Supporting Medication Administration in Social Care Settings

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HSC 3047 :
Part 2
Support the use of medication in social care settings:
Medication administration
Sheena Helyer 
12.2012
Medication delivery: learning 
o
utcomes
To understand techniques for administering medication
To be able to give the following safely:-
Tablets
Eye Drops
Nasal medication
Ear Drops
Oxygen
Inhaled medication
Nebulised medication
Medication patches
Creams
To be aware of devices which can be used to help people take their
   medicines independently
HSC 3047 Medication delivery
Medication instructions
 
When a pharmacist dispenses medication against a valid
prescription it must be clearly labelled
 
with:-
 
The dispensing date
The name of the medicine
The dose and frequency
The route
The service user’s full name and date of birth
Special instructions
Warnings or cautions
Name of pharmacy
Use by date
Instructions i.e. ‘Keep out of reach of children’
HSC 3047 Medication delivery
Care plan and recording
Care staff should always read the care plan before giving
medicine and check exactly what support is required.
There should be a record of what medication should be given
and where to find it e.g. ‘in the fridge’ .This will need to be
written out once a month and double checked.
The care plan will indicate the level of administration e.g.
prompting or administering on behalf of the service user.
The carer should sign the record sheet once he/she is sure
that the medication has been swallowed or delivered.
Any medicine which cannot be given must also be recorded
and the reason documented.
Any medication not given, gaps on the medication sheet or
irregularities must be reported to the manager.
HSC 3047 Medication delivery
Verbal messages and changes
It can be dangerous to accept instructions by phone
Carers must follow their local policy in this situation
Usually if there are any changes to the regular medication the
dosette box will need to be sent back to the pharmacy for
the changes to be made.
Warfarin doses may need to be changed following INR blood
tests. This is usually organised by the GP and pharmacy.
HSC 3047 Medication delivery
Cumbria.nhs.uk
Preparation
 
Make sure you have all the necessary equipment ready
to give medication.
This might include the following:-
Tissues
Waste bag
Tablet cutter or crusher
Measuring device
Cloth
Gloves
Glass of water (not hot drink)
HSC 3047 Medication delivery
Pictures provided by weiku.com, colourbox.com
mpeb.org
Principles underpinning medication delivery
 
 
Infection control
Hands should be washed and
clean prior to medication
administration. Ensure that there
are adequate facilities. It is good
practice to wear gloves for
administration of eye,  ear and
nasal medication. It is 
essential
to wear gloves when applying
medicated cream.
HSC 3047 Medication delivery
Pictures provided by
communityservices.heartofengland.nhs.uk
Principles underpinning medication delivery
 
Dignity and Privacy
Staff should always be polite,
gentle and respectful of the
service user’s wishes and choices.
Privacy may be needed if there
are other occupants in the home
and clothing is being removed e.g.
applying a patch.
HSC 3047 Medication delivery
Principles underpinning medication delivery
Correct identification
If there is more than one
person receiving care their
supplies and documentation
must be clearly identified and
separated.
HSC 3047 Medication delivery
Pictures provided by bbc.co.uk
Confidentiality
Information about a service user’s medication
is confidential. It should only be shared if
permission has been given by the service user
or in exceptional circumstances.
Protection in law is enshrined in the 
Human
Rights Act 1998
, the 
Data Protection
Act 1998 
and 
Common Law
. Further
guidance has been given in the 
Health and
Social Services and Public  Safety Code
of Practice on Protecting the
Confidentiality of Service Users’
Information. Jan 2012
HSC 3047 Medication delivery
Pictures provided by health.com
Can the service user self-medicate?
Has the person been self medicating recently?
Does the person show any signs of confusion?
Does the person understand how and why they should take
the medication?
Has the person got the required manual dexterity and skills
to take the medication?
Is the person able to mobilise to the place where the
medication is kept?
Is the service user showing any signs of suicidal behaviour?
Have they ever taken an overdose in the past?
HSC 3047 Medication delivery
Are there any ethical concerns?
Might there be unpleasant side effects?
Might the medication increase the risk of falling?
Might the medication alter the person’s life expectancy?
Does the service user understand why they are taking this
medication?
Is the medication being given as a means of control?
HSC 3047 Medication delivery
The route by which to give medication
 
