state of connecticut department of children and families
DESCRIPTION
STATE OF CONNECTICUT Department of Children and Families Medication Administration Certification Training Based on the Basic Medication Administration Curriculum 2010 Edition. Recertification. Review Guide. Unit 1. 2. Recertification Review Guide, Unit 1. 5. 1. Right Child - PowerPoint PPT PresentationTRANSCRIPT
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STATE OF CONNECTICUT
Department of Children and Families
Medication Administration Certification Training
Based on the Basic Medication Administration Curriculum2010 Edition
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2Recertification Review Guide, Unit 1
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RIGHTSRIGHTSof
MedicationAdministration
1.1. Right Right ChildChild
2.2. Right Right
MedicationMedication
3.3. Right Right DoseDose
4.4. Right Right RouteRoute
5.5. Right Right TimeTime
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Three Documents Necessary for Three Documents Necessary for Safe Medication AdministrationSafe Medication Administration
Licensed Practitioner’s Order
Pharmacy Label
Medication Administration Record (MAR)
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The Rule of Three is:The Rule of Three is:
Comparing the licensed practitioner’s order, MAR and the pharmacy label for the five rights three times every time you administer the medication
DocumentsDocumentsLicensed Practitioner’s OrderLicensed Practitioner’s OrderMARMARPharmacy LabelPharmacy Label
RightsRightsChildChildMedicationMedicationDoseDoseRouteRouteTimeTime
TimesTimeseveryevery timetimeyou administeryou administerthe medicationthe medication
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Roles of LP, Pharmacist, Roles of LP, Pharmacist, Medication Certified Staff and Medication Certified Staff and
NurseNurse
Licensed PractitionerLicensed Practitioner:: may diagnose and prescribe treatment/medications. May dispense medication.
PharmacistPharmacist:: dispenses medications according to a licensed practitioner’s order.
Medication Certified StaffMedication Certified Staff:: may administer medications according to a licensed practitioner’s order to children in any DCF licensed or operated child-caring facility or extended day program.
Nurse (RN, LPN or APRN)Nurse (RN, LPN or APRN):: provides ongoing supervision of medication administration program/staff.
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Responsibilities of the DCF Responsibilities of the DCF Medication Administration StaffMedication Administration Staff
AlwaysAlways follow DCF Med Admin Procedure
AlwaysAlways use the Five Rights and the Rule of Three before medication administration
Know the desired effects of a medication and report any side effects
Adhere to any precautions
Follow instructions from the LP
Contact the Chain of Command whenever you Contact the Chain of Command whenever you have a question or concernhave a question or concern
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When you have a question about a LP’s order, a pharmacy
label or MAR
There is change in the condition of a
child
A child does not receivehis medications as
ordered
Any incident where medication is not properly
safeguarded
Any time you have a question or
concern
When toContact
theChain of
Command
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Unit 1 QuizUnit 1 Quiz
1. What are the Five Rights of Medication Administration?
2. What are the three documents you must have to assure safe medication administration?
3. True or False: You only need to check the Five Rights and the Rule of Three the first time you give the medication.
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Answers to Unit 1 QuizAnswers to Unit 1 Quiz
1. What are the Five Rights of Medication Administration?
The right child, right medication, right dose, right route and right time
2. What are the three documents you must have to assure safe medication administration?
Licensed practitioner’s order, pharmacy label, MAR
3. True or False: You only need to check the Five Rights and the Rule of Three the first time you give the medication.
False – You need to check the Five Rights and the Rule of Three every time you administer a child’s medication. Recertification Review Guide, Unit 1 10
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STATE OF CONNECTICUT
Department of Children and Families
Medication Administration Certification Training
Based on the Basic Medication Administration Curriculum2010 Edition
11Recertification Review Guide, Unit 2
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12Recertification Review Guide, Unit 2
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Define the terms trade name Define the terms trade name and generic name for and generic name for
medicationsmedications
Trade name:Trade name: marketing namefor example: Tylenol
Generic Generic name:name:
chemical namefor example: acetaminophen
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Define active ingredientsDefine active ingredientsand inactive ingredientsand inactive ingredients
Active Active ingredientingredient::
chemical that actually causes the medication’s desired effect
Inactive Inactive ingredientingredient::
dyes, water and other additives to form a tablet, add flavor or color
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Define controlled medicationDefine controlled medication
Controlled medications
have the potential to be
abused or addictive
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Define unlabeled (off-labeled)Define unlabeled (off-labeled)use of medicationuse of medication
Unlabeled/Off-labeled Unlabeled/Off-labeled use of a medicationuse of a medication is the use of a medication for a purpose that has not been approved of by the FDA
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Describe the different routesDescribe the different routesof administrationof administration
Oral medication
Eye drops and ointments
Ear drops
Nasal sprays
Inhaled medication
Topical medication
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List the steps of the DCF List the steps of the DCF Medication Administration Medication Administration
ProcedureProcedure
Approach the task in a calm manner allowing no distractions
Wash hands before and after medication administration
Assemble appropriate equipment
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List the steps of the DCF List the steps of the DCF Medication Administration Medication Administration
Procedure Procedure (Cont.)(Cont.)
