Medication Administration Quick Guide

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1 Medication Administration Quick Guide Catholic Mutual Group

2 INDEX INDEX 1. Common Medical Abbreviations 2. Oral Medication Skill Competency 3. Topical Skill Competency 4. Ear Medication Skill Competency 5. Eye Medication Skill Competency 6. Inhaler Medication Skill Competency 7. Nebulizer Medication Skill Competency 8. Gastrostomy Low Profile Medication Skill Competency 9. Gastrostomy Tube Medication Skill Competency 10. EPI-pen Medication Skill Competency 11. Glucagon Medication Skill Competency 12. Diastat Acudial Medication Competency 1.

3 COMMON MEDICAL ABBREVIATIONS COMMON MEDICAL ABBREVIATIONS a.c. Before meals AD Right ear AS Left ear AU Both ears Bid BS C Twice per day bloodsugar With Caps Dsg Dx Gm Gr gtt IM MAR Med Mg Ml NKA Nsg O.D. O.S. O.U. p P.c. Per Po prn Q q.d. qid q 2 hrs rx s sc/sq Stat Syr Tab Tko Tid Wgt ung Capsules Dressing Diagnosis Gram Grain drop Intramuscularly Medication Administration Record Medication Milligram milliliter No known allergies Nursing Right eye Left eye Both eyes after After meals By By mouth As necessary Every Every day 4 times per day Every 2 hours Therapy, treatment or prescription Without Subcutaneous Immediately Syrup Tablet To keep open 3 times per day Weight ointment 2.

4 ORAL MEDICATION ORAL MEDICATION 1. Check authorization forms and records. A. Medication administration form. B. Medical provider authorization form. C. Parent/guardian authorization form. 2. Check for the 5 Rights. 3. Wash hands. 4. Give student water or have them obtain their own. 5. Pour medication in lid of container without touching the lid of container. 6. Give medication to student in cup or hand without touching the lid. 7. Dispose of medication and water cup. 8. Documentation of administration of medication on medication administration record (MAR). 9. Record any special considerations. 3.

5 TOPICAL MEDICATION TOPICAL MEDICATION 1. Check for authorization forms and records. A. Medication administration form. B. Medical provider authorization form. C. Parent/guardian authorization form. 2. Check for the 5 rights. 3. Identify area for topical medication to be applied on the medication administration records/authorization forms. 4. Wash hands and apply gloves. 5. If present; remove bandage and notice the characteristics of the skin/lesion. 6. Apply medication per the MAR/authorization forms. 7. Redress medication application areas as indicated. 8. Remove gloves and wash hands. 9. Record medication in records. If it is a patch - record its location. 10. Record any special considerations. 4.

6 EAR MEDICATION EAR MEDICATION 1. Check for authorization forms and records. A. Medication administration form. B. Medical provider authorization form. C. Parent/guardian authorization form. 2. Check for the 5 rights. 3. Have student in a side-lying position. 4. Wash hands and apply gloves. 5. Gently pull the earlobe up and back to expose the ear canal, without actually touching the skin with the dropper. 6. Administer the correct number of drops onto the side of the ear canal, without actually touching the skin with the dropper. 7. Gently rub the skin in front of the ear to help the medication flow inside the ear. 8. Put cap back on medication bottle without touching inside of cap. 9. Have student hold the position for a minute. Place cotton ball in the student s ear, if noted on MAR. 10. Remove gloves and wash hands. 11. Record on the MAR and any special considerations. 5.

7 EYE MEDICATION EYE MEDICATION 1. Check for authorization forms and records. A. Medication administration form. B. Medical provider authorization form. C. Parent/guardian authorization form. 2. Check for the 5 rights. 3. Have student in a side-lying position. 4. Wash hands and apply gloves. 5. Gently pull lower lid down with one or two fingers below the eye, exposing the conjunctival sac. 6. Bring medication toward the eye from the side, outside the student s vision. Avoid touching anything with dropper or applicator. 7. Drop the correct amount of medication into the lower sac. 8. Put cap back on without touching inside of the cap. 9. Have student close their eyes gently and keep them closed for 1-2 minutes. 10. Wipe away excess medication with a cotton ball or tissue. Use a different cotton ball/tissue for each eye. 11. Remove gloves and wash hands. 12. Record on the MAR and any special considerations. 6.

