IQ Level 2 Certificate in Understanding the Safe Handling of Medicines (QCF) Specification

Transcription

1 IQ Level 2 Certificate in Understanding the Safe Handling of Medicines (QCF) Specification Regulation No: 601/2010/1 Page 1 of 25 IQB/0.2/211 Version /01/2014 Author AW

2 Contents Page Industry Qualifications... 3 Introduction... 3 About this Qualification... 4 Structure (Credit, Rules of Combination, Guided Learning Hours)... 4 Delivery... 4 Assessment... 4 Age range and Geographical Coverage... 4 Learner entry requirements... 4 Tutor requirements... 5 Centre Requirements... 5 Unit 1: Understand medication and prescriptions Y/601/ Unit 1 Guidance on Delivery and Assessment... 9 Unit 2: Supply, storage and disposal of medication K/601/ Unit 2 Guidance on Delivery and Assessment Unit 3: Understand the requirements for the safe administration of medication T/601/ Unit 3 Guidance on Delivery and Assessment Unit 4: Record-keeping and audit processes for medication administration and storage F/601/ Unit 4 Guidance on Delivery and Assessment Resources Page 2 of 25 IQB/0.2/211 Version /01/2014 Author AW

3 Industry Qualifications IQ is approved by the UK s national regulator of qualifications Ofqual. It was launched in 2011 to provide users and learners with the objective of achieving the highest levels of assessment integrity, customer service and sector engagement. Uniquely, it is a membership based awarding organisation bringing together the best of UK vocational education in a not for profit environment. Further information can be found on the IQ web-site Introduction This specification is intended for trainers, centres and learners. General information regarding centre approval, registration, assessment papers, certification, reasonable adjustments, special consideration, appeals procedures are available from the website. This document should be read in conjunction with the IQ QMS Centre guide available from the website. Website: Enquiries: Page 3 of 25 IQB/0.2/211 Version /01/2014 Author AW

4 About this Qualification The IQ Level 2 Certificate in Understanding the Safe Handling of Medicines (QCF) develops the learners' understanding of different types of medication and how they are used. Learners will develop knowledge of the procedures for obtaining, storing, administering and disposing of medicines, medicine related legislation, audit processes and issues of responsibility and accountability. The objectives of the qualification are to prepare learners for further learning, prepare them for employment and support a role in the workplace. Structure (Credit, Rules of Combination, Guided Learning Hours) To be awarded this qualification, learners must achieve 13 credits from the four mandatory units. Unit Credit Guided Learning Hours Understand medication and prescriptions Y/601/ Supply, storage and disposal of medication K/601/ Understand the requirements for the safe administration of medication T/601/9576 Record-keeping and audit processes for medication administration and storage F/601/9578 Delivery Total Guided learning hours are 110. It is the responsibility of training centres to decide the appropriate course duration, based on their learners ability and level of existing knowledge. It is possible, therefore, that the number of Guided Learning Hours can vary from one training centre to another according to learners' needs. Guided learning hours are all times when a member of provider staff is present to give specific guidance towards the learning aim being studied on the programme. This definition includes lectures, tutorials, and supervised study. It does not include hours where supervision or assistance is of a general nature and is not specific to the study of the learners. Assessment Assessment for this qualification is by portfolio of evidence. Age range and Geographical Coverage This qualification is approved for learners 18 plus in England, Wales and Northern Ireland. Learner entry requirements There are no formal entry requirements. However, learners should be able to work at level 1or above and be proficient in the use of English Language. Progression Learners who achieve this qualification could progress on to further training or education and go on to qualifications in health and social care, such as: IQ Level 2 Diploma in Health and Social Care (Adults) for England (QCF) IQ Level 3 Diploma in Health and Social Care (Adults) for England (QCF) Page 4 of 25 IQB/0.2/211 Version /01/2014 Author AW

5 Level 2 Certificate in the Principles of Dementia Care (QCF) Level 2 Certificate in Understanding Working in Mental Health (QCF) Level 3 Certificate in the Principles of End of Life Care (QCF) Tutor requirements All trainers delivering this qualification must have: Appropriate teaching qualification e.g. PTLLS Subject knowledge Centre Requirements Centres must be approved by IQ in order to offer this qualification. Page 5 of 25 IQB/0.2/211 Version /01/2014 Author AW