Oral
  
- 
by mouth and swallowed
Buccal
  
- 
placed between the gum and teeth
Sublingual
  
- 
under the tongue
Inhalation
  
- 
breathed through the nose/mouth
Topical
  
- 
outer surface of the skin
Transdermal
 
- 
patch on the surface of the skin
Intra-ocular
 
- 
instilled into the eyes
Intra-aural
  
- 
instilled into the ears
Intra nasal
  
- 
instilled into the nose
HSC 3047 Medication delivery
Routes by which to give medication
These routes are not covered in this training program
and are normally undertaken by qualified medical staff
HSC 3047 Medication delivery
Rectal
  
                       - given via the rectum
Vaginal
  
                       - given via the vagina
PEG
   
                       - given via percutaneous
                                                             endoscopic gastrostomy
Intravenous injection                     - injected into the vein
Intramuscular injection                  - injected into the muscle
Subcutaneous injection                  - injected under the skin
The form of a 
m
edicine
Tablets: 
These are made of compacted powder. Some have a
polymer coat to make them smoother and easier to swallow. If
they are scored down the centre they may be cut in half. Some
need to be wrapped in foil so they are not exposed to moisture
or sunlight. Some may need to be dissolved in water.
Capsules:
 Hard shelled capsules contain powder or mini
pellets.
   Soft shelled capsules are made of a gelling agent to contain oils
   or liquids.
Tablets and capsules should be given using a non-touch technique.
They may be placed in the service user’s hand or into a spoon or
pot for the service user to take them.
HSC 3047 Medication delivery
Pictures provided by
four_colours_of_pillswikipedia
foildroptestkits.com capsule.com
telegraph.co.uk
Form of medicine
Tablets may come in a variety of formulations
Enteric coated……………..Helps to protect the stomach from
                                         the adverse effects of the medicine.
                                         It is absorbed after it has gone
                                         through the stomach
Slow, modified or…………Released gradually over a period of
controlled release              time. These should never be
                                         crushed or opened.
Chewable………………… Used when tablets are too big to
                                         swallow.
Soluble…………………… .Easier to take when dissolved in
                                         water
HSC 3047 Medication delivery
The form of medicine
Liquid medicine: 
This may be described as an
elixir, a mixture, a suspension, a solution  or a
syrup depending on what the active ingredient is
mixed with.
There is often advice to shake the bottle before
use as the ingredients may become more
concentrated at the bottom or separate out.
Always use the measuring device which is
supplied with the bottle and keep it clean and dry.
Be careful not to confuse measurements of
volume i.e. mls with measurements of strength i.e.
mgs.
Some liquids may need to be stored in the fridge.
HSC 3047 Medication delivery
Measuring devices
A spoon, syringe or plunger  will
often be supplied with liquid
medications so that the dose
can be measured accurately.
HSC 3047 Medication delivery
Pictures provided by measuredrugs.com
Invasive techniques which should only be
undertaken by a qualified nurse or carer who has
received specific training and is permitted by the
care provider
Injections
   
subcutaneous
     
intra muscular
     
intra venous
Suppositories
Enemas
Pessaries
HSC 3047 Medication delivery
Buccal medication
Medication is placed between the gum and the upper lip so that
it will dissolve quickly and be immediately absorbed into the
blood stream
HSC 3047 Medication delivery
Pictures provided by buccalopeni.nlm.nih.gov
Sublingual medicine
G
lyceryl trinitrate /GTN is often given for angina/chest pain via
the sublingual route, under the tongue where there are lots of
blood vessels so that the pain can be relieved quickly.
HSC 3047 Medication delivery
Pictures provided by rxlist.com
Administering medicine into the eyes.
Always wash hands and wear gloves
Explain the procedure
Check the expiry date
Remove contact lenses
Use separate containers for L and R eye
Warm the container by rotating it in your hands
Service user should sit back or lie down
Gently pull down the lower eye lid
Service user to look up or to the side
Close the eye for 30 secs
Wipe excess away with a tissue
Leave one minute between drops
HSC 3047 Medication delivery
Intra-ocular medicine
HSC 3047 Medication delivery
Pictures provided by allaboutvision.com pharmslat.unc.edu
kaboudle.com perso.numericable.fr
Giving nasal drops
Wash and dry your hands and put on gloves
Lie the service user down with their head tilted right back
Ask the service user to gently blow their nose
Drop in required number of drops and spread over inside
surface of the nose
Ask the service user to remain there for at least 2 minutes
HSC 3047 Medication delivery
Pictures provided by medicineworld.org
Nasal spray
The service user may sit upright when a nasal spray is used.
The bottle should be inserted in one nostril while the other
one is gently compressed
HSC 3047 Medication delivery
Pictures provided by peoplespharmacy.com
Ear Drops
Wash hands
Explain procedure
Lie on side/tilt to side
Warm drops if possible
Pull the pinna back and up
Use separate bottles for R+L
Insert prescribed drops
Remain in position 2-3mins
Record
Wash hands
HSC 3047 Medication delivery
Discard after opening……
Eye drops and ointment                
 