Perform the rule of three:
1. Compare the LP’s order with the pharmacy label
2. Compare the pharmacy label with the MAR
3. Compare the MAR with the LP’s order to see if the five rights match
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Pour the correct dose of medication
Identify the correct child
Administer the medication utilizing the proper techniques
Perform a mouth check
Document
Return the medication to the locked area and clean up
List the steps of the DCF List the steps of the DCF Medication Administration Medication Administration
ProcedureProcedure (Cont.)(Cont.)
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Unit 2 QuizUnit 2 Quiz
1. True or False: Unlabeled use means the medication is being used for a purpose that has not been approved by the FDA.
2. What is the description of controlled medication?
3. List the steps of the DCF Medication Administration Procedure.
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Answers to Unit 2 QuizAnswers to Unit 2 Quiz
1. True or False: Unlabeled use means the medication is being used for a purpose that has not been approved by the FDA.
True – Unlabeled/Off-labeled use of a medication is the use of a medication for a purpose that has not been approved by the FDA.
2. What is the description of controlled medication?
Controlled medications have the potential to be abused or addictive
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Answers to Unit 2 Quiz Answers to Unit 2 Quiz (Cont.)(Cont.)
List the steps of the DCF Medication Administration Procedure.
1. Approach the task in a calm manner allowing no distractions
2. Wash hands before and after medication administration
3. Assemble appropriate equipment
4. Perform the Rule of Three
5. Pour the correct dose of medication
6. Identify the correct child
7. Administer the medication utilizing the proper techniques
8. Perform a mouth check
9. Document
10.
Return the medication to the locked area and clean up
Recertification Review Guide, Unit 2 23
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STATE OF CONNECTICUT
Department of Children and Families
Medication Administration Certification Training
Based on the Basic Medication Administration Curriculum2010 Edition
24Recertification Review Guide, Unit 3
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25Recertification Review Guide, Unit 3
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Identify what you must know about a Identify what you must know about a medication before you administer itmedication before you administer it
Medication’s name
Medication’s use
Medication's action
Controlled or non-controlled
Usual dose
Precautions and considerations
Side effects
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Describe the process that must occur Describe the process that must occur in thein the
body for a medication to have an effectbody for a medication to have an effect
Enter
Absorb
Distribute
Metabolize
Eliminate
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List and describe the effects List and describe the effects a child may have to a medicationa child may have to a medication
Individual effect
Desired/Therapeutic effect
No effect
Side effect
Allergic effect
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Define the term “side effects”Define the term “side effects”and give examplesand give examples
A response to a medication that is not the desired effect; may be mild to severe and includes:
nauseaheadachedifficulty sleepingfevermuscle twitching and tics
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Identify the correct steps to take if Identify the correct steps to take if a child experiences a side effecta child experiences a side effect
1. Hold the medication
2. Contact Chain of Command
3. Document
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Describe anaphylaxis and the Describe anaphylaxis and the appropriate steps to followappropriate steps to follow
Severe potentiallyfatal allergic reaction
CALL 911911(Follow your facility’s
Policies and Proceduresre: medical emergencies)
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List factors that affect a child’s List factors that affect a child’s response to medicationresponse to medication
Age
Weight
Route of Administration
Drug and Food Interactions
Size
Gender
General Health Status
Genetics
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Define drug to drug Define drug to drug interactioninteraction
The effects of one medication are changed by the presence of another medication.
May occur whenever there is more than one medication in the child’s system.
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Describe drug to food Describe drug to food interactioninteraction
The presence of food in the stomach affects how medication is absorbed
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Factors that affect a child’s Factors that affect a child’s compliance with taking medicationcompliance with taking medication
Taste
Smell
Color
Consistency of the medication
Parental approval
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Define commonly usedDefine commonly usedmedical abbreviationsmedical abbreviations
Q Day
every day
BID twice a day
TID three times a day
HS at bedtime (Hour of Sleep)
Q#H every # hours
PRN as needed
AC before meals
PC after meals
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Define commonly usedDefine commonly usedmedical abbreviations medical abbreviations (Cont.)(Cont.)
mg milligrams
ml milliliters
cc Cubic centimeters
Tab tablet
Cap capsule
tsp teaspoon
Tbsp tablespoon
NTE Not to Exceed
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Define commonly usedDefine commonly usedmedical abbreviations medical abbreviations (Cont.)(Cont.)
PO by mouth
OU both eyes
NKA No Known Allergies
NKDA No Known Drug Allergies
SR Sustained Release
CR Controlled Release
DR Delayed Release
XL Extra Long Release
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Define commonly usedDefine commonly usedmedical abbreviations medical abbreviations (Cont.)(Cont.)
MDI Metered Dose Inhaler
NPO Nothing by mouth
c with
s without
One tsp 5ml or 5 cc
One Tbsp
15ml or 15cc or 3 tsp
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Unit 3 QuizUnit 3 Quiz
1. Translate: Depakote 250mg PO TID
2. Identify the correct steps to take if a child experiences a side effect
3. Describe the process that must occur in the body for a medication to have an effect
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Answers to Unit 3 QuizAnswers to Unit 3 Quiz
1. Translate: Depakote 250mg PO TID
Depakote 250 milligrams, by mouth, three times a day
2. Identify the correct steps to take if a child experiences a side effect
Hold the medicationContact Chain of CommandDocument
3. Describe the process that must occur in the body for a medication to have an effect
Enter, Absorb, Distribute, Metabolize, Eliminate
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STATE OF CONNECTICUT
Department of Children and Families
Medication Administration Certification Training
Based on the Basic Medication Administration Curriculum2010 Edition
42Recertification Review Guide, Unit 4
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43Recertification Review Guide, Unit 4
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Identify the componentsIdentify the componentsof a licensed practitioner’s orderof a licensed practitioner’s order
Five Rights
Signature
Date (within the last 90 days)
Special instructions
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LP’s order must be renewed …LP’s order must be renewed …
Every 90 days(per DCF regulations)
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Documentation necessaryDocumentation necessaryfor OTC medicationfor OTC medication
CT statutes and regulations require a LP’s order for any medication to be administered to a child. That includes OTC medications.