6 Unit 1: Understand medication and prescriptions Y/601/9571 Guided Learning Hours: Unit Level: Unit Credit: Unit grid: Learning outcomes/assessment Criteria/Content Learning Outcome - The learner will: Assessment Criteria - The learner can: Contents: 1.Understand the use of different types of medication 2.Understand how medicines are classified 1.1 Identify the different types of medicines available and why they are used 1.2 Describe the different routes by which medicines can be administered 2.1 Describe the following classifications of medicine: General Sales List (GSL) Pharmacy (P) Prescription Only Medicines (POM) controlled drugs Different types of medicines: To include: antacids; analgesics; anticoagulants; antihistamines; antimicrobials (antibiotics, anti-fungals, anti-virals); anti-inflammatory (steroidal, non-steroidal); cardiovascular; cytotoxic; diuretics; hormones; laxatives; psychotropics (antidepressants, mood stabilisers, anti-anxiety). Administration routes: To include: mouth as tablets, capsules, liquids; inhalation (nasal, oral); injection (intravenous, subcutaneous, intramuscular, epidural); topical (creams, ointments, lotions); drops to ear, nose, eyes; rectal (suppositories, enemas); vaginal (pessaries, creams). Classification of medicines: To include: descriptions and examples of General Sales List (GSL) for general sale; Pharmacy (P) in a pharmacy without prescription, supervised by a pharmacist; prescription only medicine (POM), prescription issued by doctors, dentists, nurse independent prescribers, pharmacist independent prescribers; controlled drugs by legislation etc. Page 6 of 25 IQB/0.2/211 Version /01/2014 Author AW

7 3.Understand legislation and guidelines related to medication 4.Understand the roles of self and others in the medication process 3.1 Outline the key points of current legislation and guidance relating to medication 3.2 Outline the consequences of not following relevant legislation and guidance 4.1 Outline the roles of self and others in the process of: prescribing medication dispensing medication obtaining and receiving medication administering medication 4.2 Identify the limitations of own role in relation to the medication process Current legislation and guidance relating to medication: To include: the Medicines Act 1968 and amendments, Misuse of Drugs Act 1971 and amendments, Health and Safety at Work Act 1974, COSHH Regulations 1999, Care Standards Act 2000 (receipt, storage and administration of medicines), Domiciliary Care Agencies Regulations 2002, Access to Health Records Act 1990, Data Protection Act 1998, Hazardous Waste Regulations 2005; guidance: Administration and Control of Medicines in Care Homes and Children s Services June 2003, The Handling of Medicines in Social Care (Royal Pharmaceutical Society 2007), Standards for Medicines Management (Nursing and Midwifery Council 2004), organisational code of conduct, procedures and guidelines. Consequences of not following legislation and guidance: To include: outline of the risks to life/ health/ wellbeing of individuals; risk to health/ wellbeing of carer; disciplinary proceedings; legal proceedings etc. Roles of self and others: Prescribing medication: Doctors, dentists, nurses, independent prescribers, pharmacists, managers, social care staff, ancillary staff, clerical staff/ administrators, family members and individuals. Dispensing/ obtaining/ receiving medication: Carrying out checks e.g. matching the medicine received to the individual s name, recording receipts using appropriate documentation, storage instructions, confidentiality etc. Administering medication: E.g. individuals managing own medications, consent, following instructions in care/ support plans and Medication Administration Record (MAR), recording administration; reporting concerns to manager/ supervisor who will seek advice from GP, pharmacist or nurse. Limitations of own role: Covering: training requirements, following written instructions in care/support plan and MAR, requirements for training to give oral medicines, ear, nose and eye drops, inhalers and topical medicines, specialised training e.g. for suppositories, enemas and injections; following organisational guidelines; decisions on take as required medication; all medication used only from original container or in a multi-compartment compliance aid filled by pharmacist or after Page 7 of 25 IQB/0.2/211 Version /01/2014 Author AW