28 days
Barrier creams
   
      
 
3 months
Creams with active ingredients 
 
1 month
Medication delivery systems    
 
2 months
HSC 3047 Medication delivery
Transdermal patches
Remove old patch.
Do not touch adhesive. Fold in half and dispose of it.
Choose a clean, hair-free, accessible and healthy site.
Date new patch.
Record position of patch.
Remove immediately if there are signs of allergy.
Never cut a patch in half.
Do not expose the application site to heat e.g. electric
blanket.
HSC 3047 Medication delivery
Transdermal patches.
HSC 3047 Medication delivery
Pictures provided by pharmainfo.net imagesCAR170QG
reference,medscape.com voices.yahoo.com
Topical medicine
Wash hands
Wear gloves
Apply to clean dry skin
Ensure privacy and dignity
Only apply to required area
Use medicated preparations sparingly
HSC 3047 Medication delivery
Topical medicine
HSC 3047 Medication delivery
Pictures provided by amazon.co.uk
personalpharmacy.co.uk
Inhalers and nebulisers
Keep the equipment clean and dry
Assemble properly
The service user should sit up or stand to enable good lung
expansion
Ensure that the service user understands the proper
technique. e.g. to press and breathe in at the same time
HSC 3047 Medication delivery
Inhalers 
and space halers
HSC 3047 Medication delivery
Pictures provided by inhalerforasthma.org
Inhalers and space haler
HSC 3047 Medication delivery
Pictures provided by realfirstaid.co.uk and hickeypharmacies.ie
 
Volumatic: space haler
Nebulisers
HSC 3047 Medication delivery
Pictures provided by expresschemist.co.uk
nebulisermask2
Oxygen
Oxygen is highly flammable it must be kept away from heat.
It must be given through the correct mask
It must be given at the correct flow rate
Check the service user has enough
Tubing must not cause a slip, trip hazard
Oxygen will dry out mucosa. Good mouth care is essential.
Check the comfort of mask/cannulae
A gentle non-flammable cream should be used to moisturise
the skin
An upright position supports breathing
HSC 3047 Medication delivery
Oxygen
HSC 3047 Medication delivery
Pictures provided by
mynewmixwordpress.com
easyoxygen.com
homeoxygenmachines.com
imagesCAD5H3KU
Different formats
Medicine often comes in different formats
For example, 
DIAZEPAM
 is available as:-
A tablet
A slow release capsule
A liquid
An injection
An inhalation
A rectal suppository
The GP will decide on the best route depending on the needs
of the person and the cost of the administration
HSC 3047 Medication delivery
Encourage independence
HSC 3047 Medication delivery
Pictures provided by toolmanager.com
livingwithablackdog.wordpress.com
alzheimers.org.uk
Encourage independence
HSC 3047 Medication delivery
Pictures provided by sciencephoto.com
Proctorhealth.co.uk
Qualifiedseniorcare.com
Epillmedicationremindersblogspot.com
The following
 