8 INHALER MEDICATION INHALER MEDICATION 1. Check for authorization forms and records. A. Medication administration form. B. Medical provider authorization form. C. Parent/guardian authorization form. 2. Check for the 5 rights. 3. Wash hands and attach mouth piece to the canister.. 4. Prime inhaler, if new or not used in 2 weeks, by releasing 2 sprays into the air. 5. Shake inhaler for 2-5 seconds. 6. Identify if student uses spacer and place on end of mouthpiece. 7. Shake inhaler for 2-5 seconds. Identify if student uses spacer and place on end of mouthpiece. 8. Have student tip their head back slightly. 7.

9 INHALER MEDICATION (cont.) 9. Open mouth: place inhaler 1-2 inches in front of lips. Closed mouth: place inhaler/spacer between or around lips/face. 10. Instruct student to breathe out. 11. Depress canister. 12. With spacer: with student s mouth on inhaler have them take 5-10 breaths. Without spacer: place inhaler in front or around lips, breathe in deeply and hold for 10 seconds. 13. If a second dose is prescribed, wait 1-2 minutes and repeat the process. 14. Have the student or person administrating the medication wash their hands. 15. Document the medication administration on the MAR and any special considerations. 8.

10 NEBULIZER MEDICATION NEBULIZER MEDICATION 1. Check for authorization forms and records. A. Medication administration form. B. Medical provider authorization form. C. Parent/guardian authorization form. 2. Check for the 5 rights. 3. Obtain nebulizer, medication and supplies. 4. Place nebulizer on level surface and plug into outlet. 5. Attach the end of tubing to air outlet on the nebulizer. 6. Wash hands and apply gloves. 7. Unscrew the top of the nebulizer cup, place medication in cup without touching inside of cup and replace the cap. 8. Attach the tubing to the nebulizer cup. 9. Attach the face mask or T-piece and mouthpiece to the medicine cup. 9.

11 NEBULIZER MEDICATION (cont.) 10. Place mask on or over nose and mouth or give the student the mouthpiece. 11. Have student inhale through the mouthpiece or mask. 12. Note time of starting medication. 13. Have student and/or person administering the medication wash hands. 14. At end of administration, turn off nebulizer and unplug. 15. Document improvement in breathing and record on the medication administration on the MAR. 16. Disconnect tubing, medication cup, mouthpiece or mask. 17. Air dry tubing and store. 18. Wash cup, mouthpiece and mask with soap and water, dry and store. 10.

12 GASTROSTOMY LOW PROFILE MEDICATION GASTROSTOMY LOW PROFILE MEDICATION 1. Check for the authorization forms and records. A. Medication administration form. B. Medical provider authorization form. C. Parent/guardian authorization form. 2. Check for the 5 rights. 3. Gather supplies. 4. Position the student in an upright position. 5. Check the stoma and access port for discoloration, movement or drainage. 6. Wash hands and apply gloves. 7. Measure the medication in a measuring device (i.e. cup). 8. Close clamp on the extension tubing and remove the cap on the medication port. 9. Remove the plunger from the syringe and connect to medication port on extension tubing. 10. Pour water in syringe, open clamp on extension tubing to fill, and close clamp. 11.

13 GASTROSTOMY LOW PROFILE MEDICATION (cont.) 11. Attach the extension tubing to access port. A. Open flap on access port. B. Attach the extension tubing to the access port so the black lines match. C. Rotate the extension tubing clockwise about 3/4 of a turn. 12. Pour medication into the syringe and open clamp. 13. Immediately after the medication has left the syringe, pour water into syringe. 14. When water has flushed the medication from the line, close the clamp. 15. Remove the extension tubing. A. Rotate the extension tubing counter clockwise until black lines match. B. Gently remove the extension tubing. C. Close flap on access port. 16. Observe stoma area for any swelling redness or discoloration. 17. Remove gloves and wash hands and equipment. 18. Record on the MAR and note any special considerations. 12.

14 GASTROSTOMY TUBE MEDICATION GASTROSTOMY TUBE MEDICATION 1. Check for authorization forms and records. A. Medication administration form. B. Medical provider authorization form. C. Parent/guardian authorization form. 2. Check for the 5 rights. 3. Gather supplies. 4. Position the student in an upright position. 5. Check the stoma and access port for discoloration, movement or drainage. 6. Wash hands and apply gloves. 7. Measure the medication in a measuring device (i.e. cup). 13.

