MEDICATION ADMINISTRATION Topic 1

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MEDICATION ADMINISTRATION Topic 1

• Topic 1 Client ID Documentation Drug Schedules

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As the student nurse gains experience in
medication administration, psychomotor skills (
the how to ) become more refined. Psychomotor
skills, however represent only a small part of
medication administration. Knowledge, physical
and mental status as well as client attitudes and
responses can make medication administration a
complex experience
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List reasons for the importance of being
competent in the administration of medications
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REASONS

• All drugs prescribed or over the counter are
  potentially dangerous
• Prescription or medication order is a legal
  document
• It is a legal requirement
• To ensure maximum safety for person who might
  benefit from drugs
• To protect the enrolled nurse and health care
  facility from serious consequences of medication
  incidents.

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INDICATIONS FOR MEDICATION USE

• Maintain normal body function. Eg. Insulin.
• Diagnostic Eg Barium.
• Symptomatic relief, Eg Analgesia.
• Prophylaxis, Eg Vaccines.
• Alter psychological functions, Eg Contraception.
• Reverse control disease process, Eg Antibiotics.

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Describe the drug controls in New South Wales
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COMMONWEALTH REGULATIONS

• The role of the Australian Government in
  regulation of the pharmaceutical industry is to
  protect the health of the people by ensuring that
  medications are safe and effective.

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AGED CARE ACT 1997

• To ensure that the facilities employ
  appropriately skilled staff who can provide for
  the needs of the residents in their care.
• They must maintain accreditation standards.
• The enrolled nurse must work within the policy
  and protocols of their employing facility.

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CONTROL IS AT 3 LEVELS

1. The Therapeutic Goods Act ( 1989 ). Medication
   manufacturer, sales, testing, labeling and
   distribution.
2. The Customs Act ( 1901 ) Advertising of
   therapeutic goods to health professionals and
   public

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CONTROL IS AT 3 LEVELS

• 3. The National Health Act ( 1953 ) Applies to
  Pharmaceutical Benefits Scheme that provides
  subsidized drugs to public. Also limits the
  amount of drugs supplied, number of times and
  frequency that the supply can be repeated. Not
  all drugs are subsidized.

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DRUG CONTROLS IN NSW
The Australian Therapeutic Goods Administration (
TGA ) a section of the Commonwealth Department of
Health, provides a framework for the regulation
of therapeutic goods to ensure their safety,
efficiency, quality and timely availability.
Before a drug can be marketed in Australia, it
must be evaluated by TGA. The product will be
assessed for quality, safety, efficacy and cost
effectiveness.
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NSW LEGISTRATION

• NSW Poisons and Therapeutic Goods Act ( 1966 )
  Poisons and Therapeutic Goods Regulation ( 2002 )
  
• Nursing Home Act 1993.

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POISONS AND THERAPEUTIC GOODS ACT 1966

• Covers the control of poisons and outlining any
  criminality related to poisons

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The poisons and therapeutic goods regulation 1994
has a direct impact on nurses during their day to
day routines and covers the practical aspects of
the possession, storage, supply, administration
and recording of the poisons and the poisons list
which classifies substances into their various
substances.
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NSW DEPARTMENT OF HEALTH

• Guidelines for the Handling of Medication in NSW
  Public Hospitals
• Guidelines fro the Handling of Medication in
  Community Based Health Services and Residential
  Facilities in NSW
• Private Hospitals and Day Procedure Centre and
  Nursing Homes Regulations

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NSW DEPARTMENT OF HEALTH

• These are the standards that regulate enrolled
  nurse practice
• Public hospitals must ensure that employees who
  are administrating medication have appropriate
  qualifications and training.
• Health care institutions establish individual
  policies that must meet Commonwealth, State and
  local government regulations

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AUSTRALIAN NURSE COMPETENCIES

• This organization outlines and limits the role
  and boundaries of the enrolled nursing practice
• The inclusion of medication administration in the
  scope of practice for the EN will ensure public
  safety through quality management and risk
  assessment intervention.

