Application
This unit of competency requires the application of skills and knowledge to administer medication to clients in a manner that is safe Competency requires an awareness of and practice consistent with health legislative requirements and codes of practice and enterprise safe workplace practices The unit must be applied strictly in accordance with relevant state/territory legislation and industry guidelines which include, but are not limited to: Aged Care Act and Regulations The Drugs and Poison's Act and other relevant legislation in the state/territory Disability Services Act continued ... | |
Legislation and industry guidelines (contd): The organisation's procedures and guidelines written in accordance with the relevant legislation and reflecting the scope of role and accountability for the level of worker in that jurisdiction Australian Nursing Council (2005) Guidelines on Delegation and Supervision of Registered Nurses NSW Nurses and Midwives Board (May 2005) Delegating the Administration of Medication in Aged Care Facilities Royal College of Nursing Australia and Australian Nursing Federation (2004) Joint Position Statement: Assistants in nursing and other unlicensed workers (however titled) When the requirements of this standard are achieved, medications will be administered strictly in compliance with advice, instruction and relevant legislation. Where necessary, health professional support is sought to administer medication as appropriate for that environment or context Annual reconfirmation of the essential knowledge and competency by the employer within performance management framework is mandatory |
Prerequisites
Elements and Performance Criteria
ELEMENT | PERFORMANCE CRITERIA |
1. Identify situations that pose a potential risk to the safe administration of medications | 1.1 Based on care plan and/or delegation, access information to enable identification of substance incompatibilities 1.2 Identify environmental and/or practice issues that may impact on or contraindicate administration of medication in specific situations 1.3 Report potential risks related to medication administration to supervisor or health professional 1.4 Confirm client identity and if any allergies exist 1.5 Identify drugs and poisons schedules and classifications as determined by law 1.6 Identify any limitations on own capability in relation to undertaking delegated medication administration function and report to delegating health professional |
2. Prepare for medication administration within a variety of settings | 2.1 Establish authority to assist with medication administration in line with organisation policies, guidelines and protocols and jurisdictional legislative and regulatory requirements 2.2 Clarify role in providing assistance with medication administration in line with delegation 2.3 Confirm that all dose administration aids are complete, ready for use and up to date 2.4 Implement personal hygiene procedures according to organisation policy and procedure to ensure cross infection is minimised 2.5 Ensure practice is at all times consistent with policies, procedures and delegations in order to fulfil duty of care requirements 2.6 Gather equipment required for medication administration 2.7 Confirm medication administration route and associated terminology and procedures for medication administration 2.8 Identify from the care plan the purpose and function of prescribed medications for administration 2.9 Report environmental and/or practice issues that may impact on or contraindicate administration of medication in specific situations and seek direction from supervisor or health professional 2.10 Accurately measure and/or calculate dosages for administration of medication 2.11 Prepare medications according to delegated role and in line with legal and environmental guidelines 2.12 Demonstrate medication administration techniques and precautions specific to each client as per delegation |
3. Identify and prepare the client for administration of medication | 3.1 Identify the client, including clients who self administer, according to organisation procedures and delegation 3.2 Greet correctly identified client and prepare for medication administration 3.3 Check client medication according to organisation guidelines and delegation 3.4 Inform the client of the administration procedure 3.5 Prior to administration, check the client for any physical or behavioural changes that may indicate the need to report to delegating health professional, according to organisation policies and procedures |
4. Administer required medications within legal parameters | 4.1 Administer medications as delegated within role responsibility according to the law and environment policy 4.2 Prepare and administer medications according to specific requirements of the form of medication, in strict accordance with defined legislation and organisation procedures, according to delegation and in line with prescriber's written instructions where available 4.3 Implement all checks to ensure the right medication is given at the right time, to the right person, in the right amount, via the right route, in the right form 4.4 Assist the client taking the medication as required and according to documented procedures 4.5 Supervise and observe the client when taking medication and confirm ingestion or completion 4.6 Dispose of all used and unused medication, containers, needles and syringes in line with organisation procedures 4.7 Identify signs that PRN medications may be required, review care plan and written instructions and act in accordance with organisation's policies, procedures and role responsibility, in line with delegation |