8 5.Know how to access information about medication 4.3 Identify ways to get support and information in the workplace related to medication 5.1 Identify the key approved national sources of information about medication 5.2 Describe the information which should be supplied with medication 5.3 Describe why it is important to seek information from the individual about their medication and condition specialised training. Support and information in the workplace: To include: patient information leaflets; medication administration records, care-plans, support from manager/ supervisor; pharmacist; organisational policies, procedures and agreed ways of working, relevant documentation etc. Key approved national sources of information: Prescriber; pharmacist; publications e.g. British National Formulary, MIMS; National Electronic Library for Medicines, NHS Choices etc. Information which should be supplied with medication: Name of individual medication is supplied to, date, how to store, dose, number of doses per day, how medication is taken, when it should be taken (e.g. at night, in the morning, with/without food), identification of medicine, possible side effects etc. Importance of seeking information from an individual about their medication and condition: To include: individual may have self medicated using products from pharmacy or on general sale; condition/ symptoms may have changed; incidence of adverse side effects of medication etc. Page 8 of 25 IQB/0.2/211 Version /01/2014 Author AW

9 Unit 1 Guidance on Delivery and Assessment Delivery This unit develops learners' knowledge of different types of medication and their uses, the classification of medicines, related legislation and guidelines. Their role and those of others in prescribing and administering medication are covered and in particular the scope and limitations of those roles. They will also develop the key knowledge and understanding which underpins the practices and procedures for administering medicines safely. Assessment This unit is about knowledge based on Skills for Health National I Occupational Standards. Assessment is by portfolio (internally set and marked and quality assured by IQ). An Achievement Record for this qualification is available from the website/ on request. All assessment criteria must be met and mapped and the location of the evidence must be indicated in the achievement record. All learning outcomes must be assessed using methods appropriate to the assessment of knowledge and understanding; these can be assessed by a variety of methods including: Question and answer test Multiple choice questions Question and answer verbal (ensure records are kept) Essay Other Links This unit maps to Skills for Health National Occupational Standards - units CHS1, CHS2, CHS3 and units HSC 24, HSC221 and HSC236. Additional information 1.1 types : antibiotics; antihistamines; analgesics; antacids; anti-coagulants; psychotropic medicine; diuretics; laxatives; hormones; cytotoxic medicines 3.1 legislation and guidance : this should be current and up-to-date (for example at the time of printing that produced by the Royal Pharmaceutical Society of Great Britain, Access to Health Records Acts etc.) 4.3 information : e.g. agreed ways of working 5.1 sources : e.g. prescriber, pharmacist, publications and websites (note a wide range of publications and internet sources are available related to medication, it is important to ensure that information learners reference is related to the United Kingdom (UK) and reflects UK requirements) Page 9 of 25 IQB/0.2/211 Version /01/2014 Author AW

10 Unit 2: Supply, storage and disposal of medication K/601/9574 Guided Learning Hours: Unit Level: Unit Credit: Unit grid: Learning outcomes/assessment Criteria/Content Learning Outcome - The learner will: Assessment Criteria - The learner can: Contents: 1. Understand how medicines are supplied and obtained 1.1 Identify the purpose of a prescription The purpose of a prescription: To permit the named individual to obtain a licensed medicine that is regulated; covering: distinct from over-thecounter drugs which can be obtained without a prescription, instructions, spectacles/ surgical appliances (by doctors, dentists, nurse prescribers or pharmacist prescribers) dose, frequency and route of administration. 1.2 List the information that has to be checked and recorded once medication has been received 1.3 Describe the procedure for: transferring medication from one setting to another obtaining medication in an emergency situation obtaining medication as and when required (PRN) renewal of prescription Information that has to be checked/ recorded once medication has been received: To include: matching dispensed medicine to the medication and dosage on the prescription; information: name of person to whom the prescription has been issued, date of prescription, expiry date, dosage, frequency, timing e.g. night, morning, before/ after food, route of administration, storage e.g. temperature etc. Procedure for transferring medication from one setting to another: Transferring in line with agreed ways of working/ policy; destinations (e.g. day-care, respite-care, residential-care); methods (e.g. with individual, in original container etc.); copy of administration record for audit trail. Procedure for obtaining medication in an emergency situation: Meeting agreed ways of working for receiving/ recording; new medications; process for prescriptions for acute medication; recording for audit trail. Procedure for obtaining medication as and when required (PRN): Meeting agreed ways of working; procedures for renewal of prescription; audit trail e.g. recording; control of stock e.g. check frequency of issue, expiry date, reducing over ordering etc. Procedure for renewal of a prescription: Meeting agreed ways of working; repeat prescription from the surgery; pharmacy collection service; time required to process renewal; changes to prescription; audit trail e.g. Page 10 of 25 IQB/0.2/211 Version /01/2014 Author AW

