5rite allergies
and sensiti*ities
here in -ED
5.3 Cleary identify contaminated or out of date medication and implement
organisation>s procedures for ensuring safe and appropriate disposal
5ost )edication has only a li)ited li(eti)e and all )edication has a useAby
date &expiry date'. The )edication )ust not be used a(ter that date. The
expiry date +ill be on the container. This is +hy you should only use
)edication pac,ed in its original container. I( a phar)acist pac,s
)edication in a dose ad)inistration aid, they )ust put the expiry date on
the label.
6o)e )edication )ight not ha*e expired, but it )ay still ha*e beco)e
conta)inated. This can happen +hen a pac,et is opened accidentally, a lid
o( a bottle is not closed properly or the opening o( a container touches a
body part.
5edication can also be a((ected by heat, da)pness, direct sunlight and
interaction +ith other tablets. 6o)e )edication )ust also be ,ept at a
certain te)perature, (or exa)ple belo+ 28Y#.
It is unsa(e (or an older person to ta,e expired, conta)inated or da)aged
)edication. It should be disposed o( in an appropriate )anner.
E,pired medication
!ll )edication )ust ha*e an expiry date on the original container. I( you
can"t (ind it, don"t use the )edication.
The expiry date )ay be +ritten in the (or)at Sexp 11 0=", +hich )eans it
expires in No*e)ber 200=. 6o)e )edication +ill ha*e a )anu(actured
date and a batch nu)ber, (or exa)ple the botto) o( the box )ight say
BBND82;2;J Fxp: 11 B2008, +hich )eans the batch nu)ber is D82;2;J
and the expiry date is No*e)ber 2008.
Ne*er )ix )edication (ro) di((erent containers.
They )ay ha*e di((erent expiry dates.
The containers +ill ha*e di((erent batch nu)bers. I( )edication is
recalled by the )anu(acturer, you +on"t be able to establish the batch
nu)ber o( the conta)inated or da)aged )edication.
Dou )ust not use )edication a(ter its expiry date.
It +ill ha*e lost its )edicinal i)pact. It +ill not be as e((ecti*e and )ay
no longer be a bene(it to the person. It could be potentially dangerous
(or a person to ta,e )edication that has passed its useAby date.
The che)ical structure o( the )edication )ay change and it can
beco)e toxic.
5.4 'dentify6 report and record changes in indi*idual>s condition6
including within essential timeframes where rele*ant6 according to
/re*iously you learnt the i)portance o( obser*ing changes to an older
person be(ore you assist the) +ith their )edication. Dou also learnt ho+
to )onitor and report reactions to the )edication they ha*e ta,en.Dou
)ust no+ obser*e any changes in the person"s condition. 0e)e)ber to
loo, (or conditions that )ight be caused by sideAe((ects or ad*erse
reactions.
1lder people are a highAris, group in relation to )edication. The +ay the
body uses )edication changes as a person gro+s older. The li,elihood o(
sideAe((ects and other di((iculties increases +hen an older person is ta,ing
)ultiple )edications.
Common causes of changes in an older personDs condition
The (ollo+ing is a list o( situations +hich )ay cause the older person"s
condition to change. Be a+are o( the situations that )ay cause a change
in an older person"s condition. 0e)e)ber that you )ust not diagnose, but
report only +hat you obser*e.
/olyphar)acy &ta,ing a nu)ber o( )edications at the !liciae ti)e' can
result in drug interaction. 2or exa)ple, the older person )ay be ta,ing
paraceta)ol (or pain and then ta,es a cold or (lu tablet that also
contains paraceta)ol.
1*erdoses &the older person )ay accidentally ta,e too )any tablets'.
5edication ta,en at the +rong ti)e.
The +rong dosage being ta,en.
Not (ollo+ing special re-uire)ents o( the )edication, (or exa)ple +ith
or +ithout (ood.
The older person ingests expired or conta)inated )edication.
5edical reasons such as an underlying physical condition.
6ideAe((ects o( )edication.
!llergies to )edication.
'dentifying a change in the older personDs condition
#hanges in the older person"s condition can be present be(ore ta,ing
)edication or as a result o( )edication. I( it is obser*ed be(ore, do not gi*e
the )edication and see, help i))ediately. I( it is obser*ed a(ter the
)edication has been gi*en, noti(y your super*isor i))ediately and )a,e
the older person as co)(ortable as possible.
The (ollo+ing are the )a3or categories o( changes to loo, (or in the older
person"s condition.
5.5 'dentify procedures to address= respond to changes in the client>s
condition or needs according to the organisation>s guidelines
-eporting a change in condition
I( you notice a change in an older person"s condition, you )ust (ollo+ the
guidelines pro*ided by your +or,place (or responding to a reaction to
)edication.
