8. Guidelines for Completing the Demonstration of Competency Basic and Intermediate Skills Checklist.


  • 8. Guidelines for Completing the Demonstration of Competency Basic and Intermediate Skills Checklist.

     

     

     

     

      Utilized proper hand washing technique and infection control principles

      Training participant must demonstrate good hand washing techniques

    which include washing hands with soap and water or using an alcohol-based

    hand sanitizer:

    • Remove rings;
    • Wet hands with warm, running water and apply liquid soap;
    • Lather well;
    • Scrub all surfaces, including the backs of hands, wrists, between fingers

    and under fingernails;

    • Rub hands together for 20 seconds (sing “Happy Birthday” twice);
    • With water running, dry hands with a paper towel;
    • Use paper towel to turn of the faucet;
    • Dispose of paper towel.
     

     

      Appropriate equipment

     

      The basic supplies that needed for medication administration include:

    1. Medication administration record;
    2. Medication cups for oral meds including tablets, capsules, and liquids;
    3. Sufficient fluids;
    4. Soap and water or appropriate antiseptic must available for use.
      Medication Administration Record utilized properly

     

      Training participant must be able to describe a medication administration record

    and know how to use it properly.

     

    Read the medication label and checked against order on MAR

      Training participant must identify that the medication label must be compared

    to the MAR 3 times;

    1. when removing the medication from the storage area, prior to pouring
    the medication;
    2. After pouring the medication and returning it to storage. The information

    on the label and the information on the MAR must match.

     

    List /recognize the components of a complete medication order

     

      The components of a complete medication order include:

    1. Medication name;
    2. Strength of medication;
    3. Dosage of medication to be administered;
    4. Route of administration;
    5. Specific directions for use, including frequency of administration;
    6. PRN orders must clearly state the reason for administration
     

     

      Observed 6 rights of medication administration

     

       The training participant must be able to list the 6 rights of

    medication administration:

    Right client

    Right medication

    Right dose

    Right route

    Right time

    Right documentation

     

     

      Used clean technique when pouring and preparing medications into appropriate container

     

      The training participant must identify that medications are not to be touched or

    handled by their hands. Medication is poured from the container which has the

       medication label into a medication cup or a cup designed to administer liquid

       medication and given to the person. 

       Must tell the instructor that cannot set all the person’s medications up

       prior to administering.

     

      Offered sufficient fluids with medications

     

      The training participant must be able to describe that a person is to be offered

    4 ounces of water or other fluids when administering medications

     

     

      Described methods used to monitor a person’s condition and reactions to medications and what to do when there appears to be a change in his or her condition or health status

      Training participant must be able to identify the following potential side effects

    when a medication has been administered:

    Change in behavior

    Change in alertness

    Change in eating or swallowing

    Change in mobility

    Skin rash develops They must be able to tell the instructor what action is to be taken

    when they identify that a person may be experiencing a side effect of a medication.

    They also must identify where the side effect

     

      Initialed the MAR immediately after medications are administered and prior to the administration of medications to another person. Equivalent signature for initials is documented.

      The training participant must identify that they are to sign the MAR only after

    they observe the person take the medication.

    (No pre-charting of medications prior to them being administered.). Must be

    done immediately after medication is administered to each person. (No charting

      after all medication is administered).

     

      Documented medications that are refused, held, or not administered appropriately

     

       The training participant is to be knowledgeable to Method of documenting why

      a medication not administered. Such as (example) H = Held, R = Refused,

      Circling their initials on MAR. They must also know how to document in the 

      person’s record what occurred and why.

     

      Administered and documented PRN medications appropriately

     

      Training participant must document PRN medications that include:

    Amount administered

    Time administered

    Reason administered

    Effectiveness of medication

     

      Returned medication to proper storage unit

     

      Training participant must return the medication for each person to the appropriate

    medication storage   area prior to administering the next person’s medication.

      Must identify that medication cart, cabinet, closet is to be locked at all times  

     

     

     1. Oral tablets and capsules

     

      Position the person with the head elevated

    Uncoated tablets can be scored to allow for splitting

    Coated Tablets should not be scored or split

    Do not break or crush any medications without a licensed practitioner’s order

    More than one tablet or capsule may be placed in the same medication cup

     2. Pouring & Measuring Liquid Medication

      1 tsp

      1Tbsp

      1 Ounce

      30 cc

      5 cc

      2tsp

      The major concern with liquid medications is measuring accurate dosage. To insure

    accurate dosage of liquid medications using a plastic marked cup, oral syringe or

      dropper, pay close attention to the markings to ensure accurate dosage. Some

      are suspension and must be shaken well. Place the medication cup on a flat surface

      and measure the liquid medication at eye level. Medication should be poured away

      from the container label. To do this, hold the medication bottle or container in the

      palm of your hand with label against your palm, to prevent spillage, causing label 

      to become illegible.