11 2.Know the requirements for storing medication 2.1 Describe the requirements of medication storage within the following settings: clinical settings residential care day services domiciliary care non care settings 2.2 Explain how controlled drugs should be stored within the settings listed in Outline how to support individuals to store medication securely for self-administration recording. Medication storage in a range of settings : Clinical settings: Medicines stored centrally in locked cabinet/cupboard, controlled access, security system, medicines in original containers as supplied/ labelled by the pharmacist or dispensing GP practice and stored at correct temperature as stated on patient information leaflet. Residential care: Risk assessment required, personal lockable cupboards for individuals to self medicate and/or central storage of medicines in locked cupboard accessible only to staff who administer medicines, key security systems etc. Day services: Individuals retain own medicines; day care staff may accept responsibility for giving medicines, provide storage facilities, arrange for a specially dispensed supply etc. Domiciliary care: Individual makes decision about how they will store medication. Non-care settings: Agreed ways of working according to setting (e.g. education facilities, religious establishments, voluntary agencies etc.). Storage of controlled drugs: Reasons for the additional safety precautions/ requirements in each setting. Clinical and residential care: Conforming to standards specified in The Misuse of Drugs (Safe Custody) Regulations 1973, can only be opened by authorised person (e.g. pharmacist, registrant in charge, a person working under their authority or an individual who is self medicating can hold their own supply of controlled drugs (CDs) in their personal lockable cupboard). Day services: If accepting responsibility for giving medicines (in locked cupboard which conforms to standards). Domiciliary care: No special cupboards are required. Non-care settings: Local operational procedures. Supporting individuals to store medication securely for self-administration: To include: risk assessment, an individual who is self medicating can hold their own supply of controlled drugs (CDs) in their personal lockable cupboard), monitoring etc. 2.4 Give examples of the types of medication that have Medication with specific storage requirements: To include: some antibiotics, vaccines, insulin, eye drops, medication awaiting disposal. Page 11 of 25 IQB/0.2/211 Version /01/2014 Author AW

12 specific storage requirements 3.Understand the requirements for the safe disposal of medication 3.1 Give examples of why drugs might need to be disposed of 3.2 Outline the procedures for the safe and secure disposal of medication and equipment for: nursing care settings care settings domiciliary care settings controlled drugs 3.3 Explain why it is important to dispose of medication and equipment in line with agreed procedures Reasons for disposal of drugs: To include: prescription for medication altered or discontinued; medication out of date; damaged/ compromised medication; no longer needed e.g. death of individual. Procedures for the safe and secure disposal of medication/ equipment: To include: current local and national organisational procedures; recording of disposal; equipment (e.g. syringes, needles). Nursing care settings: Returned to pharmacy Care settings: Collection of waste medication/ clinical waste products by licensed waste disposal company. Domiciliary care settings: Return to supplier. Controlled drugs: Procedures for disposal in care homes registered to provide nursing care and other settings. Importance of disposing of medication/ equipment in line with agreed procedures: To include: meeting legal requirements; protecting individuals (ensuring medication is not taken accidentally by others, prevent infection from needles); prevent theft/ misuse and protecting the environment. Page 12 of 25 IQB/0.2/211 Version /01/2014 Author AW