!s discussed pre*iously, you should i))ediately contact your super*isor
or the person in charge. #learly explain the situation. 9o, not proceed +ith
gi*ing any )edication until you recei*e (urther directions. Dou +ill be gi*en
ad*ice and instructions about +hat to do (ro) your super*isor.
Dou )ay be instructed to:
call an a)bulance
call a (a)ily )e)ber
call a doctor
clear air+ays
place pillo+s to support the person"s head
co*er the) +ith a blan,et
do nothing.
The super*isor +ill gi*e you (eedbac, and explain the (ollo+Aup action that
needs to occur. 2or exa)ple, your super*isor )ay tell you not to do
anything until they ha*e noti(ied the doctor or phar)acist and recei*ed
ad*ice (ro) the). Then they +ill ad*ise you +hat to do. In other situations
they )ay respond straighta+ay and pro*ide )edical assistance to the
older person.Dou )ay need to carry out basic (irst aid or procedures such
as )easuring blood pressure, blood sugar le*els or pulse &i( you ha*e
been trained to do this'.
2ollo+ the instructions and guidance you are gi*en. 0e)e)ber that you
are not the one to )a,e a decision about +hat to do next. !n aged care
+or,er )ust not gi*e any )edical ad*ice or opinions. Dou )ust not
atte)pt to treat the person unless you are instructed to do so and ha*e the
appropriate (irst aid training. 2or exa)ple, you )ust not decide to gi*e the
person the next dosage in place o( the one they )issed, or gi*e the) an
extra tablet i( they *o)ited one up. The health pro(essionals in*ol*ed +ith
the person +ill decide the course o( action to ta,e.
It is i)portant to )a,e sure the older person is co)(ortable and they
understand +hat you are doing to help the). 0eassure the). #al) the)
do+n. Tell the) +hat you are going to do. 2or exa)ple, tell the) that you
are calling your super*isor. Eeep the) in(or)ed at all ti)es by explaining
+hat you are doing and +hat +ill happen as a result. 5a,e sure they are
co)(ortable. #lean up any )ess that has been )ade.
!s soon as possible a(ter you ha*e reported the situation, you need to
record +hat has happened. The in(or)ation the super*isor recei*es (ro)
you about the situation )ay lead to an ad3ust)ent o( the person"s care
plan or a change in their )edication. 2or exa)ple, the super*isor )ay
decide to )onitor the person"s bo+el )o*e)ents, +ithhold )edication (or
a +hile, or )anage their o*erAtheAcounter )edicines di((erently.
5.9 Promptly report to the super*isor or health professional any
inconsistencies o"ser*ed with the medication or client and ta2e
action in accordance with the organisation>s procedures or health
professional>s instructions
It is essential that the health pro(essional in charge o(
the older person ,no+s that the )edication they ha*e
prescribed is being ad)inistered correctly, in the correct
dosage and at the right ti)e. I( the )edication
ad)inistration *aries in any +ay (ro) the instructions o(
the health pro(essional, the *ariations are called
inconsistencies. It is part o( an aged care +or,er"s role
to identi(y and report any inconsistencies in the +ay the
)edication is ad)inistered.
Inconsistencies )ust be reported +ithout delay and recorded in
accordance +ith speci(ic guidelines in your +or,place andBor state and
territory re-uire)ents.
Type o( inconsistencies that can occur in )edication )anage)ent are:
a. The )edication is dispensed incorrectly
". The prescription is incorrect
c. The )edication is expired, da)aged or conta)inated
d. The )edication is not being ta,en as prescribed or dispensed
e. The aged care +or,er )a,es a )ista,e
It is the phar)acist"s responsibility to correctly dispense the )edication to
)eet the doctor"s prescription. @o+e*er, the (ollo+ing errors can
so)eti)es occur:
Tablets are )issing (ro) the )ultiAdose ad)inistration aid.
Fxtra tablets are pac,ed.
5edication is not deli*ered.
5edication is deli*ered on the +rong day.
The +rong identi(ication is on the )edication container.
I( an aged care +or,er notices any o( these situations they )ust
i))ediately noti(y their super*isor. The aged care +or,er should ad*ise
the older person not to ta,e the )edication until the super*isor is noti(ied
and the situation is clari(ied by the phar)acist. I( the )edication is not
pac,ed correctly it should be returned to the phar)acist (or chec,ing and
repac,ing.
'nconsistencies are
things that are
di((erent (ro) +hat
they should be. 2or
exa)ple, so)eone
)ight ta,e a +rong
dosage or the +rong
)edication.
