Diploma Health and Social Care Medication free essay sample

The following is a list of legislation that has a direct impact upon the handling of medication within a social care setting. * The Medicines Act 1968 * The Misuse of Drugs Act 1971 * The Misuse of Drugs (Safe Custody) Regulations 1973 SI 1973 No 798 as amended by Misuse of Drugs Regulations 2001 * The NHS Scotland Pharmaceutical Service (Regulations) 1995 * The Social Work Act 1968 as amended by The Regulation of Care Act 2001 * The Children Act 1989 * The Children’s Act 1995 * The Data Protection Act 1998 * The Care Standards Act 2000 * The Regulation of Care Act 2001 * The Health and Social Care Act 2001 Adults with Incapacity Act 2000 9  © Social Care Association * The Health Act 200 * Health and Safety at Work Act (1974) * The Control of Substances Hazardous to health Regulations (1999-COSHH) * Hazardous Waste Regulations (2005) * Mental Capacity Act (2005) * The Access to health records Act (1990) This list is not exhaustive, organisations and all staff should be enabl ed to access documentation pertinent to the administration of medication like the examples listed above. The National Minimum Standards require the registered person puts in place policies and procedures for the receipt, recording, torage, administration and disposal of medicines. These policies and procedures are to protect not only the service users but also the staff who are responsible for the administration of medication. Non Registered Practitioner (NRP): remains responsible for their own actions. They should only administer the specific medicines for which they have received appropriate training, and assessed as competent, they can only practice within the sphere of this protocol for which they have received training and been assessed as competent. They should always work within the parameters identified within the protocol. They must refuse to administer any medicine if they do not feel competent to do so. Medicines must never be removed from their original containers or bottles in which they were dispensed by the pharmacist. This includes Monitored Dosage systems (MDS) or other compliance aids. Staff must always follow set procedures within their care settings and adhere to the main principals of safe administration. identify the medication correctly (Correct labelling and dose to be administered) * identify the person correctly (Name, DOB and picture on MARS) * know what the medicine is intended to do (understand the effects for visual and physical observation if needed, possible contra indications) * know whether any special precautions are needed (Safe handling and Infection control) Individual cups are used and medication is not physically handled. Under no circumstances should medication prescribed for one person be give n to another, even if they are both on the same medicine. All medication records should be referenced back to the original prescription and not the previous Medicine Administration Record (MAR) chart. An up to date record of current medication prescribed for each service user must be maintained. Medicine records should be kept together in one place. All records should be clear, legible, in black ink and signed. We need to keep a record of the initials and full signatures of all staff that are in any way involved with the care and administration of medication. Because we administer schedule 2 – 3 drugs the following must apply. keep a separate Controlled Drugs Register (CDR) in addition to the record keeping * The Register should be kept for each premise and for each cupboard within a premise if there is more than one. This Register should be in the form of a bound book or computerized record. * Within this Register, each drug, form and strength must have a separate bound book or section within a bound book with the product name and s trength written at the top of each page. * Entries must be made in chronological order with no alterations. If a mistake is made, an explanatory note must be made at the bottom of the page or margin. * Registers may only be kept electronically if safeguards are built into the software to ensure the following: The author of each entry is identifiable Entries cannot be altered at a later date A log of data entered is kept and can be recalled for audit purposes (a secure electronic backup of data held is sufficient). * The Register must be completed within 24 hours. For example, it is acceptable during procedures to mark on a white board the quantities administered and complete the Register at the end of the day. The task of completing the Controlled Drugs Register can be delegated by the prescribing officer to another member of staff, however, responsibility for the supply remains with the prescribing officer. Legally the Register should be kept for 2 years after the last recorded entry. [CU2624. 2] Know about common types of medication and their use 2. 