13 Unit 2 Guidance on Delivery and Assessment Delivery This unit develops the learners' knowledge of how medicines are supplied, the requirements for storage of different types of medication and the requirements for the safe disposal of medication. It covers the responsibilities of staff in relation to these procedures. Assessment This unit is about knowledge based on Skills for Health National Occupational Standards. Assessment is by portfolio (internally set and marked and quality assured by IQ). An Achievement Record for this qualification is available from the website/ on request. All assessment criteria must be met and mapped and the location of the evidence must be indicated in the achievement record. All learning outcomes must be assessed using methods appropriate to the assessment of knowledge and understanding; these can be assessed by a variety of methods including: Question and answer test Multiple choice questions Question and answer verbal (ensure records are kept) Essay Other Links This unit maps to Skills for Health National Occupational Standards - units CHS1, CHS2, CHS3 and units HSC 24, HSC221 and HSC236. Page 13 of 25 IQB/0.2/211 Version /01/2014 Author AW

14 Unit 3: Understand the requirements for the safe administration of medication T/601/9576 Guided Learning Hours: Unit Level: Unit Credit: Unit grid: Learning outcomes/assessment Criteria/Content Learning Outcome - The learner will: Assessment Criteria - The learner can: Contents: 1. Understand the preparations to be taken prior to administering medication 1.1 Describe the roles and responsibilities of staff involved in: supporting individuals to take medication administering medication using specialised techniques to administer medication 1.2 Explain why it is important to follow instructions on the preparation and use of medication and the method of administration from the: individual manufacturer pharmacist organisation 1.3 Explain why it is important to gain the individual's consent prior to administering medication 1.4 Identify the information that should be given to individuals to enable them to give valid consent Roles and responsibilities of staff: To include: agreed ways of working; supporting individuals to take medication, promoting independence/ freedom of choice, administering medication using specialised techniques (e.g. informed consent, safety and hygiene, care planning); importance of training, maintaining dignity and meeting personal and cultural preferences. Importance of following instructions on the preparation and use of medication: To include: maximising benefits of medication, preventing harm, obtaining information from individuals (e.g. side effects, previous adverse reactions, personal preferences); information from the manufacturer/ pharmacist (e.g. timing of doses, storage, contraindications, side effects, adverse reactions, precautions needed by care workers); information from organisation (e.g. agreed ways of working). Important gaining the individual s consent before administering medication: Adhering with agreed ways of working; obtaining informed consent; promoting individual's rights and action to take if this is not possible; respecting rights of the individual to give consent to medication etc. Information that should be given to individuals: Why medication is necessary, benefits, possible side effects, risks of adverse reactions, how medication is taken, how long the medication will be required for and implications of not taking medication. Page 14 of 25 IQB/0.2/211 Version /01/2014 Author AW

15 2.Understand how medication is administered safely and in a way that meets individual needs 1.5 Explain why it is important to agree with the individual: the medication to be taken the support to be provided in relation to their own needs and preferences 1.6 Describe how and why the following should be checked prior to administering medication: identity of individual Medication Administration Record (MAR) medication equipment environment 1.7 Describe the hygiene precautions that should be taken when preparing to administer medication in relation to: the individual receiving medication self and others who may be affected 1.8 Explain why it is important to ensure that the correct dose, of the correct medication, is given to the correct person at the correct time, by the correct route or method 2.1 Describe a range of aids and equipment available for administering medicine 2.2 Give positive and negative points of using drug administration systems Importance of agreeing with the individual: Covering: the specific medication to be taken, the support to be provided in relation to the needs/ preferences of the individual, respecting individual s contribution to their own care/support, self-medication and changes to condition/ support needs. Checks prior to administering medication: To include: following agreed ways of working, reasons, ways to confirm identity, suitable environments, correct medications, doses at correct time/ time interval, administration routes, special precautions, labelling, the Medication Administration Record (MAR), updating records etc. Hygiene precautions: Following agreed ways of working, hygiene procedures, using standard precautions to minimise/ prevent infection and cross infection (e.g. hand washing, use of personal protective equipment) correct disposal (e.g. bags, sharps bins). Importance of ensuring that the correct dose, of the correct medication, is given to the correct person at the correct time, by the correct route or method: Including: protecting individuals from harm, maximising benefits of medication and potential consequences of not following instructions. Range of aids/ equipment available for administering medicine: E.g. medicine pots, measuring spoons, oral syringes, nebulisers and Monitored Dosage Systems (MDS). Using drug administration systems: Positive points: Efficient for regular medication, monitoring use for organising repeat prescriptions, providing evidence of administration of dose, accuracy and recording of self-medication. Negative points: Restricted to tablets/ capsules only, not suitable for all medicines or for medication taken as and when' or which is varied. Page 15 of 25 IQB/0.2/211 Version /01/2014 Author AW