Inconsistencies are things that are di((erent (ro) +hat they should be. 2or
exa)ple, so)eone )ight ta,e a +rong dosage or the +rong )edication.
Dealing with inconsistencies
!n i)portant part o( caring (or an older person is to encourage their
independence, +hich )eans helping the) to continue to ad)inister their
o+n )edication. @o+e*er, so)eti)es this )ay not go s)oothly, especially
as the person"s ability to re)ain independent )ay lessen as they age. 2or
exa)ple, a person"s arthritis )ay gradually +orsen until one day they )ay
(ind it )ore di((icult to unscre+ the top o( their )edicine bottle. Farly
/ar,inson"s disease )ay )a,e it di((icult (or the) to pour the correct
)edication into a )easuring cup +ithout sha,ing. 5e)ory proble)s )ay
)ean they no longer re)e)ber +hen they ha*e ta,en their )edication.
There(ore, you )ust i))ediately report any departure (ro) the
prescription or application that you obser*e or the person tells you.
Inconsistencies your super*isors and other health pro(essionals )ust ,no+
about include:
5issed dosage
!dditional dosage
?ost )edication
7rong dosage
7rong )edication
Inco)plete ingestion
0issed dosage
!n older person )ay )iss a )edication (or a nu)ber o( reasons. They
)ay (orget +hat day it is. They )ay go out and (orget to ta,e the
)edication +ith the). They )ight be unable to (ind their )edication. They
)ay be unable to access it because they can"t get the lid o((, open the
sachet, or s-ueeKe the bottle su((iciently (or the drops to co)e out. They
)ay si)ply (orget to ta,e it.
In these circu)stances your 3ob is to (ind out +hy the )edication has been
)issed. !s, the) -uestions such as, S9o you ,no+ +hy you )issed ta,ing
the )edicationI" or S7hat trouble did you ha*e ta,ing the )edicationI" Dou
)ight notice that the pill (or the pre*ious day is still in their dosette box or
blister pac,. 5issed )edication can be serious. Noti(y your super*isor
i))ediately. In no circu)stances should you substitute another pill or gi*e
a double dosage. 9ocu)ent the situation.
Pro*iding assistance
Dou can help an older person not to )iss their )edication by preparing a
large +all chart. They )ight li,e to ha*e it pinned near the (ront door so
they can read it +hen they go out as a re)inder. Fncourage the) to use
an alar) cloc, to re)ind the) o( the ti)es (or )edication. se signs and
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 2;; o( 282
diagra)s in the ,itchen, bathroo), bedroo) and in the lounge roo) next
to the tele*ision.Dou )ight arrange (or a (a)ily )e)ber or neighbour to
call and re)ind the) +hen you are not seeing the). Dou )ight tal, to
your super*isor and suggest that the person +ould bene(it (ro) using a 3ar
opener specially designed (or people +ho ha*e di((iculty opening bottles
and 3ars.
Additional dosage
!n older person )ay ta,e an additional dose o( their )edication (or a
nu)ber o( reasons. They )ay (orget that they ha*e already ta,en their
)edication. They )ay decide to ta,e an extra dose as they are in pain, or
(eel that the )edication isn"t +or,ing +ell enough or -uic,ly enough. I( this
occurs, noti(y your super*isor i))ediately. 9ocu)ent the situation clearly.
9osage ad)inistration aids are the best +ay to assist a person +ho is
ha*ing trouble +ith re)e)bering i( they ha*e ta,en their )edication. Dou
)ight also ha*e a tic,Alist o( days and ti)es so that the older person can
)ar, +hen they ha*e ta,en their )edication.
+igure # 0edication chec2list
Day ime 0edication ta2en
5onday 8.00 a)
12.00 p)
8.;0 p)
Tuesday 8.00 a)
12.00 p)
8.;0 p)
7ednesday 8.00 a)
12.00 p)
8.;0 p)
Thursday 8.00 a)
12.00 p)
8.;0 p)
2riday 8.00 a)
12.00 p)
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 2;< o( 282
8.;0 p)
6aturday 8.00 a)
12.00 p)
8.;0 p)
6unday 8.00 a)
12.00 p)
8.;0 p)
(ost medication
The older person )ay lose their )edication. The )edication )ay ha*e
(allen into their laundry bas,et, or they )ay ha*e placed it in a di((erent
place and cannot re)e)ber +here it is. ! capsule )ay ha*e (allen into
their rubbish bin because it +as slippery in their hands. The person )ay
tell you that this has happened, or you )ay need to as, the) -uestions
li,e S7hat happened to the )edicationI" or S7here did you put the
)edicationI"
I( it has (allen into a bin you )ust not let the) ta,e it out because it )ay be
conta)inated.