1 Describe common types of medication including their effects and potential side effects Common Drug group and uses - Antibiotics fight infection - Analgesics relieve pain - Anti-histamines relieve allergy symptoms - Antacids digestion - Anticoagulants prevent blood clots - Psychotropic medicines interact with the nervous system - Diuretics to get rid of excess fluid - Laxatives alleviate constipation - Hormones steroids or insulin - Cytotoxic medicines treat some forms of cancer Analgesics are a class of drugs used to relieve pain. Common forms used are paracetomol, aspirin, nsaids’s, opiods. The pain relief induced by analgesics occurs either by blocking pain signals going to the brain or by interfering with the brains interpretation of the signals, without producing anaesthesia or loss of consciousness. There are basically two kinds of analgesics, narcotics, non-narcotics. Possible Side Effects / Adverse Reactions: Analgesic narcotic / opioids: Common side effects and adverse reactions: * nausea * vomiting * drowsiness * dry mouth * miosis (contraction of the pupil) * orthostatic hypotension (blood pressure lowers upon sudden standing) * urinary retention * constipation and/or faecal impaction Less common side effects and adverse reactions: * confusion * hallucinations * delirium * hives * itch * hypothermia * bradycardia (slow heart rate) * tachycardia (rapid heart rate) * raised intracranial pressure * ureteric or biliary spasm * muscle rigidity * flushing Most severe side effects and adverse reactions: * respiratory depression * fatal overdose Side Effects / Adverse Reactions: Analgesic non-narcotic / simple analgesics Common: * Nausea, dyspepsia * Ulceration or bleeding of the stomach or intestines * Diarrhoea * Headache * Dizziness * Salt and fluid retention(oedema) * High blood pressure Uncommon: * Ulceration of the oesophagus * Rectal irritation (with suppositories) * Heart failure * Confusion * Asthma attacks * Rash Paracetamol: Reports of side effects are rare at recommended doses. The following side effects have been reported: * Dyspepsia Allergic reactions and blood disorders SSRI antidepressants: SSRI stands for selective serotonin reuptake inhibitor. They are a group of antidepressant medicines that are used to treat depression. They are also used to treat some other conditions such as bulimia, panic disorder, and obsessional-compulsive disorder. Common SSRI’S are citalopram, sertraline, fluoxetine, venlafaxine. SSRIà ¢â‚¬â„¢S are used to treat depression and some other conditions. They can take 2-4 weeks to build up their effect to work fully. A normal course of antidepressants lasts at least six months after symptoms have eased. Antidepressants alter the balance of some of the chemicals in the brain (neurotransmitters). SSRI antidepressants mainly affect a neurotransmitter called serotonin. Possible Side Effects / Adverse Reactions: SSRI’S * nausea/vomiting * drowsiness or somnolence * headache (very common as a short-term side effect) * bruxism * extremely vivid or strange dreams * dizziness * mydriasis (pupil dilation) * changes in appetite * insomnia and/or changes in sleep * excessive diarrhoea * weight loss/gain * changes in sexual behaviour * increased feelings of depression and anxiety (which may sometimes provoke panic attacks) * mania tremors * autonomic dysfunction including orthostatic hypotension, increased or reduced sweating * akathisia * suicidal ideation (thoughts of suicide) * photosensitivity * paresthesia * cognitive disorders * Syndrome of inappropriate antidiuretic hormone hypersecretion Antibiotics are used for the treatment of an infection caused by bacteria. The most common ant ibiotics are Penicillin, Cephalosporin, Tetracycline, Macrolides. Antibiotics target microorganisms such as bacteria, fungi and parasites. However, they are not effective against viruses. If you have an infection it is important to know whether it is caused by bacteria or a virus. Most upper respiratory tract infections, such as the common cold and sore throats are generally caused by viruses antibiotics do not work against these viruses. Antibiotics work in two common ways: * A bactericidal antibiotic kills the bacteria. Penicillin is a bactericidal. A bactericidal usually either interferes with the formation of the bacteriums cell wall or its cell contents. * A bacteriostatic stops bacteria from multiplying Possible Side Effects / Adverse Reactions: Antibiotics Severe watery diarrhoea and abdominal cramps (signs of a serious bacterial infection of the gut Clostridium difficile infection. * Shortness of breath * hives * rash swelling of lips, face, or tongue * fainting * Vaginal itching or discharge (signs of vaginal thrush). * White patches on the tongue (signs of oral thrush). * Vomiting. 2. 2Identify medication which demands the measurement of specific physiolog ical measurements Some medication, especially those that are prescribed for a specific reason and to a specific person, needs to be measured for those individuals as separate ones. The person prescribing them will check the history of the illness of the individual and make other checks on the health, they will assure that the drugs prescribed are suitable with their age and health, as well as their overall condition and purpose to prescribe them to ensure that this is the right dose and medicine for the individual. For example we have some residents with blood pressure issues whom have been taking Warfarin medication. This medicine requires a physiological measurement and needs specific measurement for the prescribing of them. The residents need regular tests taken so that the forthcoming doses can be measured to the correct amount. If there were any concern in regards to any adverse reactions then we would immediately speak with a professional person. 