16 3.Understand how to support individuals to administer their own medication 2.3 Give examples of special instructions that might need to be followed when giving medication 2.4 Describe how to support individuals to take medication whilst promoting privacy, dignity, hygiene, safety and active participation 2.5 Explain how to record the outcomes following administration of medication 2.6 Give examples of when it may be necessary to seek additional support and guidance and who should provide it 2.7 Identify the key requirements of legislation and guidance in relation to the administration of medicine 3.1 Explain why it is important to support an individual to administer their own medication Special instructions: Covering: times to be taken (night, morning, before, with or after food), methods (swallowed whole, with water) and varying according to test results (blood tests, checking of pulse rates). Supporting individuals to take medication whilst promoting privacy, dignity, hygiene, safety and active participation: To include: agreed ways of working, confidentiality, reference to care/ support plans, sensitivity to personal, religious and cultural preferences and use of reminders/ compliance aids. Recording the outcomes following administration of medication: To include: agreed ways of working, MAR, outcomes, taken/ declined medication, difficulties experienced when/ after taking medication (vomiting after taking medication, adverse reaction) etc. Additional support and guidance and who should provide it: To include: when individual declines/ cannot take the medication, adverse reactions, difficulties with instructions, mislaid/ spilled medication and who to contact (managers, nurses, senior staff, prescribers, pharmacists etc.). Key requirements of legislation and guidance: Legislation: Relevant sections of Care Standards Act 2000 (receipt, storage and administration of medicines); Medicines Act 1968 and amendments, Misuse of Drugs Act 1971 (Controlled Drugs) and amendment etc. Guidance: Administration and Control of Medicines in Care Homes and Children s Services June 2003, The Handling of Medicines in Social Care (Royal Pharmaceutical Society 2007), Standards for Medicines Management (Nursing and Midwifery Council 2004); internal codes of conduct, guidelines and procedures. Importance of supporting an individual to administer their own medication: To include: individual as active partner in own care and support; maintain dignity; encourage independence and support freedom of choice. Page 16 of 25 IQB/0.2/211 Version /01/2014 Author AW

17 3.2 Identify key aspects of legislation and guidelines related to self-administration of medication 3.3 Explain how to carry out a risk assessment for an individual who prefers to administer their own medication 3.4 Outline the conditions that must be in place when a client self-medicates 3.5 Describe the records that must be kept in relation to selfmedication Key aspects of legislation and guidelines related to self-administration of medication: Legislation: Relevant sections of Care Standards Act 2000 (receipt, storage and administration of medicines); Medicines Act 1968 and amendments, Misuse of Drugs Act 1971 (Controlled Drugs) and amendment, Guidance: Administration and Control of Medicines in Care Homes and Children s Services June 2003, The Handling of Medicines in Social Care (Royal Pharmaceutical Society 2007), Standards for Medicines Management (Nursing and Midwifery Council 2004); internal codes of conduct, guidelines and procedures. Risk assessment for an individual who prefers to administer their own medication: E.g. recognising hazards, persons at risk of harm, controlling risk, evaluating risk and recording support required in the care plan. Conditions that must be in place when a client self-medicates: To include: requirements for risk assessment and regular reassessment, consent of clients and client understanding of how to store medication; ensuring the client receives information about: medication, storage, common side effects and how to address them, special instructions and obtaining further supplies; aids: alarm clock, reminders, enlarged labels, eye drop dispensers etc. Records that must be kept in relation to self-medication: To include: following agreed ways of working, recording of dates and quantities of medication given to individuals, regular monitoring of the individual s condition, review and reassessment. Page 17 of 25 IQB/0.2/211 Version /01/2014 Author AW