Noti(y your super*isor. They +ill tell youA+hether the person can ta,e the
next tablet in their box, or +hether they +ill ha*e to a call the doctor and
phar)acist to obtain a ne+ prescription.
Fncourage the older person to al+ays ,eep their )edication in the !liciae
place. Dou )ight prepare a large sign and a box or tray to help the). I(
they lose the )edication by dropping it you need to report this as it )ay be
a sign that their condition is +orsening.
5rong dosage
It is crucial that the aged care +or,er +atches +hen the older person sel(A
)edicates so they are a+are o( the a)ount o( )edication the person
ad)inistered. 2or exa)ple, the person )ight:
not ta,e all tablets they need to
not apply all the lotion, or apply too )uch
not ta,e the co)plete dosage, (or exa)ple ta,e only 28 )l instead o(
80 )l, or use only three drops instead o( 10
ta,e the +rong )edication.
The person )ay not read the label or )easuring cup correctly. They )ight
(eel they don"t need all the )edication. They )ay ha*e (orgotten the
correct )ethod o( application. Their coordination )ay be unsteady and
they )ight place too )uch into the cup or s-ueeKe )ore drops than
re-uired into,their eye.
! large )edical chart placed in a pro)inent position is ideal (or helping a
person ta,e the correct dosage.Dou )ight enlarge the in(or)ation on the
label.Dou )ay need to dra+ pictures to indicate the correct dosage. I( you
belie*e their (ailing eyesight is contributing to the situation, )a,e sure you
discuss this +ith your super*isor as it )ay result in a re*ised care plan (or
the person.
@elp people +ith poor eyesight or language s,ills to ,no+ ho+ )uch
)edication to ta,e.
5rong medication
I( an older person ad)inisters their )edication be(ore you arri*e to see
the), you need to as, the) +hat they too, and +hen they too, it. I( you
(ind that they ad)inistered the +rong )edication by )ista,e, you need to
i))ediately noti(y your super*isor. 2or exa)ple, they )ay ha*e put ear
drops into their eyes.
Dour super*isor )ay tell you to contact the /oisons In(or)ation #entre.
5a,e sure you record exactly +hat the person ad)inistered and in +hat
dosage. Dou +ill need to let the centre ,no+ the prescribed dosage, the
unintentional dosage, +hether the person has eaten &as this )ay ha*e an
e((ect on the )edication', and any other in(or)ation you are as,ed (or.
5a,e the person as co)(ortable as possible i( they are in pain or sho+ing
any disco)(ort.
Dou )ay need to (ind di((erent places to put the di((erent )edications the
person is ad)inistering. Dou )ay need to colourAcode the bottles or tubes.
!s, your super*isor (or tips.
In the (ollo+ing exa)ple an aged care +or,er assists a person +ho has
trouble (inding her glasses.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 2;% o( 282
E,ample
! ho)eAbased care +or,er *isits =8AyearAold 5rs @u)phries three ti)es a
+ee,. 5rs @u)phries li*es alone. 7hile she generally en3oys good health,
she su((ers (ro) arthritis in the 3oints o( both hands and her ,nees. @er
eyesight is deteriorating. 6he is constantly lea*ing her glasses
so)e+here, but o(ten (orgets +here she le(t the). This poses a danger to
her as she so)eti)es tries to guess +hich )edication is +hich.
The aged care +or,er did the (ollo+ing things:
/repared a container +ith a largeAprint label saying SGlasses" on it and
le(t it so 5rs @u)phries could put her glasses in it so she +ould ,no+
+here they should be at all ti)es.
6uggested a nec, chain (or her glasses.
/laced largeAprint signs, diagra)s and +ritten instructions +ith the
)edication dispenser (or easier reading.
'ncomplete ingestion or application
The older person )ay not co)plete the )edication. They )ight *o)it or
e3ect it. They )ay lea*e so)e in the glass. They )ay decide not to ta,e all
the tablets. I( they ha*e ad)inistered the )edication be(ore you arri*e you
need to as, the) ho+ )uch they too,. Dou should also loo, around to
chec, that it has been ad)inistered correctly. Dou )ight obser*e a glass
+ith an undissol*ed tablet in it or notice *o)it in the toilet bo+l or the
re)ains o( a capsule in the bathroo) basin. The tube o( lotion )ay see)
(ull, an indication that the correct dosage )ay not ha*e been applied.
Dou ha*e a better chance o( )a,ing sure they co)plete the )edication i(
you are there to obser*e the). I( they *o)it or e3ect the )edication, ne*er
atte)pt to gi*e the) any )ore. !l+ays (ind out +hat you are allo+ed to
suggest i( they tell you they cannot ta,e it because they hate the taste. 2or
exa)ple, the doctor )ay say they can ta,e it +ith so)e (ood.
