Medication Problem A.C.T.I.O.N. Plan. A Resource Guide for Home Support Workers
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1 Medication Problem A.C.T.I.O.N. Plan A Resource Guide for Home Support Workers
2 2 Medication Problem A.C.T.I.O.N. Plan 2004 Canadian Pharmacists Association. All rights reserved.
3 Medication Problem A.C.T.I.O.N. Plan A Resource Guide for Home Support Workers What A.C.T.I.O.N. means: A Assess/observe the situation C T I Contact your supervisor Talk to family member if present Identify how you can help O Open the chart and document N Note to follow-up The purpose of the resource guide is to provide direction when you have identified possible medication-related problems. Each section of the screening tool and the resource guide is colour coded. If a problem is identified on the screening tool, go to the corresponding colour section of the resource guide and follow the A.C.T.I.O.N. plan. Medication Problem A.C.T.I.O.N. Plan 2004 Canadian Pharmacists Association. All rights reserved. 3
4 Table of Contents SECTION A Problems taking medication correctly (5 rights) SECTION B Physical or cognitive problems SECTION C Barriers and other problems SECTION D Change in client condition SECTION E Change in client medication
5 PROBLEMS TAKING MEDICATION CORRECTLY (5 RIGHTS) Any problems... Have you noticed any of the following behaviours that might suggest that the client has not taken his/her medication correctly? Right Patient: Client is taking medication prescribed for someone else Right Medication: Client took the wrong medication SECTION A Right Dose: Client took the wrong dose (e.g., too little/too much medication or no medication taken) Right Time: Client took the medication at the wrong time Right Route: Client used the wrong method/way to take medication* * An example of wrong method/way: Client did not take wrapping off the suppository before inserting it NO ACTION Stop here CONTACT your supervisor Medication Problem A.C.T.I.O.N. Plan Plan Copyright 2004 Canadian 2004 Canadian Pharmacists Pharmacists Association. Association. All rights All reserved. rights reserved. 5
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7 PHYSICAL OR COGNITIVE PROBLEMS Client has difficulty seeing ASSESS/OBSERVE the situation SECTION B Does the client have eye glasses, contact lenses or use a magnifying glass? Is the room too dark? NO CONTACT your supervisor and inform him/her that the client is having difficulty seeing IDENTIFY how you can help Bring eye glasses, contact lenses or magnifying glass to the client Open the curtains and/or turn on the lights If the client is still having difficulty seeing, contact your supervisor AND/OR TALK to family member if present OPEN the chart and document what you have done NOTE to follow-up next visit to see if client is still having problems Medication Problem A.C.T.I.O.N. Plan 2004 Canadian Pharmacists Association. All rights reserved. 7
8 PHYSICAL OR COGNITIVE PROBLEMS SECTION B Client has difficulty hearing ASSESS/OBSERVE the situation Does the client have a hearing aid? Is the hearing aid not working properly? NO CONTACT your supervisor and inform him/her that the client is having difficulty hearing IDENTIFY how you can help If the hearing aid is not working properly, check to see if it needs batteries If it is still not working, contact your supervisor AND/OR TALK to family member if present OPEN the chart and document what you have done NOTE to follow-up next visit to see if client is still having problems 8 Medication Problem A.C.T.I.O.N. Plan 2004 Canadian Pharmacists Association. All rights reserved.
9 PHYSICAL OR COGNITIVE PROBLEMS Client has difficulty taking or preparing medication ASSESS/OBSERVE the situation SECTION B Is the client unable to swallow or having difficulty swallowing? Is the client having difficulty cutting tablets, using inhalers, giving injections, measuring medications, etc.? CONTACT your supervisor immediately and inform him/her that the client is having difficulty swallowing; open the chart and document what you have done CONTACT your supervisor and inform him/her that the client is having difficulty taking or preparing medications TALK to family member if present IDENTIFY how you can help Ask the client why he/she thinks he/she is having trouble If the pills are too large or the client has a dry mouth, give the client a drink of water OPEN the chart and document what you have done NOTE to follow-up next visit to see if client is still having problems Medication Problem A.C.T.I.O.N. Plan 2004 Canadian Pharmacists Association. All rights reserved. 9
10 PHYSICAL OR COGNITIVE PROBLEMS SECTION B Client has difficulty opening medication bottles ASSESS/OBSERVE the situation Is the client having difficulty with stiffness, painful hands, or shakiness? Is this difficulty related to clumsiness or weakness? Is there another problem that is preventing the client from opening his/her medication bottles? CONTACT your supervisor and inform him/her that the client is having difficulty opening medication bottles TALK to family member if present IDENTIFY how you can help Follow agency policy on medication procedures OPEN the chart and document what you have done NOTE to follow-up next visit to see if client is still having problems 10 Medication Problem A.C.T.I.O.N. Plan 2004 Canadian Pharmacists Association. All rights reserved.