Orders must include the Five Rights, be dated within the last 90 days and signed by a LP.
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Define “Define “standing ordersstanding orders””
Standing orders are licensed practitioner’s orders that include PRN OTC medications used to help treat or manage routine, minor childhood illnesses or symptoms
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General rules of documentationGeneral rules of documentation
Use permanent ink – no pencils or erasable pens
Write legibly
Only approved abbreviations
No white-out
Do not obliterate a documentation error – draw a single line through the mistake, write your initials and date above it
Use full, proper names and titles
Do not use one child’s full name in another child’s record
The time and date should be noted in all documentation
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DocumentingDocumentingNon-controlled medicationsNon-controlled medications
Every child who is prescribed medication must have his own MAR for each medication he is prescribed
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Documenting Controlled Documenting Controlled MedicationsMedications
When you administer a controlled medication you must document how much of that medication remains
All controlled medications must be counted and the count documented at the beginning of each shift or whenever responsibility for the controlled medication is transferred from one staff member to another
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Documenting PRN medicationsDocumenting PRN medications
The time, dose, reason and outcome for the PRN medication must be documented in an objective manner
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Unit 4 QuizUnit 4 Quiz
1. Identify the components of a licensed practitioner’s order
2. Define “standing orders”
3. When should controlled medications be counted?
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Answers to Unit 4 QuizAnswers to Unit 4 Quiz
1. Identify the components of a licensed practitioner’s order
Five Rights, Signature, Date (within the last 90 days), Special Instructions
2. Define “standing orders”
Standing orders are licensed practitioner’s orders that include PRN OTC medications used to help treat or manage routine, minor childhood illnesses or symptoms
3. When should controlled medications be counted?
All controlled medications must be counted and the count documented at the beginning of each shift or whenever responsibility for the controlled medication is transferred from one staff member to another.
Recertification Review Guide, Unit 4
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STATE OF CONNECTICUT
Department of Children and Families
Medication Administration Certification Training
Based on the Basic Medication Administration Curriculum2010 Edition
54Recertification Review Guide, Unit 5
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55Recertification Review Guide, Unit 5
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Household vs. metric termsHousehold vs. metric terms
5ml = 1 tsp
5cc = 1 tsp
15ml = 1 Tbsp
15cc = 1 Tbsp
1ml = 1cc
“ml” and “cc” are used interchangeably
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Identify how weight is measured Identify how weight is measured for medication administrationfor medication administration
Milligrams (mg) indicate the weight of the medication in a:
Pill
Capsule
Tablet
In a certain amount of liquid
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Units for measuringUnits for measuringliquid medicationliquid medication
Liquid medication must be carefully measured using only standardized or calibrated measuring tools
Measured in metric (“ml” or “cc”) or household (tsp or Tbsp) units
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Using decimalsUsing decimals
Write a “0” in front of the decimal point for doses less than 1:
Correct: 0.25 mg0.5 mg
Incorrect:
.25mg
.5mg
Do not write a “0” after last number:Correct: 0.25 mg
1 mgIncorrect
:0.250mg1.0mg
Write the decimal point clearly so that it is clearly visible
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Verify that the dose on the LP’s order Verify that the dose on the LP’s order matches the pharmacy label and the matches the pharmacy label and the
MARMAR
Is this a liquid medication?Do I need to convert mm/cc to tsp/Tbsp?4
What dose does the MAR or pharmacy label say to give?3
What is the concentration?2What dose is prescribed? 1To verify To verify
thatthatdoses all doses all matchmatchyou will you will needneedto ask:to ask:
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Practice math for medication administration(click on the link below)
Unit 5 Quiz
Answers to: Unit 5 Quiz
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STATE OF CONNECTICUT
Department of Children and Families
Medication Administration Certification Training
Based on the Basic Medication Administration Curriculum2010 Edition
62Recertification Review Guide, Unit 6
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The physical changes in theThe physical changes in thelungs of people with asthmalungs of people with asthma
Bronchial constriction
Inflammation
Increased mucous
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Common asthma triggers are:Common asthma triggers are:
Smoke Dust Pollen Fumes Strong odors Strong emotions Exercise Cold air
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Common symptomsCommon symptomsof an asthma attack are:of an asthma attack are:
Shortness of breath
Cough
Wheezing
Chest tightness
Difficulty breathing
Chest and neck retractions
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Two general types ofTwo general types ofasthma medications are:asthma medications are:
RescueRescue – inhaled bronchodilator – will quickly open constricted airways during an asthma attack
Maintenance or PreventionMaintenance or Prevention – inhaled steroids, cromolyn sodium, Leukotriene antagonists, oral steroids – taken daily to keep asthma under control and prevent attacks
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Know how to administer an MDIKnow how to administer an MDI
Hold the inhaler upright and shake it
Exhale completely
Hold the inhaler 1 to 2 inches from the mouth
or Place the mouth piece of
the inhaler in the mouth forming a tight seal
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Know how to administer an MDI Know how to administer an MDI (Cont.)(Cont.)
