Caring for Our People Training Medication Administration

First of all.....

WHEN IN DOUBT – ask! Giving the wrong medication or wrong dosage can cost a person his life. When you think of it that way, it is not so hard to ask the doctor or nurse to repeat instructions or use other words so that you can be sure you know what you need to do. Often people in the medical field get so used to talking to one another that they forget that not everyone is as familiar with medical terms as they are. The doctor or nurse should be happy to see you are taking this responsibility seriously. Get a phone number to call if you have any questions later. If they act impatient with you or as if you should already know this information, that is their problem, not yours. Be sure you know exactly what you need to do because someone’s life is in your hands.

Get the doctor’s instructions in writing. Before you give any medication, check the written instructions and check the label on the bottle. If the two don’t agree, call the doctor or nurse for advice on what to do.

The *FIVE RIGHTS when giving medications –

Right PERSON, MEDICINE, DOSE, ROUTE & TIME

Some key ideas are given below. A lot of these may seem to be just common sense, but when you are giving the same medication time after time or to lots of different people, it is easy to fall into bad habits, get in a hurry or just plain forget.

RIGHT PERSON, RIGHT MEDICINE - If you provide care to more than one person, make SURE you have the medication for the correct person. Even if you only provide care for one person, check the name on the label on the bottle. Make sure they gave you the medication for the right person.

RIGHT DOSE
Keep the medicine in one place! When medication is sent back and forth from one place to another, there is more chance of missed doses, lost medicine, unsafe storage, and other people accidentally taking the drug. If you work with a patient who needs to take medication several times a day in different places, such as at school and home, have a bottle in each place. Ask the pharmacy to split the prescription into two bottles. They will usually do this at no extra charge. You can check that the patient has been receiving the right dosage at home by counting or measuring the amount left in the container.

Read the label and instructions each time a prescription is re-filled. Although you may have been giving a person this medication for three years, it is always possible the doctor may have adjusted the prescription due to weight loss or gain or some other reason.

Just because you administered the medication to a person doesn’t mean she took it. When my daughter was younger, she sometimes decided she did not want to take her pills, for reasons ranging from “I’m mad at you, so I want to have a seizure,” to “I just don’t feel like it”.

For a while, I thought I had solved the problem by making her take her pills in front of me. I found out how poorly that worked months later when we moved to a new house and I found Tegretol tablets behind the couch, in the shag carpet, under her bed and just about everywhere else. She would hide them under her tongue or in her cheeks and then spit them out later.

RIGHT ROUTE
Now, it may seem obvious that eye drops go in the eye and ear drops go in the ear. However, plenty of times people get medicine they take by mouth for an ear infection. Before giving the medication, read the instructions and be sure it is given by the right route.

RIGHT TIME

OTHER THINGS YOU SHOULD KNOW ABOUT MEDICATION ADMINISTRATION

Keep it safe: Lock up all medication in a safe and secure place, away from children and mental impairments.

Write it down. Write down every dose.Keep a record of all medication administered. This is particularly important if more than one person is responsible for administering medication. Even if you are the only one, no one's memory is perfect. It is also important to keep a written record of missed or late doses and errors! Although the temptation to try to forget mistakes is understandable, not writing down an error in medication is a HUGE mistake. Having a record of errors can lead to a quick diagnosis and treatment if a problem occurs.

A safe and secure method of medication storage is essential.

READ THE INSTRUCTIONS! PAY PARTICULAR ATTENTION TO WARNINGS NOT TO USE WITH ALCOHOL!

YOU are the last line of defense against medical errors. If the pills don’t look right – the color or size is different from what you usually give the patient, or different in any way- CALL THE DOCTOR OR NURSE. Do not give medication if you don’t think it is correct.

As a care provider, you are the one in the best position to describe the effect of medication changes on the individuals you work with. A person with autism or other severe developmental disorder may not be able to talk about any problems that occur as a result of medication changes.

Be sure to report any changes you notice after a change in the type, amount or schedule of medication. Please try to be specific, e.g., “I noticed since he has been taking those new pills Greg has been sleeping a lot more. He doesn’t get up until around noon and then takes a nap in the afternoon for a couple of hours. He used to get up earlier and never took a nap.”

For further information on medication administration by child care providers, click here.