5. Monitor client response to administered medication | 5.1 Record administration of medications according to organisation policy 5.2 Contribute to information provided to clients and carers on medication administration, including possible side effects 5.3 Identify apparent acute and delayed adverse reactions to medications, respond within role responsibility and report to supervisor or health professional 5.4 Implement emergency response for identified acute and delayed adverse reactions within role responsibility 5.5 Record and report response to emergency strategies 5.6 Identify signs of a client experiencing pain and report to supervisor or health professional 5.7 Observe and record client response to pain relieving medication and report to supervisor or health professional |
6. Comply with the organisation's procedures for handling the range of issues/contingencies which may arise | 6.1 Report to supervisor and health professional client refusal to take medication or incomplete ingestion according to organisation's procedures and protocols 6.2 Identify contaminated or out of date medication 6.3 Implement organisation procedures for disposal of contaminated or out of date medication 6.4 Observe and record changes in the client's condition according to the organisation's guidelines and report to supervisor and health professional 6.5 Record and report any inconsistency (e.g. with the medication, the time or the client) according to the delegation 6.6 Document inconsistencies and address according to the organisation's guidelines and procedures |
7. Complete medication distribution and administration | 7.1 Manage the trolley, or other medication container and used medication containers according to industry and the organisation's infection control guidelines 7.2 Complete arrangements and procedures to replenish dose administration aids and supplies 7.3 Store medication charts according to the organisation's procedures to ensure safety, security and confidentiality 7.4 Complete medication storage procedures to maximise security, prevent medication deterioration and in compliance with legislation |
Required Skills
This describes the essential skills and knowledge and their level required for this unit. |
Essential knowledge: The candidate must be able to demonstrate essential knowledge required to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role These include: Clear understanding of principles, practices and regulatory framework underpinning delegation and supervision, accountability and responsibility Basic understanding of medication groups and categories and their effect on body systems and major disorders, including: central nervous system musculo-skeletal system peripheral nervous system endocrine system cardiovascular system respiratory system gastrointestinal system urinary system reproductive systems immune system integumentary system eye, ear and special senses micro-organisms neoplastic disease Principles of safe medication administration and consequences of incorrect use of medication, main reasons for errors in medication administration Cross infection and prevention strategies including correct hand washing techniques, glove usage and awareness of how infection is spread Basic understanding of major factors that affect the action of drugs, including age, disease processes, nutrition, and hydration Measurement and calculation requirements for medication administration Relevant medical/medication terminology Commonly accepted medication abbreviations Basic knowledge of commonly used medications Basic pharmacology of medications, including: pharmacodynamics pharmacokinetics pharmacotherapeutics toxicology Forms of medication, modes and routes for medication delivery Legal requirements of each route of administration continued ... |
Essential knowledge (contd): Procedures for medication administration routes listed in the Range Statement How and when to use the equipment listed in the Range Statement Roles within the health care team in the administration of medications Role in medical emergency Basic understanding and knowledge of substance incompatibilities and contra-indications, such as: warfarin and aspirin medication and diet medication and sunlight Basic understanding of: anaphylactic reactions side effects precautions Basic understanding of complementary therapies Legal requirements for practice parameters including Poisons Act, Poison Schedules S4Ds and S8s Relevant workplace health and safety policies to ensure safe practice, including: management of sharps potential hazards in a health environment chemical use in cleaning and sanitising in relation to medication residue in containers Appropriate storage of medications Methods of storage, handling and usage of medications Organisation procedures for the documentation of medication and the use of medication charts |
Essential skills: It is critical that the candidate demonstrate the ability to: Read and accurately interpret delegated medication responsibilities from the care plan or other written instructions Ensure all work is in accordance with supervisor and health professional's instructions Accurately observe, report and record discrepancies in medications, instructions and/or client Observe and record changes in the client's condition as listed in the Range Statement, during and after medication administration and report to supervisor and health professional Provide administration of medications according to the specific delegation and in compliance with legal and organisation policies and procedures, including principles of best practice relating to: following medication label and/or instructions occupational health and safety (OHS) infection control including correct hand washing managing and reporting contingencies as they arise applying standard and additional precautions in infection control correct documentation of medication administered Demonstrate the following skills correctly, including specific levels of literacy and numeracy and physical capabilities required: read and correctly