Depress the canister once while inhaling for 2–5 seconds
Hold breath for up to 10 seconds or as long as possible
Wait 1 minute and repeat the entire process if a second puff is ordered
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Unit 6 QuizUnit 6 Quiz
1. What are the three physical changes that occur in the body during an asthma attack?
2. True or False: Inhaled bronchodilators (rescue medications) are typically used to treat an asthma attack.
3. True or False: Chest and neck retractions and cough are two symptoms of an asthma attack.
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Answers to Unit 6 QuizAnswers to Unit 6 Quiz
1. What are the three physical changes that occur in the body during an asthma attack?
Bronchial constrictionInflammationIncreased mucous
2. True or False: Inhaled bronchodilators (rescue medications) are typically used to treat an asthma attack.
True
3. True or False: Chest and neck retractions and cough are two symptoms of an asthma attack.
True
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STATE OF CONNECTICUT
Department of Children and Families
Medication Administration Certification Training
Based on the Basic Medication Administration Curriculum2010 Edition
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Medications for Medical ConditionsMedications for Medical Conditions
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AntibioticsAntibiotics
May reduce theeffectiveness of birth controlmedications
5
Follow specific instructions about administration with food
4Do not give double doseto make up for a misseddose
3
Watch forallergies1
Finish entireprescription2TreatTreat
BacterialBacterialInfectionInfection
ss
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Anti-viral medicationsAnti-viral medications
Treat viral infections
1. Reduces symptoms – will not cure viral infection
2. Must start at the earliest sign of viral infection
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ScabicidesScabicides
Treat scabies infestation of the skin
1. Follow orders and directions exactly
2. May cause serious adverse effects if overused
3. Potentially toxic to the Central Nervous System
4. LP’s order required for administration
5. Contact the chain of command if child is re-infected
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PediculocidesPediculocides
Treat lice infection
1. Follow orders and directions exactly
2. May cause serious adverse effects if overused
3. Potentially toxic to the Central Nervous System
4. LP’s order required for administration
5. Contact the chain of command if child is re-infected
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Antifungal medicationAntifungal medication
Treat fungal infection
1. Treatment may take a long time
2. Keep infected area clean and dry
3. Good hygiene prevents spread of infection
4. Report any side effects to chain of command
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AnalgesicsAnalgesics
Relieve pain
1. Frequent, unusual, or pain that interferes with child’s usual activity must be reported to the chain of command
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AntipyreticsAntipyretics
Reduce fever
1. Monitor child’s temperature before and 1 hour after administering antipyretic
2. Fever is a change of condition that must be reported to the chain of command
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ExpectorantsExpectorants
Promote coughing up mucous
1. Report any persistent cough to the child’s physician
2. Increased fluid intake will help to loosen secretions
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AntitussivesAntitussives
Suppress cough
1. May mask signs of infection such as pneumonia or bronchitis
2. May be ordered at night to quiet a cough that interrupts sleep
3. Narcotic antitussives should be used cautiously with clients who have a history of drug or alcohol abuse
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DecongestantsDecongestants
Reduce congestion in the sinuses and nasal passages
1. May cause excitability and insomnia
2. Avoid administering at bedtime
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AntihistamineAntihistamine
Reduce symptoms of allergic reactions
1. May cause drowsiness – use with caution
2. May cause decreased ability to urinate
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Cardiovascular medicationsCardiovascular medications
Affect the heart and circulatory system
1. BP and pulse must be checked routinely
2. Do not stop abruptly
3. Doses should not be missed
4. Unlabeled use: Anxiety and ADHD
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AnticonvulsantsAnticonvulsants
Reduce or prevent seizures
1. Give consistently on time
2. May require periodic blood work
3. Unlabeled use: mood disorders
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LaxativesLaxatives
Promote bowel movements; treat constipation
1. Increased fluids, fiber, and activity may reduce the need for laxative medication
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AntacidsAntacids
Control or reduce acid in stomach
1. Check with pharmacist or licensed practitioner before administering at the same time as another medication: may interfere with absorption of other meds
2. Frequent complaints of heartburn or stomach upset should be evaluated by a physician
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Birth control / contraceptivesBirth control / contraceptives
Prevent pregnancy
1. Must be administered as ordered for maximum effectiveness
2. Follow LP’s order re: missed doses
3. May be prescribed to regulate menstrual cycle
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Unit 7 Quiz Unit 7 Quiz (click on the link below and print)(click on the link below and print)
Medications to treat medical conditions
Answers to: Medications to treat medical conditions
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STATE OF CONNECTICUT
Department of Children and Families
Medication Administration Certification Training
Based on the Basic Medication Administration Curriculum2010 Edition
91Recertification Review Guide, Unit 8
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Medications for Psychiatric ConditionsMedications for Psychiatric Conditions