15 GASTROSTOMY TUBE MEDICATION (cont.) 8. Close clamp on the extension tubing and remove cap on the medication port. 9. Remove the plunger from the syringe and connect to medication port on tubing. 10. Pour water in syringe, open clamp on tubing to fill and close clamp. 11. Pour the medication into syringe and open clamp. 12. Immediately after medication leaves the syringe, add water to syringe as directed until the medication has left the tubing. 13. Close clamp on tubing. 14. Remove syringe. 15. Close medication port. 16. Observe stoma area for swelling, redness or discoloration. 17. Remove gloves and wash hands and equipment. 18. Record on MAR and note any special considerations. 14.

16 EPI-PEN MEDICATION EPI-PEN MEDICATION 1. Check for authorization forms and record. A. Medication administration form (optional depending on circumstance). B. Medical provider authorization form (optional depending on circumstance). C. Parent/guardian authorization form (optional depending on circumstance). 2. Check the 5 rights. 3. Identify symptoms of severe allergic reaction (as indicated on Emergency Action Plan, if available). 4. Have another school personnel call Wash hands and apply gloves. 6. Remove Epi-Pen from container. 7. Remove gray cap from pen. 8. Firmly press the black tip against the student s thigh and hold for 10 seconds. 9. If alone with student, call 911 or emergency medical service, if not already done. 10. Monitor student s pulse and respirations. 11. When student is stabilized or transported to hospital, remove gloves and wash hands; document event/medication on MAR and note any special considerations. 15.

17 GLUCAGON MEDICATION GLUCAGON MEDICATION 1. Check for authorization forms and records. A. Medication administration form (optional depending on circumstance). B. Medical provider authorization form (optional depending on circumstance). C. Parent/guardian authorization form (optional depending on circumstance). 2. Check for the 5 rights. 3. Identify symptoms of severe low blood sugar reaction (i.e. Emergency Action Plan). 4. Have another school personnel call Wash hands and apply gloves. 6. Remove Glucagon vial and diluents (syringe) from container. 7. Remove gray cap from vial. 8. Remove cap from syringe, place needle tip in center top of the vial and slowly push syringe placing diluents in vial. 9. Gently swirl vial and syringe in vial until solution is clear, (takes approximately seconds). 10. Remove cap from syringe and carefully replace needle into center of the top of the vial. 16.

18 GLUCAGON MEDICATION (cont.) 11. Gently withdraw the diluents from vial by slowly removing syringe as you withdraw the liquid. 12. Position student in a side-lying position. 13. Identify location (buttock, thigh or arm) of injection. 14. Wipe injection site with alcohol. 15. Insert the needle into the skin at the injection site and slowly inject the solution. 16. Apply pressure and massage injection site. 17. If alone with student, call 911 or emergency medical service, if not already done. 18. Monitor student s arousal, pulse and respirations. 19. Maintain side lying position to prevent aspiration due to vomiting. 20. When student is stabilized or transported to hospital, remove gloves and wash hands. 21. Documentation of event and administration of medication on the MAR and note any special considerations. 17.

19 DIASTAT ACUDIAL MEDICATION DIASTAT ACUDIAL MEDICATION 1. Check for authorization forms and records. A. Medication administration form (optional depending on circumstance). B. Medical provider authorization form (optional depending on circumstance). C. Parent/guardian authorization form (optional depending on circumstance). 2. Check for the 5 rights. 3. Identify prolonged, cluster seizure activity and need to give medication. 4. Have another adult call Obtain supplies, Diastat, gloves, lubricant and blanket. 6. Apply gloves and confidentially remove clothing form buttock and drape. 7. Push up on the cap with your thumb and pull to remove the cap from the syringe. 8. Lubricate the tip by inserting it in the lubricating jelly. 9. Move the student to side-lying position with upper leg forward so the rectum is exposed. 10. Separate the buttock to expose the rectum. 11. Insert the syringe gently into the rectum until the rim is snug against the rectal opening. Push the plunger slowly counting to 3 until the plunger stops. 18.

20 DIASTAT ACUDIAL MEDICATION (cont.) 12. Hold the syringe in place after releasing the medication and count to Remove the syringe from buttock. 14. Immediately hold the buttocks together and count to 3 again, this helps to keep the medication from leaking out. 15. Keep the student on their side. 16. Note time. 17. If alone, call 911 or emergency medical service. 18. Assist student with redressing. 19. Document improvement in seizure activity and record the medication administration on the MAR. 20. Discharge unused medication in syringe by depressing syringe and expelling medication in wastepaper basket, coffee grounds or kitty litter. Dispose of bag immediately. 21. Remove gloves and wash hands. 3/29/

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