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NSW NRB
Enrolled Nurses who have been competent in the
medication module will be permitted to administer
medication by what ever route including S4 drugs
but not S8 drugs of addiction.
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CLIENT IDENTIFICATION

• How do you Identify a client?

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DOCUMENTATION

• Medication charts should have patients
• Full name.
• MRN.
• Date of birth.
• Allergy.
• Legible order.
• Drug ordered by Generic name.
• Signature of Doctor and their printed name.

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DOCUMENTATION

• Date medication ordered.
• Times for medication.
• Reasons for use of medication.
• Age and weight of paediatric patient.
• Cessation date. Forms of medication, eg rectally,
  orally, transdermal.

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MEDICATION ADMINISTRATION

• TERMINOLOGY

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DRUG SCHEDULES

• Schedule 1. Dangerous poisons eg Arsenic.
• Schedule 2. Medicinal Poisons, eg Paracetamol.
• Schedule 3. Potent substances, eg Insulin.
• Schedule 4. Restricted substances, eg Oral
  hypoglycaemics.
• Schedule 4D. Prescribed Restricted Substances, eg
  Diazepam.

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DRUG SCHEDULES

• Schedule 5. Domestic Poisons, eg Bleach.
• Schedule 6. Industrial and Agriculture, eg
  Phenol.
• Schedule 7. Special Poisons, eg Insecticides.
• Schedule 8. Drugs of Addiction, eg Morphine.

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PROHIBITED DRUGS

• Substances which are controlled under the Drug
  Misuse and Trafficking Act 1985 and are not
  specified in Schedule 8 of the Poisons and
  Therapeutic Goods Act, eg Heroin.

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INDICATIONS

• An illness or disorder for which a drug has a
  documented specific usefulness.

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CONTRAINDICATIONS

• A factor that makes dangerous or undesirable the
  administration of a drug or the performance of an
  act or procedure in the care of a specific
  patient.

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SIDE EFFECT

• A side effect occurs when a medication causes
  unintended, secondary effects ( that may be
  predictable ) Side effects may be harmless or
  injurious. If the side effects are serious
  enough to negate the beneficial effects of
  medications therapeutic action, the prescriber
  may discontinue the medication.

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ADVERSE REACTIONS/AFFECTS

• These are generally unexpected effects of the
  medication. They may be related to the
  pharmacological effect or they may be related to
  the individual taking the medication.

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NEAR MISS

• Error recognised prior to administration of
  medication given to patient

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SENTINEL EVENT

• An error in drug administration that may cause
  permanent disability or death.

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TRADE NAME
The trade name, brand name or proprietary name is
the name under which a manufacturer markets a
medication
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CHEMICAL NAME
Is the name by which the chemist knows it, it
provides an exact description of the drugs
chemical composition.
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GENERIC NAME
Is the name given by the manufacturer who first
developed the drug. To prevent confusion and to
reduce medication errors, medication orders
should be written using the generic name
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Lets look at an example

• D (- ) a amino r benzyl penicillin
  trihydrate
• Amoxycillin trihydrate
• Alphamox, Cilamox, and Amoxyn.

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THERAPEUTIC EFFECT

• The therapeutic effect of the drug is the
  intended use of the drug, that is , its desired
  effect.
• E.g. Panadol for a headache, the therapeutic
  effect is pain relief.

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MEDICATION INCIDENT
All health facilities should have as part of
their quality improvement programs a system in
place or reporting medication errors. Please
check where these are kept.
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ABBREVIATIONS
Ac before meals Bid/bd twice a day h
hour pc after meals prn whenever there is a
need/necessary
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ABBREVIATIONS
m mane n nocte IV intravenous SC
subcutaneous
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ABBREVIATIONS
IM intramuscular mist mixture asap as soon
as possible qqh every 4 hours po by mouth (
orally )
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ABBREVIATIONS
qid four times a day tds three times a day q2h
every 2 hours q4hevery 4 hours statgive
immediately