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AntipsychoticAntipsychotic
Treat psychotic conditions/symptoms
1. For suspected side effects: hold the medication, hold the medication, contact the chain of command, and documentcontact the chain of command, and document
2. Difficulty swallowing, drooling, facial tics, twitches, and change in gate may be the first sign of a serious side effect
3. Fever is also a possible side effect
4. Call 911 if appropriate
5.5. Certified staff must directly consult with a LP Certified staff must directly consult with a LP before administering any psychotropic PRNbefore administering any psychotropic PRN
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AnticholinergicAnticholinergic
Treat muscle movement disorders associated with antipsychotic meds
1. Adequate fluid intake is essential, especially in hot weather
2. Contact the chain of command if symptoms don’t improve/get worse
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AntidepressantAntidepressant
Treat depression
1. Watch for signs of worsening depression or thoughts of suicide
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Mood stabilizer Mood stabilizer – – LithiumLithium
Treats mood disorders
1. Encourage adequate fluid intake
2. Routine blood test may be ordered
3. Ibuprofen should not be administered to patients treated with Lithium
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Mood stabilizer Mood stabilizer – – AnticonvulsantAnticonvulsant
“Off-labeled” use to treat mood disorders
1. Must be given on time as ordered
2. Take as prescribed
3. Routine blood test may be ordered
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Anti-anxietyAnti-anxiety
Treats anxiety, tension and nervousness
1. May be controlled medication
2.2. Med certified staff must Med certified staff must directly consult with a LP directly consult with a LP before administering a PRN before administering a PRN anti-anxietyanti-anxiety
3. Overdose can be fatal
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StimulantsStimulants – ADHD medications– ADHD medications
Treat attention deficit hyperactivity disorder
1. Usually not administered late in the day
2. Monitor weight and food intake
3. May be controlled medication
4. May delay growth
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HypnoticsHypnotics – sleep medication– sleep medication
Promotes sleep
1. Offer non-medication interventions first
2. Report insomnia or poor sleeping to the LP
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Serious side effectsSerious side effects(adverse reactions)(adverse reactions)
Some serious side effects are potentially life-threatening or may become permanent.
If you notice or the child complains of any of these side effects, hold the medication, contact your chain of command and document.
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Serious side effects (adverse reactions) Serious side effects (adverse reactions) (Cont.)(Cont.)
If you notice or the child complains of any of these side effects:
hold the medication
contact your chain of command &
document
Fever or complaint of sore throat
Drooling or difficulty swallowing
Changes in gait (walking)
Confusion or increased sedation
Muscle stiffness, esp. in the neck or mouth area
Eyes rolling back involuntarily
Complaint of stomach pain
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Other side effectsOther side effects(Must report to chain of command)(Must report to chain of command)
Sensitivity to Sensitivity to sunsun
Apply sunscreen
Sensitivity to Sensitivity to heatheat
Encourage increased fluid intake
ConstipationConstipation Encourage fluids, fiber, exercise
Appetite Appetite changeschanges
Monitor food intake, encourage healthy food choices
Weight gainWeight gain Follow nutritional recommendations
Sleep Sleep disturbancesdisturbances
Allow for relaxing bedtime routine
Dry mouthDry mouth Encourage fluids to relieve dry mouth
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Unit 8 Quiz Unit 8 Quiz (click on the link below and print)(click on the link below and print)
Medications to treat psychiatric conditions
Answers to: Medications to treat psychiatric conditions
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STATE OF CONNECTICUT
Department of Children and Families
Medication Administration Certification Training
Based on the Basic Medication Administration Curriculum2010 Edition
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Medication Administration TechniquesMedication Administration Techniques
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General InformationGeneral Information
Follow the steps of the Medication Administration Procedure every time you administer any medication to any child. You must perform the Five Rights and the Rule of Three making sure that the five rights match on all three documents
Thoroughly wash your hands before and after you administer medication
Use Standard Precautions whenever necessary
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Standard PrecautionsStandard Precautions(aka: Universal Precautions)(aka: Universal Precautions)
A set of practices that prevent the spread of infection including the use of personal protective equipment such as gloves, gowns, masks and goggles
Frequent hand washing is the best way to prevent the spread of infection
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Forms of oral medicationForms of oral medication
Liquid medications
Tablets
Capsules
Gel caps
Chewable tablets
Quick dissolving tablets
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Forms of oral medicationForms of oral medication (Cont.)(Cont.)
EntericEntericcoated tabletscoated tablets
have a special coating so that the tablet will not be absorbed until it reaches the small intestine
SustainedSustainedRelease tabletsRelease tablets
designed to be absorbed over a long period of time so that the child may not need to take the medication several times daily
XR, XL, CR, or XR, XL, CR, or SRSR
after the medication name indicate a sustained release medication
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Scored tabletsScored tablets
Scored tablets – a scored tablet has a groove(s) dividing the pill in equal parts (half, third, etc.)
