Part 2 - Skills for Care

HSC 3047 :Part 2
Support the use of medication in social care settings:
Medication administration
Sheena Helyer 12.2012
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
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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’
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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.
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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.
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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)
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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.
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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.
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Principles underpinning medication delivery
Correct identification
If there is more than one
person receiving care their
supplies and documentation
must be clearly identified and
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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
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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?
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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
• Is the medication being given as a means of control?
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The route by which to give medication
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
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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
• Intravenous injection
• Intramuscular injection
• Subcutaneous injection
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- given via the rectum
- given via the vagina
- given via percutaneous
endoscopic gastrostomy
- injected into the vein
- injected into the muscle
- injected under the skin
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
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.
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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
Soluble…………………… .Easier to take when dissolved in
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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.
• Some liquids may need to be stored in the fridge.
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Measuring devices
A spoon, syringe or plunger will
often be supplied with liquid
medications so that the dose
can be measured accurately.
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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
• Enemas
• Pessaries
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intra muscular
intra venous
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
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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.
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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
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Intra-ocular medicine
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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
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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
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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
Wash hands
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Discard after opening……
• Eye drops and ointment
28 days
• Barrier creams
3 months
• Creams with active ingredients
1 month
• Medication delivery systems
2 months
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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
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Transdermal patches.
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Topical medicine
• Wash hands
• Wear gloves
• Apply to clean dry skin
• Ensure privacy and dignity
• Only apply to required area
• Use medicated preparations sparingly
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Topical medicine
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Inhalers and nebulisers
• Keep the equipment clean and dry
• Assemble properly
• The service user should sit up or stand to enable good lung
• Ensure that the service user understands the proper
technique. e.g. to press and breathe in at the same time
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Inhalers and space halers
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Inhalers and space haler
Volumatic: space haler
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• 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
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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
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Encourage independence
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Encourage independence
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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.
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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
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.
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