Medicine Matters
Training programme in
medicine management
for carers
Introduction
Medicine must be taken by:
 Right person
 Right dose
 Right time
 Right way
Learning Objectives
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Understand carers role
Understand good practice
Understand problems
Understand and follow instructions
Understand and follow additional instructions
Identify side effects
Record
Know where to get help
Errors happen when
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Lack of understanding of purpose and use
Believing more is better
Physical impairment
Confusion
Forgetfulness
Side effects unpleasant
Unhelpful comments
Errors continued
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Failure to get the medicine
Poor storage
Old medicines
Roles & Responsibilities
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Only trained carers can assist with
medication
Only when authorised by managers
Consent from service user
Only those medications which have been
prescribed with specific instructions
Needs assessment
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The level of help needed will be assessed by
GP practice
Sometimes in consultation with home care
managers
Level 1 user
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Can take full responsibility for her/his own
medication
Level 2 user
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Assistance with ordering, collection and
disposal
Confirming reading of medicine label
Opening containers or strip packages
Level 3 user
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Needs assistance with administration of oral
dose medicine, some topical preparations
and other types of medication where
approved, e.g. eye drops
Taking the medicine what next?
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Swallow
Stomach
Intestine
Blood
Eliminated
Amount of medicine eliminated = amount of
medicine absorbed
Types of medications
How many can you think of?
Pills & capsules powders
Liquids
Patches
Creams
Drops
Gels
Sprays
Inhaled
Intravenous
Subcutaneous
Pessaries, suppositories.
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Help is permitted with
Tablets
 Liquids
 Creams
 Drops*
 Gels*
 Sprays*
 Pessaries micro enemas*
*with advice from primary health care team
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Help is not permitted with
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Intravenous medication
Subcutaneous medication
Diabetes testing
Risk Factors
What can go wrong?
Forgetting to take it
Taking too much, too little
Taking wrong one
Taking someone else’s
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Risk factors
People factors
Sensory Impairment
Dementia
Physical disability
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Risk factors
Medication factors
Unclear instructions
Pills look alike
Packaging hard to open
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Ordering & Collecting Medication
Level 2 user
 Must request the carer to order
 Must indicate what medicine, the strength
and quantity.
Level 3 user
 Only medicines listed on the chart may be
ordered
Storage of medication
General
 Safe
 Cool & dry out of sun
 Original containers
 Some in fridge
Storage of medicines to be
administered by carer
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Keep together in sealed container labelled
Chart to be kept in care plan or alongside
Look for special storage instructions
Medicine in fridge to be kept separate from
food
Oral medicine separate from external
Disposal of medication
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Never throw into public waste system
List unwanted medicine on disposal form
signed by client
Return to pharmacy
Get signature
Dispensing Labels
How to take the medicine what would you expect to find?
Date of dispensing
What is it and how much is there - strength
Name
DOB
Pharmacy address
Dosage amount
When to take
How to take
Storage instructions
* Expiry date may be on but is not a legal requiremnet
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Additional instructions
Swallow whole
Do not crush
 Take before or on empty stomach
30 minutes
 Take after food
30 minutes
 Take regularly complete course
Same times
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Additional instructions
Take with or after food
During meal
 Do not take indigestion remedies at same
time
Minimum of 30 minutes preferably 2 hours
 Dissolve or mix with water
Ensure fully dissolved
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Additional instructions
Allow to dissolve under tongue
 Take with plenty of water
Glassful
 Apply sparingly
No coating on skin about fingertip to cover size of a
hand
 Rinse mouth after use
E.g. steroid inhalers may cause thrush
 Shake the bottle
Do it thoroughly
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Ambiguous instructions or none!
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When (or as) required
As directed
As before
No instructions
Do not administer unless the instructions are
clear
Side effects
List as many as you can think of
Nausea - stomach upset
Tiredness
Motor function affected – dizzy – unsteady
Hallucination paranoia
Leg cramps
Skin itching, skin pallor
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Side effects
Rashes
Headaches
Confusion
Constipation – diarrhoea
Restlessness
Mood changes
General aches and pains
Over the counter medicines
List the types that client may buy or you may be asked
to buy for them
 Pain killers
 Indigestion remedies
 Cold remedies including vapour rubs e.g. Vick
 Anti histamines
 Laxatives
 Vitamin supplements
Over the counter medicines
Homeopathic medicines
 Cough medicine
 Rub ins e.g. rheumatism
 Steroid nasal sprays
 Eye nose and ear drops
 Herbal remedies
 Antiseptics
Check with pharmacist before buying OTC remedies
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Documentation
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Must be completed before assistance can be
given
Self medication assessment
Medication permission (level 3) SHCO
Medication chart (level 3) GP team
Documentation
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To be completed by carer
Medication administration chart (level 3)
Medicines disposal chart
Documentation emergencies
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Emergency procedures form GP team
Action on reverse of medication chart GP
team
Administration on reverse of medication
administration record
Administration Practice
All Formulations
 Clean and tidy space
 Wash hands
 Check medicine has not been given
 Select medicine to be given
 For each item, read the label, compare with
medication chart
 Assemble medicines to be administered.
Administration Practice
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Put medicine packages back into containers
Administer
Complete the administration record sheet
Wash your hands
Administration Practice
Solid oral dose formulations (pills and
capsules)
 Transfer the correct number of units into a
clean container without touching them
 Prepare a drink of cold water
 Ensure client is upright and comfortable
 Hand the client the container and drink
Administration Practice
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Ask client to take a sip of drink then place
medicine on the middle of the tongue and
swallow with remaining drink chin slightly
down
Ensure dose had been swallowed
Encourage client to finish drink
If client cannot take medicine themselves use
a spoon not your hands
Administration Practice
Liquid oral dose formulations
 Shake the bottle
 Measure the correct dose
 Offer medicine to client
 If using oral dose syringe expel liquid to the
middle of tongue NOT back of throat
 Clean the bottle with damp tissue before
replacing lid
Administration Practice
Soluble dispersible formulations
 Measure dose from original container
 Place in a third of tumbler of cold water
 Swirl the solution gently in the glass to
ensure adequate mixing
 Hand to client and offer drink afterwards
Administration Practice
Sublingual formulations
 Place tablet under the tongue and leave to
dissolve
Buccal formulations
 Place the tablet high up between the upper
lip and the gum on either side of the front
teeth and leave to dissolve
Administration Practice
Topical (external) preparations
 Use only as instructed
 Apply only where prescribed
 Smallest quantity that will easily rub in
 Use only for as long as stated
 Return partly used tubes
 Wear disposable gloves
Administration Practice
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Transfer the quantity needed to a gloves
Gently rub into the skin
Dispose of gloves in a sealed polythene bag
and place in general waste container
Administration Practice
Eye Ear & Nose preparations
 When approval has been given for carers to
administer these s/he MUST be given a
practical demonstration by the community
nurse
 Good practice guidance is in packs
Good Practice Points
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Clean, tidy and systematic work reduces risk
of errors
Good hygiene practice at all time never touch
medication with your hands
Seek advice if in doubt
Never administer unless competent to do so
Always read the label, read what is written
not what you expect to be there