A groove across the center of the tablet indicates that the tablet may be cut exactly in half
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General guidelines forGeneral guidelines foradministering oral medicationadministering oral medication
Ask the child to remove gum, candy or food from his mouth before you administer medication to him
Always give oral medication with fluids; water is usually the best choice
A mouth check should be done to make sure that the child swallowed the medications
If you must directly touch a tablet, wear gloves
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Forms of oral medicationsForms of oral medicationsthat should not be crushedthat should not be crushed
Enteric coated tablets
Sustained release tablet
Gel caps
Other liquid filled capsules
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How to crush a tabletHow to crush a tablet
Use a clean, dry mortar and pestle, a pill crusher or place the tablet between the bowls of two spoons
Wrap the tablet in waxed paper or in a paper med cup to prevent the crushed medication from spilling
Mix the crushed medication with a small amount of food (applesauce, yogurt, pudding, etc.) Use no more than a tablespoon or two to mix with the medication
Offer glass of water after administering the medication
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LiquidsLiquids
Liquid medications are often prescribed for young children or for children who cannot swallow pills
Any dose of medication that is less than 5cc/ml must be measured in an oral syringe or calibrated dropper
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Measuring liquid medicationsMeasuring liquid medications
The medication cup must be placed on a flat surface at eye level
While pouring medication from the bottle hold the label facing upward to avoid spilling the medication onto the label
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Technique forTechnique foradministering oral medicationsadministering oral medications
1. Follow the medication administration procedure
2. Pour the accurate dose: place the prescribed number of pills or pour the correct amount of liquid into a medication cup
3. Administer the medication to the client with water or juice
4. After administering the medication, perform a mouth check to ensure that the child swallowed the medication
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Eye medicationsEye medications
1. Wash hands and wear gloves when administering eye medication
2. Ask the child the following questions: Does the eye feel worse? Does the eye hurt?
3. If the child answers yes to either of these questions: Hold the medication Contact the chain of command Document and follow instructions
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Eye medications Eye medications (Cont.)(Cont.)
4. After administering an eye medication, have the child remain in a safe environment until medication is completely absorbed and the client’s vision is cleared
5. Never bandage an eye unless there is a specific order to do so
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How to clean an infected eyeHow to clean an infected eye
Wash hands and wear gloves
Moisten a washcloth, gauze, or cotton ball with warm water
Wipe the infected eye gently from the inner to outer corner
To prevent spreading the infection, never use the same area of the washcloth for more than one wipe AND use separate washcloth for each eye
Remove your gloves and wash hands when the eye is clean
Put on clean gloves before handling the medication
Recertification Review Guide, Unit 9120
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Technique forTechnique foradministering eye ointmentadministering eye ointment
1. Follow the DCF Med Admin procedure
2. Prepare medication correctly: place the cover of the medication on its side to avoid contamination. Warm the medication to room temperature.
3. Clean the child’s eye if necessary
4. Wear gloves. Squeeze a small amount of medication out of the tube onto a tissue before administering
5. Have the child tilt his head slightly backward, resting it against a hard surface if possible. Ask the child to look up and away
Recertification Review Guide, Unit 9121
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Technique forTechnique foradministering eye ointment administering eye ointment (Cont.)(Cont.)
6. Do not touch the eye with the medication container
7. Gently pull down the lower eyelid using the side of a finger. Beginning at the inner corner of the eye, place a thin ribbon of medication into the lower lid
8. Instruct the child to close his eyes for 1-2 minutes so the medication may be absorbed
9. Gently wipe away any excess medication that may have dripped out of the eye.
Recertification Review Guide, Unit 9122
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Technique forTechnique foradministering eye dropsadministering eye drops
1. Follow the DCF Med Admin procedure
2. Have tissues available; place the cover of the medication on its side to avoid contamination. Warm the medication to room temperature.
3. Clean the child’s eye if necessary
Recertification Review Guide, Unit 9123
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Technique forTechnique foradministering eye dropsadministering eye drops
4. Wear gloves. Have the child tilt his head slightly backward, resting against a hard surface if possible. Ask the child to look up and away.
5. Do not touch the medication dropper to the eye or eyelashes
6. Gently pull down the lower eyelid using the side of your finger. Form a small pocket and place the prescribed number of drops into pocket.
Recertification Review Guide, Unit 9124
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Technique forTechnique foradministering ear dropsadministering ear drops
1. Follow the DCF Med Admin procedure
2. Wash hands and wear gloves
3. Remove the cover and place on its side to avoid contamination; warm the medication to room temperature
4. Position the child with the ear to be treated upward
Recertification Review Guide, Unit 9125
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Technique forTechnique foradministering ear drops administering ear drops (Cont.)(Cont.)
5. Straighten the ear canal by the following methods:
3 years old or younger:3 years old or younger: gently pull ear lobe down and back
Over 3 years old:Over 3 years old: gently pull upper part of the ear up and back
6. Place the prescribed number of drops against the side of the ear near the ear canal opening to allow the medication to roll in
7. Have the child remain with affected ear upward for 3-5 minutes
Recertification Review Guide, Unit 9126
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Technique forTechnique foradministering nasal sprayadministering nasal spray
1. Follow the DCF Med Admin procedure
2. Have the child gently blow his nose. Have tissues available.
3. Wear gloves. While plugging one nostril, place the tip of the sprayer 1cm (3/8 inch) into the other nostril
4. Ask the child to breathe in through his nose as the spray is administered
5. Have the child exhale through his mouth after the spray is administered, repeat the procedure if prescribed
6. Discourage him from blowing his nose for 5 minutes
Recertification Review Guide, Unit 9127
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Types of inhaler devicesTypes of inhaler devices
Metered Dose Metered Dose Inhaler (MDI)Inhaler (MDI)
use chemical propellants to push out the medication from the inhaler. A spacer or aero-chamber may be prescribed to use with the MDI to make proper use easier and the medication more effective.