2. 3Describe the common adverse reactions to medication, how each can be recognised and the appropriate action(s) required The residents I work with may experience unwanted or adverse effects after the administration of medication which I would need to recognise and take action. The most common adverse effects could be: Anaphylactic shock – can occur sometimes after the administration of medication. * Symptoms of anaphylaxis include * Abdominal pain or cramping * Confusion * Diarrhoea * Difficulty breathing with wheeze or hoarse voice * Dizziness * Fainting, light-headedness * Hives over different parts of the body * Nausea, vomiting * Rapid pulse * Sensation of feeling the heart beat (palpitations) General symptoms * Hives * Itching of the skin or eyes (common) * Skin rash (common) * Swelling of the lips, tongue, or face * Wheezing, breathing difficulties etc. * skin changes If I observe any adverse changes I need to follow our protocol as set out in Livingstone House procedures. * Inform the manager and seek professional help immediately. * Observe the individual * Document all adverse reactions and action taken * Treat the symptoms following clinical advice. * Record the medicine and reaction in the care plan and MAR chart. * Inform the residents own doctor and the pharmacist as soon as possible. 2. 4Explain the different routes of medicine administration Administration Route - Oralby mouth, tablets and syrups Aural ear drops - Rectal suppositories - Vaginal tablets, creams - Sublingual under tongue - Nasogastric via a nasogastric tube - Buccal between the lips and gums - Inhaled into lungs via inhaler or nebuliser - Ocular/ophthalmic eye drops - Nasal sprays, drops - Topical skin creams - Intra venous directly or via a drip into a vein - Intramuscular injection into muscle - Subcutaneous injection into subcutaneous layer of skin - Transdermal injection under top layer of skin, patches e. g. HRT - Peg Percutaneous Endoscopic Gastrostomy – medicines are introduced via a PEG tube which has been inserted directly into the service user’s stomach. [CU2624. 3] Understand procedures and techniques for the administration of medication 3. 1Explain the types, purpose and function of materials and equipment needed for the administration of medication via the different routes Some of the most common used equipment used in Livingstone House are as follows. Medicine which Pot Insures all tablets are placed together safely for the service user to access, in line with the carers no contact method. Also facilitates and promotes independent administering. Spoon to Place medicine onto. Safely measures the correct amount of liquid medicine and facilitates and promote independent administering. Syringes which safely measures the amount of liquid medicine and can be given slower than if placed onto a spoon. Also facilitates and promote independent administering if used for oral medication Dose Up Box which holds Pills and ensures that they are all separated into the correct times as well as days and doses. This also facilitates and promotes independence if self-administering. A drinking cup with water which enables easy swallowing of medication. Gloves which Cover hands to minimise cross infection Sharps Disposal Container to dispose of medication paraphernalia. This avoids infection and helps to eliminate non-injection safety. It is imperative to have a sharps disposal container as it Safeguards clients as well as staff. 3. 2Identify the required information from prescriptions/medication administration charts All staff at Livingstone House should adhere to and be fully aware of the policies set out by the directive and follow the procedures meticulously when administering medication to residents. Correct patient * Correct medicine * Correct dose * Correct route * Correct time It is the responsibility of Livingstone House to provide medication administration records for support workers to use. The form should contain * Photograph of resident * Date of birth * The name and address of the service user * Date started * Medication details including name, stre ngth and dose of medication * Time given/prompted/observed * Signature of care worker * Code for Administration or prompting or observing [CU2624. 4] Prepare for the administration of medication Assessment Criteria 4. 1Apply standard precautions for infection control 4. 