     

     3. Sublingual

     

      Place the medication under the person’s tongue. Instruct them to allow the sublingual

    medication to dissolve   under their tongue and not to swallow or chew the medication. 

      (Verbally explain a technique/procedure in lieu of actually performing it).  

     

     4. Instilling eye drops

     

      Prior to applying eye drops, wash your hands. Person should be sitting up straight

    and looking at the ceiling. Pull down on the lower lid with the hand not holding the bottle.

      Place one drop inside the lower eyelid. If you are not sure that a drop went in,

      WAIT 5 minutes before instilling another drop. Dropper must not touch the eye.

     

     

     

     

     

     

      5. Instilling ear drops

     

      Store ear drops at room temperature. Prior to applying ear drops, wash your

     hands and dry completely. Gently shake the bottle before using. Hold the

      bottle in your hands for a few minutes to warm drops. The dropper should be

      held with the dropper tip down at all times. This prevents the medicine from flowing

      back to the bulb where there may be germs. Avoid touching the dropper against

      anything else. Ask the person to lie down or tilt their head to one side. In adults,

      the earlobe should be held up and back. For children, the earlobe should be held

      down and back. Holding the ear with one hand and the dropper in the other, place

      the correct number of drops into the ear – DO NOT SQUEEZE THE DROPPER

      TOO HARD. Replace the dropper in the medicine bottle right away – DO NOT

      RINSE OFF. Press the ear flap and have the client keep their head tilted back for

      several minutes to give the drops ample time to coat the ear. You may want to insert

      a cotton plug. Wash your hands.

     

     

    6. Nasal sprays

     

      Ask the person to hold their head erect. Have them blow their nose as needed.

    Spray the nasal spray forcefully into the nose and ask the person to sniff

      the medication into their nose. May tilt their head back to help them absorb the

      medication. Wipe the tip of the nasal spray with a clean tissue prior to replacing

      the cap.

     

     

     

    7. Application of topical ointment/cream

     

      Use universal precautions at all times when applying ophthalmic or dermal

    ointments. Cleanse skin prior to application of dermal ointment.

      As always, observe for any adverse effects such as worsening of the condition.

    Wear gloves. Use a new tongue blade or cotton tipped applicator to remove the

    medication from its  container and to apply the ointment or cream. Lay the lid of

      the container with the top facing up, so it will not contaminate the medication in

      the container.  

     

     

     

     

     

    8. Rectal suppository

     

      If the suppository is soft, hold it under cool water to harden it before removing the

    wrapper. Remove the wrapper. If you are to use half of the suppository,

      cut it lengthwise. Put on a finger cot or a disposable glove. Lubricate the

      suppository tip with a water-soluble lubricant such as KY Jelly. Ask the person

      to lie on their side with their lower leg straightened out and upper leg bent

      forward toward their stomach. Lift upper buttock to expose the rectal area. Insert

      the suppository, pointed end first, with your finger until it passes the muscular

      sphincter of the rectum, about 1 inch in adults. If not inserted past the sphincter,

      the suppository may pop out. Hold buttocks together for a few seconds. Remain

      lying down for about 15 minutes to avoid having the suppository come out.

      Discard used materials and wash your hands thoroughly. (Verbally explain

      a technique/procedure in lieu of actually performing it). 

     

     

     

     

     

    9. Application of vaginal cream/ suppository

     

      To use vaginal cream or suppository, first wash your hands thoroughly. To use

    the cream, fill the applicator that comes with the cream to thelevel indicated.

      To use the suppository, unwrap it, wet it with lukewarm water, and place it

      on the applicator shown with the accompanying instructions. Have the woman

      lie on their back with their knees drawn upward and spread apart. Insert the

      applicator high into the vagina (unless she is pregnant), and then push the

      plunger to release the medication. If pregnant, insert the applicator gently.

      If you feel resistance (hard to insert), do not try to insert if further; call the

      doctor. Withdraw the applicator. Pull the applicator apart and clean it with

      soap and warm water after each use. Wash your hands thoroughly. (Verbally

      explain a technique/procedure in lieu of actually performing it).

     

     

     

      10. Use of metered dose inhaler

     

      Wash hands. Shake the inhaler several times. Have the person hold their head

    up straight or stand. Have them exhale all the way until can’t breathe out anymore

      and then place the mouthpiece of inhaler between teeth and close lips around the

      mouth piece. Press down on the canister to release a dose of the medication and

      ask the person to breathe in. Hold breath for 10 seconds. If more than one puff is

      required, wait 2 minutes before administering second puff.

     

     

     

    Medication error.

     

      Describe what constitutes a medication error and actions to take when a

    medication error is made or detected. Must verbalize that it is very important to

      familiarize yourself with any medication that is being administered. Pharmacies

      are required to provide a “medication” education sheet with each drug dispensed.

      The sheet contains the most common side effects of that medication. Another way

      to learn the side effects of medications is to review the medication in a current

      Drug Handbook.