!s, the person +hy they are not co)pleting the )edication. 7hen you
,no+ the reason, you can noti(y your super*isor, +ho +ill tell you +hat to
do next. They )ay need to contact the person"s doctor. 2ind out (ro) your
super*isor +hat help you can gi*e a person to encourage the) to ta,e
their )edication. The doctor )ay suggest you split the tablet in hal( or gi*e
the) so)e (ood they li,e to ta,e it +ith. 9on"t do anything +ithout
instructions. 2or exa)ple, so)e loKenges )ust be suc,ed not s+allo+edJ
so)e )edications, li,e those (or angina, are ine((ecti*e i( crushed.
6o)eti)es, there )ay be so)ething +ithin your authority that you can
suggest to help the person co)plete their )edication. Dou )ight (ind that
they cannot reach the lo+er part o( their leg to apply the crea), so you
)ight sho+ the) ho+ they can use a longAhandled spatula to apply the
crea) there.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 2;= o( 282
Acti*ity #
%. 7hat should an aged care +or,er do i( they (ind out that an older person
they are caring (or has )issed ta,ing their )edicationI
3. #an you double the next dosage the next ti)e i( an older person has
)issed a dosageI 7hy or +hy notI 7hat should you doI
Acti*ity #
6elect !7E o( the (ollo+ing inconsistencies.
5issed dosage
!dditional dosage
?ost )edication
7rong dosage
7rong )edication
Inco)plete ingestion
7rite do+n in point (or) &or tell your trainer' ho+ you +ould help an older
person i( you (ind they ha*e departed (ro) the correct prescription or
application.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 2;$ o( 282
5.: Document all inconsistencies and address according to organisation
guidelines and procedures
The next step is to docu)ent any inconsistencies, errors or actions that
occurred. 0e)e)ber to record the date and ti)e o( the situation, +ho +as
in*ol*ed, +hat happened and +ho you reported the situation to.
!s +ell as in(or)ing your super*isor *erbally o( any di((iculties or
inconsistencies +ith the )edication, you )ust docu)ent +hat has ta,en
place. ! +ritten record is essential. 2ollo+ +or,place procedures to
docu)ent +hat happened. These *ary (ro) one +or,place to another.Dou
)ay ha*e to co)plete an incident report or +rite up the situation in the
person"s care notes, co))unication boo, or on a (eedbac, (or).
7hate*er the )ethod used, the i)portant thing is that the in(or)ation is
+ritten clearly and accurately so e*eryone +ho reads the notes is clear
about +hat happened. 0e)e)ber that you are part o( a tea) and
e*eryone else in*ol*ed in the person"s care needs to be noti(ied. They can
then )a,e an in(or)ed decision about +hat to do. 5a,e sure you sign and
date the docu)entation. ! health pro(essional )ay need to get in touch
+ith you to discuss +hat occurred.
2ollo+ these guidelines:
In(or)ation )ust be correct and ob3ecti*e. 1nly record +hat you ,no+.
9on"t )a,e up +hat Ayou thin, )ay ha*e happened. 2or exa)ple,
don"t say SEe*in did not ta,e the )edication because he loo,s pale and
I thin, he (eels sic," +hen you are only guessing that this is the reason.
The correct entry +ould be SEe*in did not ta,e the )edication because
he said he (elt sic,".
Be brie(. 9on"t include any in(or)ation that is not directly associated
+ith the situation. 2or exa)ple, don"t +rite S5r.s Baxter, the neighbour,
+as *isiting" i( this has nothing to do +ith the (act that the person
*o)ited.
Be co)prehensi*e. !lthough you )ust be brie( you )ust also +rite as
)uch rele*ant in(or)ation as you can.
2ollo+ your organisation"s procedures (or using abbre*iations.
Generally, abbre*iations are not allo+ed exceptA(or units o(
)easure)ent.
5ost (or)s need:
the date, ti)e and location o( the situation
the people in*ol*ed in the situation
speci(ic details, such as +hat occurred, changes in the person"s
condition, +ho the situation +as reported to
action ta,en by you, and actions suggested by the person it +as
reported to
any outco)es as a result o( these actions
na)e and signature o( the person co)pleting the notes or (or).
se the organisation"s (or)s. There )ay be separate docu)ents
(or di((erent situations.
!n incident report (or) )ay be used in a court, so )a,e sure it is
(actual and accurate.
!l+ays sign any notes you +rite or docu)entation you co)plete.