interpret care plan or other written instruction from supervisor or health professional for administration requirements for medications use dose administration aids observe, report and record discrepancies in medications, instructions and/or client report any obvious changes in client's condition as listed in the Range Statement before, during and after self-medication to a supervisor and / or health professional so remedial action can be taken Negotiate the physical assistance that can be provided Use equipment listed in the Range Statement effectively and appropriately Distribute medications in a timely, appropriate and effective way to clients with differing needs and according to form of medication Apply language, literacy and numeracy required for drug calculation, administration and documentation of medications Demonstrate correct preparation, administration and recording of medications via delegated routes within the range identified in the Range Statement Correctly administer and support self-administration of insulin by sub-cutaneous injection using pre-loaded syringes or pens Skills and knowledge to conduct BSL monitoring including knowledge of the acceptable and safe range of results for an individual client and operating in accordance with organisation's policy and practice and seeking advice and assessment of the health professional when results are outside the acceptable and safe range before administering insulin by sub-cutaneous injection continued ... |
Essential skills (contd): It is critical that the candidate demonstrate the ability to: Undertake basic calculations for oral administration of tablets Safely measure liquids according to directions In addition, the candidate must be able to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role These include the ability to: Respond within job role in an emergency situation where a client is experiencing an adverse medication reaction Oral communication skills required to fulfill job role, including: interviewing skills questioning active listening seeking clarification |
Evidence Required
The evidence guide provides advice on assessment and must be read in conjunction with the Performance Criteria, Required Skills and Knowledge, the Range Statement and the Assessment Guidelines for this Training Package. | |
Critical aspects for assessment and evidence required to demonstrate this unit of competency: | The individual being assessed must provide evidence of specified essential knowledge as well as skills This unit must be assessed in the workplace under the normal range of work conditions Assessment must be conducted on more than one occasion to cover a variety of circumstances Assessment must reflect actual delegation from a health professional Development of assessment tools and methods may include the input of a health professional |
Access and equity considerations: | All workers in community services should be aware of access, equity and human rights issues in relation to their own area of work All workers should develop their ability to work in a culturally diverse environment In recognition of particular issues facing Aboriginal and Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on Aboriginal and Torres Strait Islander people Assessors and trainers must take into account relevant access and equity issues, in particular relating to factors impacting on Aboriginal and/or Torres Strait Islander clients and communities |
Context of and specific resources for assessment: | This unit can be assessed independently, however holistic assessment practice with other community services units of competency is encouraged Competency in this unit should be assessed using all the relevant resources commonly provided in the residential care service setting Specific tools may include: medication charts and documentation medications and equipment relevant policies and procedures manuals other documentation relevant to the work context such as: relevant equipment and cleaning agents currently used in the workplace |
Method of assessment: | Assessment will include: Observation of work performance Supporting statement of supervisor or health professional Authenticated evidence of relevant work experience and/or formal/informal learning Case studies and scenarios as a basis for discussion of issues and strategies to achieve required infection control outcomes in specific work environments and communities Written assessment of functional English language, literacy and numeracy skills appropriate to the level of responsibility of the care worker Annual reconfirmation of the essential knowledge and competency by the employer within a performance management framework is mandatory |
Range Statement
The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Add any essential operating conditions that may be present with training and assessment depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts. | |
Potential risk may include but is not limited to: | Client identification Allergic reactions Immunisation status Medication incompatibilities |
Delegation refers to: | Conferring of authority to perform specific medication administration activities to a worker not usually authorised but who has been determined as appropriate for the task by the delegating health professional Delegation is within the context of a care plan or other written instruction Where delegation is provided verbally it must be confirmed as soon as practicable according to organisation procedures in writing and incorporated in the care plan The authority is specific to an individual client within a specific care context and is not transferable Delegation instructions must include: medication and its purpose medication form and instructions e.g. enteric coated - do not crush dosage and related instructions route contra-indications any other relevant instructions or information, especially information specific to the client |