2Explain the appropriate timing of medication e. g. check that the individual has not taken any medication recently Upon administering medication at the correct time and at the appropriate intervals we must first identify the medication correctly (Correct labelling and dose to be administered). Generally the label will describe appropriate time of day and Dose. We must adhere to any warning signs labelled which might include (May cause drowsiness) or must be taken with food. Do not consume alcohol. Some medications may be taken 2 – 4 times per day For example: Take 1 capsule in the morning and 1 capsule at bedtime. Some medications may be written as: Take 1 2 tablets as needed for pain. This is where discretion may be used to determine if 1 or 2 doses are necessary Because the wide variety of medications used at Livingstone House means that we need to be aware that the effects experienced by a resident are taken into consideration. Things that may affect medication timing may be sleep disruption, cause a resident to feel or it may make a resident feel nauseous. These are taken into account when medication times are prescribed by the pharmacist. During medication distribution the Mar sheet is cross referenced to ensure that no medication has been given at the wrong interval or by another member of staff by discretion e. g. pain relief, this is to safe guard the resident and ensures they are not over or under medicated. 4. 3 Obtain the individuals consent and offer information, support and reassurance throughout, in a manner which encourages their co-operation and which is appropriate to their needs and concerns . 4Select, check and prepare correctly the medication according to the medication administration record or medication information leaflet [CU2624. 5] Administer and monitor individuals’ medication Assessment Criteria 5. 1Select the route for the administration of medication, according to the patient’s plan of care and the drug to be administered, and prepare the site if necessary 5. 2a Safely administer the medication in line with legislation and local policies 5. 2b in a way which minimises pain, discomfort and trauma to the individual . 3 Describe how to report any immediate problems with the administration We have procedures at to ensure that safety and wellbeing of all residents are maintained. When they are any problems with the administration of medication, the following procedures are carried out. The assessment of the resident’s condition is carried out. When this done we immediately advice the medical staff on duty and ask for advice. Any error is reported to our line manager or senior nurse. The senior nurse or line manager would ensure that the individual does not administer medication until a full investigation is carried out. We must ensure that all information is clearly documented and all action advised must be carried out. Ensure that the wellbeing of the patient is monitored and all advice is clearly documented. We must also ensure that an incident form is completed with all details, including the risk outcome and send to the line manager within 24 hours. All relevant staff on duty at the time of the incident will have to make a tatement. All relevant detailed entries are made and handed over in details at all shift changes 5. 4Monitor the individual’s condition throughout, recognise any adverse effects and take the appropriate action without delay 5. 5Explain why it may be necessary to confirm that the individual actually takes the medication and does not pass the medication to others We always ensure that the resident takes any medication in our presence. We also encourage the resident to take the medication by advising them on the advantage of the medication. We also have written policies for self-administration of medicinal products which details the assessment of the patients and the supply of medicinal products. All residents are adequately supervised so that they adhere to the medication treatment plan. All information gathered regarding administration or self administration is recorded as necessary in the residents care plan. 5. 6Maintain the security of medication and related records throughout the process and return them to the correct place for storage 5. Describe how to dispose of out of date and part used medications in accordance with legal and organisational requirements All care settings should have a written policy for the safe disposal of surplus, unwanted or expired medicines. When support staff are responsible for the disposal, a complete record of medicines should be made the normal method for disposing of medicines should be by returning them to the supplier. The supplier can then ensure that these medicines are dispose d of in accordance with current waste regulations. In England, care homes (nursing) must not return medicines to a community pharmacist but use a licensed waste management company. Additional advice is provided by CQC in safe disposal of waste medicines from care homes (nursing). The situations when medicines might need to be disposed of include: A person’s treatment has changed or is discontinued – the remaining supplies of it should be disposed of safely (with the persons consent) A person transfers to another care service – they should take all of their medicines with them, unless they agree to dispose of any that are no longer needed A person dies. The person’s medicines should be kept for seven days, in case the Coroner’s Office, Procurator Fiscal (in Scotland) or courts ask for them The medicine reaches its expiry date. Some medicine expiry dates are shortened when the product has been opened and is in use, for example, eye drops. When applicable, this is stated in the product information leaflet (PIL). All disposals of medicines must be clearly documented.