%. #o)plete the distribution and

ad)inistration o( )edication
9.%
#lean and store unused andBor used )edications, containers
and ad)inistration aids in accordance +ith industry and the
organisationCs in(ection control guidelines
9.3
2ollo+ the organisationCs arrange)ents and procedures to
replenish dose ad)inistration aids and supplies o( )edications
9.3
6ecurely store )edication chartsBcare plansB treat)ent sheets
according to organisation procedures to ensure sa(ety, security
and con(identiality
9.4
2ollo+ the organisationCs procedures to ensure )edication
storage co)plies +ith legislation and )anu(acturerCs
instructions, )axi)ises security and pre*ents )edication
deterioration
9.% Clean and store unused and= or used medications6 containers and
administration aids in accordance with industry and the
organisation>s infection control guidelines
0anaging trolleys and used medicine containers
!ll +or,places ha*e strict guidelines (or occupational health and sa(ety.
These guidelines are de*eloped (ro) their stateBterritory"s 1ccupational
@ealth and 6a(ety !ct. The !ct is a legal re-uire)ent that explains +hat an
e)ployer and e)ployee )ust do to ,eep their +or,place sa(e and
hygienic. The regulations are en(orceable, +hich )eans that i( they are not
(ollo+ed, e)ployers and e)ployees can be (ined.
It is crucial that you help )aintain a clean, hygienic en*iron)ent at all
ti)es to pre*ent in(ection (ro) spreading. In(ection is a )edical condition
that is caused by )icroAorganis)s such as bacteria and *iruses. These are
tiny particles that cause disease i( they lodge in the hu)an body and
)ultiply.
@ere are so)e guidelines to pre*ent in(ections:
7ash your hands be(ore and a(ter all )edication procedures.
se clean e-uip)ent (or each application.
@andle and clean conta)inated linen andBor clothing according to
occupational health and sa(ety guidelines.
se clean aids to apply )edication.
7ash e-uip)ent a(ter use.
#orrectly handle and dispose o( sharp instru)ents and bro,en glass.
#lean and deconta)inate all sur(aces used during application o(
treat)ents.
9ispose o( conta)inated +aste products appropriately.
Acti*ity #
9iscuss +ith your trainer, +or,)ates and colleagues other pre*ention
strategies you )ight use. 7rite the) do+n.
Caring for medication trolleys
!n i)portant part o( in(ection control procedures is to ensure that all
e-uip)ent used +hen you ad)inister )edication is ,ept clean and (ree
(ro) bacteria and *iruses. 5ost +or,places ha*e a )aintenance and
cleaning schedule to ensure e-uip)ent gets cleaned properly on a regular
and scheduled basis. 5a,e sure you understand +here the schedule is
,ept, the in(or)ation it contains and +hat your responsibilities are.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 2<; o( 282
9.3 +ollow the organisation>s arrangements and procedures to replenish
dose administration aids and supplies of medications
9.3 Securely store medication charts= care plans= treatment sheets
according to organisation procedures to ensure safety6 security and
confidentiality
/rotecting the pri*acy and con(identiality o( older people is a high priority in
an aged care setting. !ged care +or,ers ha*e a duty o( care to protect the
pri*acy o( the people they care (or.
9ocu)entation about a person"s )edication in their care plan, )edication
chart or other docu)ents contains their na)e, date o( birth, diagnosis and
details o( current treat)ent. It )ust be ,ept in a sa(e and secure place at
all ti)es. ?egislation on pri*acy is clear and exact. !n aged care (acility
can be (ined and be open to legal action i( these guidelines are not
(ollo+ed.
F)ployees )ust recei*e training in ho+ to use and store care records
correctly. They are generally as,ed to sign a con(identiality clause +hen
e)ployed. This )eans that they )ust not tal, about an older person"s
details to anyone other than their super*isor and other )e)bers o( the
health care tea).
Storing current records
5a,e sure you understand and (ollo+ your organisation"s policies and
procedures (or storing )edication charts. Dou +ill be told +hat to do +hen
you (irst start +or,.
The older person"s )edication charts )ay be ,ept in:
)edication trolleys
treat)ent roo)s
the older person"s roo)
a central (iling syste).
7hen records and charts are ,ept in a )edication trolley, they should be
loc,ed in a co)part)ent o( the trolley.Dou )ay need to )o*e a+ay (ro)
the trolley (or a short period +hile you are assisting an older person. 2or
exa)ple, the trolley )ay be le(t in the corridor (or a )o)ent. 5a,e sure
any records are not accessible to anyone but yoursel(.
7hen ,ept in treat)ent roo)s, records should be stored in a loc,able
cupboard, +hich should be ,ept loc,ed at all ti)es. The roo) should be
loc,ed at all ti)es, +ith sta(( access only.