Dry powder or Dry powder or Rotary Rotary Inhalers Inhalers (Turbuhaler, (Turbuhaler, Discus)Discus)
dry powder inhalers are activated through breathing; they release the medication through rapid inhalation instead of using propellants
NebulizersNebulizers
convert liquid medication into a fine mist and deliver the mist through a face mask or mouth piece that is connected to the nebulizer machine with plastic tubing. Your program nurse should teach you the correct way to use a particular child’s nebulizer before you use it.
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AdministeringAdministeringtopical medicationtopical medication
1. Allow for client privacy
2. Clean the skin if necessary per LP’s directions
3. Wear disposable gloves
4. The skin should be dry prior to applying topical medication
5. Apply enough medication to cover the area to be treated, unless otherwise directed
Recertification Review Guide, Unit 9129
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AdministeringAdministeringtopical medicationtopical medication
6. Except for powders, never apply a topical medication directly from the container onto the skin. Place a small amount of medication onto clean gauze then apply to the skin. This prevents contamination of the medication container.
7. Observe the client for any rashes that are new or that get worse
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The correct method for applying and The correct method for applying and removing transdermal medication removing transdermal medication
patchespatches
Gloves should be worn to apply or remove transdermal patches
The patch should be applied to clean, intact, dry skin that is not infected, scarred, callused or tattooed
Wash the skin with soap and water both where the new patch will be placed and where the old patch was removed
Remove the old patch before applying the new one. Check the skin under the patch for redness or rash
Recertification Review Guide, Unit 9131
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The correct method for applying and The correct method for applying and removing transdermal medication patchesremoving transdermal medication patches
(Cont.)(Cont.)
Change application sites to avoid skin irritation
Peel backing off the patch, press onto the skin and apply pressure to assure that it sticks to the skin
Document in the child’s record the site where you applied the patch (for example: 6/18/2010, upper right arm)
Read package instructions for any further information
Recertification Review Guide, Unit 9132
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The role of DCF Med Admin certified The role of DCF Med Admin certified staff in administering rectal and staff in administering rectal and
vaginal medicationvaginal medication
Do not directly administerDo not directly administer to any child
DCF Med Admin certified personnel are not trained nor certified to administer any rectal or vaginal medications
The children who have these types of medication ordered must be able to self administer the medication or have a nurse available to administer the medication
Recertification Review Guide, Unit 9133
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The role of DCF Med Admin certified staff in The role of DCF Med Admin certified staff in administering rectal and vaginal administering rectal and vaginal
medicationmedication (Cont.)(Cont.)
Medication certified staff may provide the child with instructions on self administration. This information may be found on the package information.
Review of instructions may be done by a staff member of the same sex as the child and in the presence of another staff member as witness. This review should be documented.
Recertification Review Guide, Unit 9134
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Unit 9 QuizUnit 9 Quiz
1.
True or False: After administering oral medication you must always perform a mouth check.
2.
True or False: Hand washing is the most effective way of preventing the spread of infection.
3.
True or False: To administer ear drops to a 2year old child you straighten the ear canal by gently pulling the ear lobe down and back.
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Answers to Unit 9 QuizAnswers to Unit 9 Quiz
1. True or False: After administering oral medication you must always perform a mouth check.
True
2. True or False: Hand washing is the most effective way of preventing the spread of infection.
True
3. True or False: To administer ear drops to a 2year old child you straighten the ear canal by gently pulling the ear lobe down and back.
True
Recertification Review Guide, Unit 9136
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STATE OF CONNECTICUT
Department of Children and Families
Medication Administration Certification Training
Based on the Basic Medication Administration Curriculum2010 Edition
Recertification Review Guide, Unit 10137
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RegulationsRegulations re: safeguarding the re: safeguarding the medications and the medication storage medications and the medication storage
keyskeys
The medication storage keys must be carried by the medication certified staff person or licensed medical person on duty
Recertification Review Guide, Unit 10139
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Storage requirement forStorage requirement fornon-controlled medicationsnon-controlled medications
Non-controlled medications must be stored in a locked, immobile container that is accessible only to med certified or licensed medical staff
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Storage requirement forStorage requirement forcontrolled medicationscontrolled medications
Controlled medications must be stored in a locked, immobile container that is inside another locked, immobile container accessible only to medication certified staff or licensed medical staff
Recertification Review Guide, Unit 10141
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Controlled medication countControlled medication count
Must be performed at the change of shift or whenever the responsibility for the medications changes
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IncorrectIncorrectControlled medication countControlled medication count
Recertification Review Guide, Unit 10143
Forward the incident report to theDept. of Consumer Protection Drug Control Division and to DCF
3
Complete an incident report2Contact your chain of command 1If the If the
controlled controlled medication medication count is count is wrongwrong(there is a (there is a discrepancy)discrepancy)
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Refrigerated medicationsRefrigerated medications
The medication refrigerator must be kept at 36° - 46°F. Medications stored in the refrigerator must be accessible only to med certified or licensed medical staff
Recertification Review Guide, Unit 10144
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Storage of external, internal Storage of external, internal and emergency medicationsand emergency medications
Internal medications and external (topical) medications must be stored separately from each other
EmergencyEmergency medications (Epi-pens and rescue asthma inhalers) must be stored where all trained staff may have easy access to them. They should not be locked with other medications.