Supervision refers to: | Instructing, advising, and monitoring another person in order to ensure safe and effective performance in carrying out the duties of their position Supervision may be conducted by various means including: in person through use of electronic communications media such as telephone or video conferencing, where necessary Supervision level, form and frequency must be established by the delegating health professional for all work delegated to another worker Frequency and form of supervision will be determined by factors such as: the task maturity of the person being supervised the need to review and assess client conditions and progress in order to establish or alter treatment plans The need to correct and develop non-clinical aspects such as time management, organisation requirements, communication skills, and other factors supporting the provision of clinical care and working within a team |
Health professional includes: | Registered nurses Medical practitioners Pharmacist Complementary medicine therapist (for delegation within legislative requirements, specific to their area of expertise where included in the care plan) Dentist |
Settings may include: | Aged care residential Client's home Group home Respite service |
Dose administration aids may include: | Blister packs - single dose packs and multi-dose packs |
Equipment required may include: | Aprons Container for dirty spoons/dishes Medication charts/sheets Gloves Key to medication trolley/medication cupboard Lubricant Measuring cups Measuring spoon Mortar and pestle Nebuliser/spacer Oxygen cylinder Oxygen mask/nasal prongs Pre-loaded dose administration aids for insulin Paper towels/tissues Tablet divider Tea towel Tumblers Water pitcher |
Medication administration routes include: | Aural Insulin by sub-cutaneous injection using pre-loaded syringes or pens Intranasal Ocular Oral Rectal Topical (including transdermal) Vaginal administration |
Measure and/or calculate dosages includes: | 100% accurate measurement and/or calculation of medication required as per written delegation and/or prescription, including: measurement of liquid medications into measuring cup or spoon calculation of medication mixtures and solutions use of standard formulae to calculate the number or fraction of tablets to be administered to equate to required dose calculation of the number or fraction of tablets to equate to identified weight |
Prepare medications may include: | Dispensing tablets from dose administration aids into medicine cup Measuring liquid medications into measuring cup/spoon Dissolving powder in water Placing medication in nebuliser/spacer Use of lubricant |
Medication administration techniques may include, for example: | Techniques to assist clients with difficulties swallowing Techniques to assist clients with specific disabilities Techniques for managing behaviours of concern |
Prepare for medication administration may include: | Discussing procedures with client Encouraging client participation Adjusting posture and positioning client Seeking assistance from other staff Providing privacy Exposure to treatment area |
Check client medication may include: | Checking medication is free from contamination Checking that medication, time and resident/client correlate with documentation Checking dose administration aids for evidence of tampering |
Physical or behavioural changes observed in condition of the client that must be immediately reported to a supervisor or health professional may include, but are not limited to: | Changes to airway (e.g. choking), breathing (including slowed, fast or absent breathing, colour changes) or circulation (including unexpected drowsiness, colour change and absence of pulse) Rash Inflammation or redness Swelling Headache Skin tone Feelings of dizziness Slurring of speech Nausea and vomiting Blurred vision Confusion Changes in behaviour Anything that appears abnormal about the resident/client Others as advised by a doctor or health professional |
The form of medication may include: | Capsules Ear drops Eye drops Inhalants Liquid Lotion and cream Nose drops Patches Pessaries Powder Pre-loaded syringes or pens Suppositories Tablets Wafers |
All checks include: | Checking medication against the requirements Checking client details Checking the chart Checking for authorisation Checking specific delegation |
Incomplete ingestion includes: | Inability or difficulties in swallowing whole or divided tablets Ejection of medication Vomiting Refusal to take medications |
Document inconsistencies may include: | Incident reports Medical charts Progress notes |
Drug storage procedures include: | Acting in accordance with defined job role Locking and storing medications according to organisation policy and procedure |
Required medications may include: | Medications prescribed for client by doctor or health professional and dispensed by pharmacist in dose administration aids PRN medications as prescribed (and identified in medication chart/sheet and/or care plan) according to relevant legislation, organisation guidelines and delegations |
Client identification may include: | Referral to forms of identification such as photographs, wristbands Recognition by response Confirmation from nursing/care staff |
References may include: | MIMS annual or drug reference guide Drugs hotline/drug information line |
Industry guidelines may include: | Australian Pharmaceutical Advisory Council Integrated best practice model for medication management in residential aged care facilities State and territory health department legislation, policies and guidelines Organisation policies and procedures Internal facility medication audits |
Sectors
Not Applicable
Employability Skills
This unit contains Employability Skills |
Licensing Information
Not Applicable