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 2<< o( 282
6o)e older people ,eep their )edication in their roo). Their )edication
chart )ay be ,ept +ith the )edication. It is up to you to )a,e sure the
chart re)ains in the cupboard +ith the )edication.
9.4 +ollow the organisation>s procedures to ensure medication storage
complies with legislation and manufacturer>s instructions6 ma,imises
security and pre*ents medication deterioration
Storing medication
! crucial part o( a residential care (acility is to )a,e sure that all the
)edication that is stored on the pre)ises is stored sa(ely, securely and
correctly. There are strict la+s about +ho has access to drugs and ho+
they )ust be stored to sa(eguard e*eryone"s sa(ety. !ged care +or,ers
)ust understand the la+s. The la+s di((er bet+een statesB territories so
)a,e sure you are (a)iliar +ith the legislation in your stateB territory.
Dou also need to be (a)iliar +ith the )anu(acturer"s guidelines (or storing
the )edication and the procedures your +or,place has in place.
#orrect storage )eans that the )edication is:
)anaged according to go*ern)ent legislation
secure at all ti)es so only authorised people ha*e access to it
stored at the correct te)perature so it does not get da)aged.
Storing medication securely
5edication )ust be stored according to legislation. This )eans that it is
stored in a sa(e, loc,ed area that only authorised people ha*e access to.
The ,ey (or access to )edication in residential aged care (acilities should
be ,ept in the i))ediate and personal possession o( an authorised sta((
)e)ber. This is usually the registered nurse, endorsed enrolled nurse or
senior sta(( )e)ber on duty. 6hould another )e)ber o( sta(( re-uire the
,ey, they )ust as, the authorised sta(( )e)ber (or the ,ey, and return it to
the) i))ediately a(ter they ha*e (inished +ith it. It is so)eti)es
necessary that a ,ey register is signed or that the authorised person does
the unloc,ing so that the ,ey doesn"t lea*e their possession.
It should not be possible (or *isitors, children, pets, other older people or
unauthorised sta(( to access the storage area.
Storing controlled drugs
6peci(ic guidelines are prescribed (or the )anage)ent and storage o(
controlled drugs such as 6chedule 8 drugs. #ontrolled drugs )ust be ,ept
in an appro*ed container as speci(ied in the drugs and poisons regulations
(or di((erent states and territories. There )ay also be a re-uire)ent to
,eep a register o( all controlled drugs stored onsite and recorded +hen
ta,en by older people. @ere is an exa)ple o( a controlled drugs register.
Common 0edical A""re*iations
1ne o( the )ost challenging tas,s (acing a student is learning the
language o( )edicine. I( this +asn"t di((icult enough, )edicine also uses a
large nu)ber o( )edical abbre*iations.
I( students +ant to co))unicate )ore e((ecti*ely they )ust understand
)edical abbre*iations. 5any students (ind report +riting is easier +hen
they can use abbre*iations, but it is *ital to )a,e sure the abbre*iations
used are used correctly and co))only understood. /oor docu)entation
can )a,e the s)artest student loo, (oolish.
This is not a co)prehensi*e list o( abbre*iations, but rather a guide to help
get the student started on their 3ourney into the language o( )edicine.