11 PHYSICAL OR COGNITIVE PROBLEMs Client has difficulty remembering ASSESS/OBSERVE the situation SECTION B Is the client confused or having memory problems? Have you noticed your client forgetting to take his/her medication? CONTACT your supervisor and inform him/her that the client is having difficulty remembering TALK to family member if present IDENTIFY how you can help Follow agency policy on medication procedures OPEN the chart and document what you have done NOTE to follow-up next visit to see if client is still having problems Medication Problem A.C.T.I.O.N. Plan 2004 Canadian Pharmacists Association. All rights reserved. 11
12 PHYSICAL OR COGNITIVE PROBLEMS SECTION B Client does not understand the purpose of medication what medication to take how/when to take medication ASSESS/OBSERVE the situation Has anyone explained the purpose of the medication to the client? Has anyone ever explained to the client what medication to take and/or how and when to take medication? If NO or if client has forgotten CONTACT your supervisor and inform him/her that the client does not understand something about his/her medication or he/she has forgotten TALK to family member if present IDENTIFY how you can help Follow agency policy on medication procedures OPEN the chart and document what you have done NOTE to follow-up next visit to see if client is still having problems 12 Medication Problem A.C.T.I.O.N. Plan 2004 Canadian Pharmacists Association. All rights reserved.
13 BARRIERS AND OTHER PROBLEMS Client unwilling to take medication as prescribed ASSESS/OBSERVE the situation SECTION C Ask the client why he/she is not willing to take medication Why does the client feel this way? CONTACT your supervisor and inform him/her that the client is unwilling to take medication TALK to family member if present IDENTIFY how you can help Follow agency policy on medication procedures OPEN the chart and document what you have done NOTE to follow-up next visit to see if client is still having problems Medication Problem A.C.T.I.O.N. Plan 2004 Canadian Pharmacists Association. All rights reserved. 13
14 BARRIERS AND OTHER PROBLEMS SECTION C Client has financial difficulty paying for prescriptions ASSESS/OBSERVE the situation Are there any medications that the client has not purchased because of financial difficulties? CONTACT your supervisor and inform him/her that the client may not be filling prescriptions because of financial difficulties TALK to family member if present IDENTIFY how you can help OPEN the chart and document what you have done NOTE to follow-up next visit to see if client is still having problems 14 Medication Problem A.C.T.I.O.N. Plan 2004 Canadian Pharmacists Association. All rights reserved.
15 BARRIERS AND OTHER PROBLEMS Client physically unable to leave home or has no transportation ASSESS/OBSERVE the situation SECTION C Ask the client what is making it difficult for him/her to leave the home Does this affect the client s ability to receive medical care and/or get prescriptions? CONTACT your supervisor and inform him/her that the client is having difficulty either leaving home and/or has no transportation TALK to family member if present IDENTIFY how you can help OPEN the chart and document what you have done NOTE to follow-up next visit to see if client is still having problems Medication Problem A.C.T.I.O.N. Plan 2004 Canadian Pharmacists Association. All rights reserved. 15
16 BARRIERS AND OTHER PROBLEMS SECTION C Client needs more caregiver support with medication ASSESS/OBSERVE the situation Does the client have a reliable caregiver to help with medications? Was there a previous caregiver who is no longer involved? NO CONTACT your supervisor and inform him/her that the client does not have a reliable caregiver to help with medications TALK to family member if present IDENTIFY how you can help OPEN the chart and document what you have done NOTE to follow-up next visit to see if client is still having problems 16 Medication Problem A.C.T.I.O.N. Plan 2004 Canadian Pharmacists Association. All rights reserved.