o
utcomes have now been covered:-
Outcome 4
1. The learner can describe the routes by which medication can
be delivered.
2. The learner can describe different forms in which medication
may be presented.
3. The learner can describe materials and equipment to assist in
administering medication.
Continued
HSC 3047 Medication delivery
The following outcomes have now been covered:-
Outcome 6
1.  The learner can explain the importance of the following
principles in the use of medication:-
        Self medication or active participation
        Dignity and privacy
        Confidentiality
2. Explain how risk assessment can be used to promote an
individual’s independence in managing medication.
3. Describe how ethical issues that may arise over the use of
medication can be addressed.
HSC 3047 Medication delivery
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Explore the importance of medication administration in social care settings, emphasizing techniques for safely giving various types of medications. Understand medication instructions, care planning, and recording procedures. Learn about the risks of verbal messages for medication changes and the importance of proper preparation for administering medications.

  • Medication administration
  • Social care
  • Medication delivery
  • Care planning
  • Medication safety

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  1. HSC 3047 :Part 2 Support the use of medication in social care settings: Medication administration Sheena Helyer 12.2012

  2. Medication delivery: learning outcomes To understand techniques for administering medication To be able to give the following safely:- Tablets Eye Drops Nasal medication Ear Drops Oxygen Inhaled medication Nebulised medication Medication patches Creams To be aware of devices which can be used to help people take their medicines independently HSC 3047 Medication delivery

  3. Medication instructions When a pharmacist dispenses medication against a valid prescription it must be clearly labelledwith:- The dispensing date The name of the medicine The dose and frequency The route The service user s full name and date of birth Special instructions Warnings or cautions Name of pharmacy Use by date Instructions i.e. Keep out of reach of children HSC 3047 Medication delivery

  4. Care plan and recording Care staff should always read the care plan before giving medicine and check exactly what support is required. There should be a record of what medication should be given and where to find it e.g. in the fridge .This will need to be written out once a month and double checked. The care plan will indicate the level of administration e.g. prompting or administering on behalf of the service user. The carer should sign the record sheet once he/she is sure that the medication has been swallowed or delivered. Any medicine which cannot be given must also be recorded and the reason documented. Any medication not given, gaps on the medication sheet or irregularities must be reported to the manager. HSC 3047 Medication delivery

  5. Verbal messages and changes It can be dangerous to accept instructions by phone Carers must follow their local policy in this situation Usually if there are any changes to the regular medication the dosette box will need to be sent back to the pharmacy for the changes to be made. Warfarin doses may need to be changed following INR blood tests. This is usually organised by the GP and pharmacy. Cumbria.nhs.uk HSC 3047 Medication delivery

  6. Preparation Make sure you have all the necessary equipment ready to give medication. This might include the following:- Tissues Waste bag Tablet cutter or crusher Measuring device Cloth Gloves Glass of water (not hot drink) Pictures provided by weiku.com, colourbox.com mpeb.org HSC 3047 Medication delivery

  7. Principles underpinning medication delivery Infection control Hands should be washed and clean prior to medication administration. Ensure that there are adequate facilities. It is good practice to wear gloves for administration of eye, ear and nasal medication. It is essential to wear gloves when applying medicated cream. Pictures provided by communityservices.heartofengland.nhs.uk HSC 3047 Medication delivery

  8. Principles underpinning medication delivery Dignity and Privacy Staff should always be polite, gentle and respectful of the service user s wishes and choices. Privacy may be needed if there are other occupants in the home and clothing is being removed e.g. applying a patch. HSC 3047 Medication delivery

  9. Principles underpinning medication delivery Correct identification If there is more than one person receiving care their supplies and documentation must be clearly identified and separated. Pictures provided by bbc.co.uk HSC 3047 Medication delivery

  10. Confidentiality Information about a service user s medication is confidential. It should only be shared if permission has been given by the service user or in exceptional circumstances. Protection in law is enshrined in the Human Rights Act 1998, the Data Protection Act 1998 and Common Law. Further guidance has been given in the Health and Social Services and Public Safety Code of Practice on Protecting the Confidentiality of Service Users Information. Jan 2012 Pictures provided by health.com HSC 3047 Medication delivery

  11. Can the service user self-medicate? Has the person been self medicating recently? Does the person show any signs of confusion? Does the person understand how and why they should take the medication? Has the person got the required manual dexterity and skills to take the medication? Is the person able to mobilise to the place where the medication is kept? Is the service user showing any signs of suicidal behaviour? Have they ever taken an overdose in the past? HSC 3047 Medication delivery