+igure # A""re*iations and their meaning
a Be(ore
!F9 !uto)ated Fxternal 9e(ibrillator
a.c. Be(ore )eals
!6! !spirin
!5! !gainst )edical ad*ice
!5I !cute )edical in(arction
!6@9 !rteriosclerotic heart disease
b.i.d. T+ice a day
B/ Blood pressure
B6 Breath sounds, bo+el sounds, or blood sugar
B>5 BagA*alueA)as,
cB o #o)plaining o(
#a #ancerB carcino)a
cc #ubic centi)eter
## #hie( #o)plaint
#@2 #ongesti*e heart (ailure
#1 #arbon )onoxide
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 2<% o( 282
#1/9 #hronic obstructi*e pul)onary disease &e)physe)a,
chronic bronchitis'
#/0 #ardiopul)onary resuscitation
#62 #erebrospinal (luid
#>! #erebro*ascular accident
#[0 #hest [Aray
dB c 9iscontinue
95 9iabetes )ellitus
91! 9ead on arri*al
91B 9ate o( birth
9x 9iagnosis
F#G, FEG Flectrocardiogra)
e.g. 2or exa)ple
FT! Fsti)ated ti)e o( arri*al
FT1@ !lcohol &ethanol'
2x 2racture
GI Gastrointestional
G67 Gunshot +ound
gtt. 9rop
G Genitourinary
GDN Gynecologic
h, hr. @our
@B ! @eadache
@FFNT @ead, ears, eyes, nose, throat
@g 5ercury
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 2<= o( 282
hB o @istory o(
hs !t bedti)e
@TN @ypertension
@x @istory
I#/ Intracranial pressure
I# Intensi*e #are nit
I5 Intra)uscular
I1 Intraosseous
J>9 Jugular *enous distension
E>1 Eeep *ein open
? ?e(t or ?iter
?!# ?aceration
?1# ?e*el o( consciousness
?0 ?actated 0ingers solution
)cg 5icrogra)s
56 5orphine sulphate, )ultiple sclerosis
N!9 No apparent distress
N# Nasal cannula
NE! No ,no+n allergies
npo Nothing by )outh
N0B NonArebreather )as,
N6 Nor)al saline
N60 Nor)al sinus rhyth)
NTG Nitrogycerin
NB > NauseaB *o)iting
1\ 1xygen
1B 1bstetrics
19 1*erdose
10 1perating 0oo)
/#N /enicillin
/F! /ulseless electrical acti*ity
/F0? /upils e-ual and reacti*e to light
/I9 /el*ic in(la))atory disease
/N9 /aroxys)al nocturnal dyspnea
po By )outh
/0N !s needed
/6>T /aroxys)al supra*entricular contraction
/t /atient
/T! /rior to arri*al
/># /re)ature *entricular contraction
-.h. F*ery hour
-.i.d. 2our ti)es a day
0 0ight
rB o 0ule out
0x or Tx Treat)ent
6I96 6udden In(ant 9eath 6yndro)e
61B 6hortness o( breath
stat. i))ediately
John Bailey 2008, 2010, 2011 /age 6e-uence: /age 2<$ o( 282
6>T 6upra*entricular tachycardia
TI! Transient ische)ic attac,
t.i.d. Three ti)es a day
TE1 To ,eep open
>.6. >ital signs
x Ti)es
+B o or s +ithout
7N? 7ithin nor)al li)its
yB o or y.o. Dears old
] change
^ /ositi*e
A Negati*e
Acti*ity #
Translate this report (ro) R)edicineQ into Fnglish:
%= yB o )ale cB o chest pain and 61B x 2 h. /ain is se*ere &8 out o( 10',
centered under sternu), and radiates to the ? ar) and 3a+. /ain +o,e
patient (ro) sleep, and is +B o ] +ith )o*e)ent or breathing. /t. has a hBo
!6@9, 5I 1B18B01. @TN, and 95. 5eds include !6!, insulin, lasix, and
lisinopril. !llergic to /#N.
1n exa) pt is ! ^ 1 x <, diaphoretic, and anxious.
@FFNT: /F0?
Nec,: A J>9, positi*e use o( accessory )uscles
!bdo)en: so(t, nonAtender
Fxtre)ities: A ede)aB clubbingB cyanosis
!ssess)ent: rB o chest pain o( cardiac origin
/lan: oxygen &1%? N0B', I> N6 TE1, cardiac )onitor, )onitor >.6.,
transport position o( co)(ort, NTG x ; 56 2 )g I> +ith decrease in pain
(ro) an 8 to a ;, !6! de(erred as patient had a dose today.
0esource F*aluation 2or)
/lease co)e bac, to this page +hen you ha*e (inished +or,ing on this resource and
co)plete this (or). Dour (eedbac, can assist us to continually i)pro*e this resource.
Course &nit# #@##6;08! A !ssist clients +ith )edication
-! Date at finish of unit
Please Circle
7as your learning totally external, +ith occasional phone contact
+ith a designated trainerBteacherI
1es 7o
7as your learning externally supported by a study group o( other
learners studying the sa)e unitI
1es 7o
@o+ )any +or,shops +ere gi*en to support your learningI &/lease
circle a nu)ber 0,1,2,;'
0 % 3 3
9id your learning in*ol*e class support )aterial at your collegeI 1es 7o
9id you (ind this resource easy to useI 1es 7o
!ny #o))entsI
7as the content use(ulBclearBrele*antI 1es 7o
!ny #o))entsI
/lease co))ent on any +ays this resource could be i)pro*ed (or (uture learners
7hat other resources did you (ind that helped you +ith your studiesI
Than, you (or your ti)e to gi*e us your *aluable (eedbac,. /lease gi*e this to your
trainerB(acilitatorBteacher +ho can send to us at the belo+ address L or i( you pre(er you can do
it yoursel(
I7B Pu"lications
/.1. Box 2%8
5acarthur 6-uare, N67, 28%0
2ax: 02A<%2=A08;0

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