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
and under fingernails;
| The basic supplies that needed for medication administration include:
| 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
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:
Observed 6 rights of medication administration
| The training participant must be able to list the 6 rights of
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:
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
| 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.
| 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
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
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.
| 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