  12. Are there any ethical concerns? Might there be unpleasant side effects? Might the medication increase the risk of falling? Might the medication alter the person s life expectancy? Does the service user understand why they are taking this medication? Is the medication being given as a means of control? HSC 3047 Medication delivery

  13. The route by which to give medication Oral Buccal Sublingual Inhalation Topical Transdermal Intra-ocular Intra-aural Intra nasal - by mouth and swallowed - placed between the gum and teeth - under the tongue - breathed through the nose/mouth - outer surface of the skin - patch on the surface of the skin - instilled into the eyes - instilled into the ears - instilled into the nose HSC 3047 Medication delivery

  14. Routes by which to give medication These routes are not covered in this training program and are normally undertaken by qualified medical staff Rectal Vaginal PEG Intravenous injection - injected into the vein Intramuscular injection - injected into the muscle Subcutaneous injection - injected under the skin - given via the rectum - given via the vagina - given via percutaneous endoscopic gastrostomy HSC 3047 Medication delivery

  15. The form of a medicine Tablets: These are made of compacted powder. Some have a polymer coat to make them smoother and easier to swallow. If they are scored down the centre they may be cut in half. Some need to be wrapped in foil so they are not exposed to moisture or sunlight. Some may need to be dissolved in water. Capsules: Hard shelled capsules contain powder or mini pellets. Soft shelled capsules are made of a gelling agent to contain oils or liquids. Tablets and capsules should be given using a non-touch technique. They may be placed in the service user s hand or into a spoon or pot for the service user to take them. Pictures provided by four_colours_of_pillswikipedia foildroptestkits.com capsule.com telegraph.co.uk HSC 3047 Medication delivery

  16. Form of medicine Tablets may come in a variety of formulations Enteric coated ..Helps to protect the stomach from the adverse effects of the medicine. It is absorbed after it has gone through the stomach Slow, modified or Released gradually over a period of controlled release time. These should never be crushed or opened. Chewable Used when tablets are too big to swallow. Soluble .Easier to take when dissolved in water HSC 3047 Medication delivery

  17. The form of medicine Liquid medicine: This may be described as an elixir, a mixture, a suspension, a solution or a syrup depending on what the active ingredient is mixed with. There is often advice to shake the bottle before use as the ingredients may become more concentrated at the bottom or separate out. Always use the measuring device which is supplied with the bottle and keep it clean and dry. Be careful not to confuse measurements of volume i.e. mls with measurements of strength i.e. mgs. Some liquids may need to be stored in the fridge. HSC 3047 Medication delivery

  18. Measuring devices A spoon, syringe or plunger will often be supplied with liquid medications so that the dose can be measured accurately. Pictures provided by measuredrugs.com HSC 3047 Medication delivery

  19. Invasive techniques which should only be undertaken by a qualified nurse or carer who has received specific training and is permitted by the care provider Injections Suppositories subcutaneous intra muscular intra venous Enemas Pessaries HSC 3047 Medication delivery

  20. Buccal medication Medication is placed between the gum and the upper lip so that it will dissolve quickly and be immediately absorbed into the blood stream Pictures provided by buccalopeni.nlm.nih.gov HSC 3047 Medication delivery

  21. Sublingual medicine Glyceryl trinitrate /GTN is often given for angina/chest pain via the sublingual route, under the tongue where there are lots of blood vessels so that the pain can be relieved quickly. Pictures provided by rxlist.com HSC 3047 Medication delivery

  22. Administering medicine into the eyes. Always wash hands and wear gloves Explain the procedure Check the expiry date Remove contact lenses Use separate containers for L and R eye Warm the container by rotating it in your hands Service user should sit back or lie down Gently pull down the lower eye lid Service user to look up or to the side Close the eye for 30 secs Wipe excess away with a tissue Leave one minute between drops HSC 3047 Medication delivery

  23. Intra-ocular medicine Pictures provided by allaboutvision.com pharmslat.unc.edu kaboudle.com perso.numericable.fr HSC 3047 Medication delivery

