Transcript MEDICATION ADMINISTRATION 1

MEDICATION
ADMINISTRATION Topic 1
Topic 1 Client ID Documentation Drug Schedules
As the student nurse gains
experience in medication
administration, psychomotor
skills ( the how to ) become more
refined. Psychomotor skills,
however represent only a small
part of medication
administration. Knowledge,
physical and mental status as well
as client attitudes and responses
can make medication
administration a complex
experience
List reasons for the importance of
being competent in the
administration of medications
 All drugs prescribed or over the counter are potentially
dangerous
Prescription or medication order is a legal document
It is a legal requirement
To ensure maximum safety for person who might benefit
from drugs
To protect the enrolled nurse and health care facility
from serious consequences of medication incidents.
INDICATIONS FOR
MEDICATION USE
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Maintain normal body function. Eg. Insulin.
Diagnostic Eg Barium.
Symptomatic relief, Eg Analgesia.
Prophylaxis, Eg Vaccines.
Alter psychological functions, Eg
Contraception.
Reverse control disease process, Eg
Antibiotics.
Describe the drug controls in
New South Wales
COMMONWEALTH
REGULATIONS
The role of the Australian Government in
regulation of the pharmaceutical
industry is to protect the health of the
people by ensuring that medications
are safe and effective.
AGED CARE ACT 1997
To ensure that the facilities employ
appropriately skilled staff who can provide
for the needs of the residents in their care.
They must maintain accreditation standards.
The enrolled nurse must work within the
policy and protocols of their employing
facility.
CONTROL IS AT 3 LEVELS
1.
The Therapeutic Goods Act ( 1989 ).
Medication manufacturer, sales,
testing, labeling and distribution.
2.
The Customs Act ( 1901 )
Advertising of therapeutic goods to
health professionals and public
CONTROL IS AT 3 LEVELS
3. The National Health Act ( 1953 )
Applies to Pharmaceutical Benefits
Scheme that provides subsidized
drugs to public. Also limits the
amount of drugs supplied, number of
times and frequency that the supply
can be repeated. Not all drugs are
subsidized.
The Australian Therapeutic Goods
Administration ( TGA ) a section of the
Commonwealth Department of Health,
provides a framework for the regulation of
therapeutic goods to ensure their safety,
efficiency, quality and timely availability.
Before a drug can be marketed in Australia,
it must be evaluated by TGA. The product
will be assessed for quality, safety, efficacy
NSW LEGISTRATION
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NSW Poisons and Therapeutic Goods
Act ( 1966 ) Poisons and Therapeutic
Goods Regulation ( 2002 )
Nursing Home Act 1993.
POISONS AND
THERAPEUTIC GOODS ACT
1966
Covers the control of
poisons and
outlining any
criminality related
to poisons
The poisons and therapeutic goods
regulation 1994 has a direct impact on
nurses during their day to day routines and
covers the practical aspects of the
possession, storage, supply, administration
and recording of the poisons and the
poisons list which classifies substances into
their various substances.
NSW DEPARTMENT OF
HEALTH
Guidelines for the Handling of
Medication in NSW Public Hospitals
 Guidelines fro the Handling of
Medication in Community Based
Health Services and Residential
Facilities in NSW
 Private Hospitals and Day Procedure
Centre and Nursing Homes
Regulations
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NSW DEPARTMENT OF
HEALTH
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These are the standards that regulate
enrolled nurse practice
Public hospitals must ensure that employees
who are administrating medication have
appropriate qualifications and training.
Health care institutions establish individual
policies that must meet Commonwealth,
State and local government regulations
AUSTRALIAN NURSE
COMPETENCIES
This organization outlines and limits the role
and boundaries of the enrolled nursing
practice
The inclusion of medication administration in
the scope of practice for the EN will ensure
public safety through quality management
and risk assessment intervention.
Enrolled Nurses who have been
competent in the medication module will
be permitted to administer medication by
what ever route including S4 drugs but
not S8 drugs of addiction.
CLIENT IDENTIFICATION
How
do you Identify a
client?
DOCUMENTATION
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Medication charts should have patients:
• Full name.
• MRN.
• Date of birth.
• Allergy.
• Legible order.
• Drug ordered by Generic name.
• Signature of Doctor and their printed
name.
DOCUMENTATION
• Date medication ordered.
• Times for medication.
• Reasons for use of medication.
• Age and weight of paediatric
patient.
• Cessation date. Forms of
medication, eg rectally, orally,
transdermal.
MEDICATION
ADMINISTRATION
TERMINOLOGY
DRUG SCHEDULES
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Schedule 1. Dangerous poisons eg Arsenic.
Schedule 2. Medicinal Poisons, eg
Paracetamol.
Schedule 3. Potent substances, eg Insulin.
Schedule 4. Restricted substances, eg Oral
hypoglycaemics.
Schedule 4D. Prescribed Restricted
Substances, eg Diazepam.
DRUG SCHEDULES
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Schedule 5. Domestic Poisons, eg
Bleach.
Schedule 6. Industrial and Agriculture,
eg Phenol.
Schedule 7. Special Poisons, eg
Insecticides.
Schedule 8. Drugs of Addiction, eg
Morphine.
PROHIBITED DRUGS
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Substances which are controlled under
the Drug Misuse and Trafficking Act
1985 and are not specified in Schedule
8 of the Poisons and Therapeutic
Goods Act, eg Heroin.
INDICATIONS
An illness or disorder
for which a drug
has a documented
specific usefulness.
CONTRAINDICATIONS
A factor that makes dangerous or
undesirable the administration of a
drug or the performance of an act or
procedure in the care of a specific
patient.
SIDE EFFECT
A side effect occurs when a medication
causes unintended, secondary effects (
that may be predictable ) Side effects
may be harmless or injurious. If the
side effects are serious enough to
negate the beneficial effects of
medication’s therapeutic action, the
prescriber may discontinue the
medication.
ADVERSE
REACTIONS/AFFECTS
These are generally unexpected effects
of the medication. They may be
related to the pharmacological effect
or they may be related to the
individual taking the medication.
NEAR MISS
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Error recognised prior to
administration of medication given to
patient
SENTINEL EVENT
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An error in drug administration that
may cause permanent disability or
death.
The trade name, brand name or proprietary
name is the name under which a manufacturer
markets a medication
Is the name by which the chemist knows
it, it provides an exact description of the
drug’s chemical composition.
Is the name given by the manufacturer
who first developed the drug. To
prevent confusion and to reduce
medication errors, medication orders
should be written using the generic
name
Lets look at an example
D – (- ) –a amino – r – benzyl penicillin
trihydrate
Amoxycillin trihydrate
Alphamox, Cilamox, and Amoxyn.
THERAPEUTIC EFFECT
The therapeutic effect of the drug is the
intended use of the drug, that is , its
desired effect.
E.g. Panadol for a headache, the
therapeutic effect is pain relief.
All health facilities should have as part of
their quality improvement programs a
system in place or reporting medication
errors. Please check where these are
kept.
Ac = before meals
Bid/bd = twice a day
h= hour
pc= after meals
prn= whenever there is a need/necessary
m = mane
n = nocte
IV = intravenous
SC = subcutaneous
IM = intramuscular
mist = mixture
asap = as soon as possible
qqh = every 4 hours
po = by mouth ( orally )
qid= four times a day
tds= three times a day
q2h= every 2 hours
q4h=every 4 hours
stat=give immediately