17 BARRIERS AND OTHER PROBLEMS Client keeps old or expired bottles of medication ASSESS/OBSERVE the situation SECTION C Does the client have old or expired bottles of medication (including over-the-counter medication, vitamins, and herbal products)? CONTACT your supervisor and inform him/her that the client has old or expired bottles of medication or that the client is using these medications TALK to family member if present IDENTIFY how you can help Follow agency policy on medication procedures OPEN the chart and document what you have done NOTE to follow-up next visit to see if client is still having problems Medication Problem A.C.T.I.O.N. Plan 2004 Canadian Pharmacists Association. All rights reserved. 17
18 BARRIERS AND OTHER PROBLEMS SECTION C Client has poor storage conditions of medication ASSESS/OBSERVE the situation Does the client keep medication in unlabelled containers? Does the client keep medication too near a stove or in too much sunlight? CONTACT your supervisor and inform him/her that medication storage conditions are poor TALK to family member if present IDENTIFY how you can help Follow agency policy on medication procedures OPEN the chart and document what you have done NOTE to follow-up next visit to see if client is still having problems 18 Medication Problem A.C.T.I.O.N. Plan 2004 Canadian Pharmacists Association. All rights reserved.
19 CHANGE IN CLIENT CONDITION Any changes... Have you noticed any changes in your client s condition? Change in bowel patterns (diarrhea, constipation, gas) Change in bladder patterns (frequency, odour, colour) Change in behavior, memory, mood, or thinking pattern Change in mobility (problems wtih walking, standing up, dizziness, falling) Change in appetite (increased/decreased appetite, nausea, dry mouth, thirst) Change in energy level (more tired than usual or more energy than usual) Change in sleeping pattern (difficulty staying awake/falling asleep) Change in comfort level (unusual discomfort, pain, headache) Other SECTION D NO ACTION Stop here CONTACT your supervisor Medication Problem A.C.T.I.O.N. Plan 2004 Canadian Pharmacists Association. All rights reserved. 19
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21 CHANGE IN CLIENT MEDICATION Any changes... Are you aware or have you been informed of any recent changes in the client s medication either after a visit to the doctor or discharge from the hospital? SECTION E NO ACTION Stop here CONTACT your supervisor Medication Problem A.C.T.I.O.N. Plan 2004 Canadian Pharmacists Association. All rights reserved. 21
22 This program was developed by the Canadian Pharmacists Association in collaboration with the Canadian Association for Community Care and Canada s Association for the Fifty-Plus. The project was funded by the Population Health Fund, Health Canada. PROJECT STEERING COMMITTEE Kirsten Woodend, Co-chair, Canadian Pharmacists Association Taylor Alexander, Co-Chair, Canadian Association for Community Care Judy Cutler, CARP, Canada s Association for the Fifty-Plus Barbara Ryan, Access Health Care Services Inc. Jeannine Boyd, Canadian Home Care Association Ron Silver, Westboro Pharmasave Barb Farrell, Sisters of Charity of Ottawa Health Service Linda MacKeigan, University of Toronto Nancy Unsworth, VON Ottawa Carleton Branch Andrea Moser, Family Physician, Care of the Elderly, Huntsville Malcolm Anderson, Queen s University Stephanie Gariepy, Access Health Care Services Inc. Anne Dawson, Seniors Representative Barbara Levitan, ParaMed Home Health Care Sarah Mifflin-Bloom, Project Coordinator, Canadian Pharmacists Association Sandra Young, Research Assistant, Canadian Pharmacists Association Lyne Stuewe, Research Assistant, Canadian Pharmacists Association The Medication Problem A.C.T.I.O.N. Plan kit contains information representing the opinions and experience of health care professionals who developed the program. Every effort has been made to provide useful and accurate information. However, the Canadian Pharmacists Association, the Canadian Association for Community Care and Canada s Association for the Fifty-Plus are not responsible for the use or the consequences of the use of the information in this program. Users are advised that the information presented is not intended to be all inclusive. Consequently, health care professionals and other users of the program are encouraged to seek additional and confirmatory information to meet their practice requirements as well as the information needs of their patients. 22 Medication Problem A.C.T.I.O.N. Plan 2004 Canadian Pharmacists Association. All rights reserved.
23 Medication Problem A.C.T.I.O.N. Plan A Resource Guide for Home Support Workers Medication Problem A.C.T.I.O.N. Plan A Resource Guide for Home Support Workers 1785 Alta Vista Drive, Ottawa, ON K1G 3Y6 Tel Toll Free Fax hc@pharmacists.ca Medication Problem A.C.T.I.O.N. Plan 2004 Canadian Pharmacists Association. All rights reserved. 23
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