Recertification Review Guide, Unit 10145
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Guidelines for destroying non-Guidelines for destroying non-controlled and controlled controlled and controlled
medicationsmedications
2 DCF med certified staff may destroy non-controlled medications
Contact Drug Control Division of Consumer Protection if controlled medications need to be destroyed
Follow your facility’s policy and procedure for destroying medications
Recertification Review Guide, Unit 10146
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Unit 10 QuizUnit 10 Quiz
1.
Who may legally dispense medication?
a) licensed practitioners, RN’s, med admin certified staff
b) pharmacists, licensed practitioners, RN’s
c) pharmacists, licensed practitioners
d) pharmacists, med admin certified staff
2.
True or False: The controlled medication count must be performed at the change of shift or whenever the responsibility for the medications changes
3.
True or False: 2 DCF med certified staff may destroy non-controlled medications
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Answers to Unit 10 QuizAnswers to Unit 10 Quiz
1. Who may legally dispense medication?
c) pharmacists, licensed practitioners
2. True or False: The controlled medication count must be performed at the change of shift or whenever the responsibility for the medications changes
True
3. True or False: 2 DCF med certified staff may destroy non-controlled medications
True
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STATE OF CONNECTICUT
Department of Children and Families
Medication Administration Certification Training
Based on the Basic Medication Administration Curriculum2010 Edition
Recertification Review Guide, Unit 11149
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Types of medication errorsTypes of medication errors
Error in communication
Error in documentation
Error in storage and control
Error in ordering or dispensing medications
Error in administration
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1. Check on the child and follow your facility’s policy and procedures
2. Inform your supervisor and chain of command and follow any directions
3. Document the error; use objective description
Recertification Review Guide, Unit 11152
Steps to take if an error occursSteps to take if an error occurs
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Documenting Documenting a medication errora medication error
Note the child’s name, medication, the date and time, staff involved
Write an objective description of the error: what happened, action taken, and status of the child
Documentation must be completed before the end of the shift by the person who made or discover the error
Follow facility policy and procedure on submitting required documentation to DCF Risk Management
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Reporting medication error that Reporting medication error that leadsleads
to the child needing medical to the child needing medical attentionattention
1. Notify child’s guardian, social worker
2. Call DCF Careline if after hours
3. Send copy of incident report to the DCF Medical Director within one business day
In additionto the
documentationalready
discussed
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When to contact the Dept. of When to contact the Dept. of Consumer Protection Drug Control Consumer Protection Drug Control
DivisionDivision
When controlled medications appear to be missing
If controlled medications need to be destroyed
Recertification Review Guide, Unit 11155
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Unit 11 QuizUnit 11 Quiz
Recertification Review Guide, Unit 11156
1.
True or False: Documenting a medication error must be completed before the end of the shift by the person who made or discover the error
2.
Who must be contacted when controlled medication appears to be missing or needs to be destroyed?
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Answers to Unit 11 QuizAnswers to Unit 11 Quiz
1. True or False: Documenting a medication error must be completed before the end of the shift by the person who made or discover the error
True
2. Who must be contacted when controlled medication appears to be missing or needs to be destroyed?
The Department of Consumer Protection, Drug Control Division
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STATE OF CONNECTICUT
Department of Children and Families
Medication Administration Certification Training
Based on the Basic Medication Administration Curriculum2010 Edition
Recertification Review Guide, Unit 12158
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A LP’s orderA LP’s ordershould be questioned when:should be questioned when:
You do not understand the order
Unusual quantities or doses are prescribed
The medication is ordered to be given at unusual times
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Medication should Medication should not be administered when:not be administered when:
You have a question about the order
A child has a sudden change in physical or mental state
The pharmacy label is illegible
The child refuses to take medication
Any of the five rights is violated
If there is no LP’s order or you cannot perform the Rule of Three
If storage practices are questionable
Medication looks unfamiliar to you or the child
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Steps to take whenSteps to take whenquestioning an order or a questioning an order or a
medicationmedication
Do not administer the medication (hold the medication)
Contact the chain of command and follow directions
Document contacts and directions
Follow up on directions
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Why borrowing medicationWhy borrowing medicationis is not permittednot permitted
Med admin certification permits you to administer medications only when the Five Rights match on the order, pharmacy label and MAR.
If you are borrowing on child’s medication for another child, the Five Rights will not match on all three documents.
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Criteria for administering Criteria for administering medicationmedication
at the right timeat the right time
Medications may be administered one hour before until one hour after the scheduled administration time unless the LP has ordered the medication to be given at a specific time.
Recertification Review Guide, Unit 12164
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DispensingDispensing
The act of placing a medication into a container, labeling the container and giving the container for someone else to administer
Medication certified staff may not dispense
Only LP’s and pharmacists may dispense medications
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Unit 12 QuizUnit 12 Quiz
1.
When would you not administer a medication?
a) if there is no change in status of the client
b) if the client refuses
c) if the medication is stored in a locked and immobile container
d) if the licensed practitioner's order is present
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Answers to Unit 12 QuizAnswers to Unit 12 Quiz
1. When would you not administer a medication?
b) if the client refuses
Recertification Review Guide, Unit 12167