  24. Giving nasal drops Wash and dry your hands and put on gloves Lie the service user down with their head tilted right back Ask the service user to gently blow their nose Drop in required number of drops and spread over inside surface of the nose Ask the service user to remain there for at least 2 minutes Pictures provided by medicineworld.org HSC 3047 Medication delivery

  25. Nasal spray The service user may sit upright when a nasal spray is used. The bottle should be inserted in one nostril while the other one is gently compressed Pictures provided by peoplespharmacy.com HSC 3047 Medication delivery

  26. Ear Drops Wash hands Explain procedure Lie on side/tilt to side Warm drops if possible Pull the pinna back and up Use separate bottles for R+L Insert prescribed drops Remain in position 2-3mins Record Wash hands HSC 3047 Medication delivery

  27. Discard after opening Eye drops and ointment 28 days Barrier creams 3 months Creams with active ingredients 1 month Medication delivery systems 2 months HSC 3047 Medication delivery

  28. Transdermal patches Remove old patch. Do not touch adhesive. Fold in half and dispose of it. Choose a clean, hair-free, accessible and healthy site. Date new patch. Record position of patch. Remove immediately if there are signs of allergy. Never cut a patch in half. Do not expose the application site to heat e.g. electric blanket. HSC 3047 Medication delivery

  29. Transdermal patches. Pictures provided by pharmainfo.net imagesCAR170QG reference,medscape.com voices.yahoo.com HSC 3047 Medication delivery

  30. Topical medicine Wash hands Wear gloves Apply to clean dry skin Ensure privacy and dignity Only apply to required area Use medicated preparations sparingly HSC 3047 Medication delivery

  31. Topical medicine Pictures provided by amazon.co.uk personalpharmacy.co.uk HSC 3047 Medication delivery

  32. Inhalers and nebulisers Keep the equipment clean and dry Assemble properly The service user should sit up or stand to enable good lung expansion Ensure that the service user understands the proper technique. e.g. to press and breathe in at the same time HSC 3047 Medication delivery

  33. Inhalers and space halers Pictures provided by inhalerforasthma.org HSC 3047 Medication delivery

  34. Inhalers and space haler Volumatic: space haler Pictures provided by realfirstaid.co.uk and hickeypharmacies.ie HSC 3047 Medication delivery

  35. Nebulisers Pictures provided by expresschemist.co.uk nebulisermask2 HSC 3047 Medication delivery

  36. Oxygen Oxygen is highly flammable it must be kept away from heat. It must be given through the correct mask It must be given at the correct flow rate Check the service user has enough Tubing must not cause a slip, trip hazard Oxygen will dry out mucosa. Good mouth care is essential. Check the comfort of mask/cannulae A gentle non-flammable cream should be used to moisturise the skin An upright position supports breathing HSC 3047 Medication delivery

  37. Oxygen Pictures provided by mynewmixwordpress.com easyoxygen.com homeoxygenmachines.com imagesCAD5H3KU HSC 3047 Medication delivery

  38. Different formats Medicine often comes in different formats For example, DIAZEPAM is available as:- A tablet A slow release capsule A liquid An injection An inhalation A rectal suppository The GP will decide on the best route depending on the needs of the person and the cost of the administration HSC 3047 Medication delivery

  39. Encourage independence Pictures provided by toolmanager.com livingwithablackdog.wordpress.com alzheimers.org.uk HSC 3047 Medication delivery

  40. Encourage independence Pictures provided by sciencephoto.com Proctorhealth.co.uk Qualifiedseniorcare.com Epillmedicationremindersblogspot.com HSC 3047 Medication delivery

  41. The following outcomes have now been covered:- Outcome 4 1. The learner can describe the routes by which medication can be delivered. 2. The learner can describe different forms in which medication may be presented. 3. The learner can describe materials and equipment to assist in administering medication. Continued HSC 3047 Medication delivery

  42. The following outcomes have now been covered:- Outcome 6 1. The learner can explain the importance of the following principles in the use of medication:- Self medication or active participation Dignity and privacy Confidentiality 2. Explain how risk assessment can be used to promote an individual s independence in managing medication. 3. Describe how ethical issues that may arise over the use of medication can be addressed. HSC 3047 Medication delivery

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