18 4.Understand the procedures to follow when there are problems with the administration of medication 5.Understand how the effects of medication are monitored 4.1 Describe the actions to be taken in line with agreed ways of working in relation to the following situations: errors administering medication individual declines prescribed medication medication is compromised discrepancies in records administering controlled drugs 4.2 Outline how to support an individual who has difficulty taking medication in the form it has been prescribed 4.3 Explain how to support the best interests of individuals who are unable to consent to prescribed medication 5.1 Describe how to monitor the effects of medication on the individual and the condition it has been prescribed for Actions to be taken in line with agreed ways of working: Errors administering medication: Incorrect dose, missed dose, wrong individual; recording and reporting using MAR/ incident report form. Prescribed medication declined: Follow written procedure; record on MAR; consulting managers, nurses and senior staff. Compromised medication: Why it is compromised (e.g. out-of-date, damaged, tampered with, incorrect storage), where to seek advice and reporting and recording actions. Discrepancies in records: E.g. label attached by the pharmacist or dispensing GP has been changed, ambiguous instructions on MAR; where to seek advice and reporting and recording actions. Administering controlled drugs: Following agreed common procedures for all drugs, checking identity of the individual, checking medication, dose, time and administration route; recording both on MAR and Controlled Drug (CD) record book; updating balance remaining for each drug residential setting witnessed by trained member of staff. Support an individual taking medication: Covering: care/support plans and the range of options which have been agreed with prescriber (e.g. offer water/ food, split or crush tablet). Supporting the best interests of individuals unable to consent to medication: To include: agreed ways of working; Mental Capacity Act 2005; assessment by healthcare professional of the individual; taking into account case history, cultural or religious values; documenting decisions. Monitoring effects of medication: To include: agreed ways of working, recording/ reporting, regular observations (pulse, blood pressure and breathing) and feedback by individual. 5.2 Identify common side effects of widely used medicines Common side effects of widely used medicines: E.g. antibiotics, antihistamines, aspirin, non-steroidal anti-inflammatory drugs, diuretics, antidepressants and statins. 5.3 Explain what is meant by an adverse reaction Adverse reaction: Including: intolerance, allergic reactions and reactions outside of documented side effects. Page 18 of 25 IQB/0.2/211 Version /01/2014 Author AW

19 5.4 Describe the actions to be taken if side effects or an adverse reaction to medication are suspected 5.5 Outline how medication reviews should be carried out in line with national guidelines 5.6 Explain how the outcomes of monitoring should be recorded and reported Actions to be taken on side effects: To include: agreed ways of working, who to seek advice from and accurately recording actions taken. How medication reviews should be carried out in line with national guidelines: Following National Service Framework/ National Minimum Standards; covering: confidential regular reviews doctor or nurse, annual reviews for clients over 75/ on long term medication, individuals raising concerns, recording outcomes in medical records etc. Recording and reporting outcomes of monitoring: To include: following agreed ways of working; MAR, care/ support plans etc. Page 19 of 25 IQB/0.2/211 Version /01/2014 Author AW

20 Unit 3 Guidance on Delivery and Assessment Delivery This unit develops the learner s knowledge and understanding of the preparations to be taken prior to administering medication, how medication is administered safely and in a way that meets individual needs, how to support individuals to administer their own medication, the procedures to follow when there are problems with the administration of medication and how the effects of medication are monitored. Assessment This unit is about knowledge based on Skills for Health National Occupational Standards. Assessment is by portfolio (internally set and marked and quality assured by IQ). An Achievement Record for this qualification is available from the website/ on request. All assessment criteria must be met and mapped and the location of the evidence must be indicated in the achievement record. All learning outcomes must be assessed using methods appropriate to the assessment of knowledge and understanding; these can be assessed by a variety of methods including: Links Question and answer test Multiple choice questions Question and answer verbal (ensure records are kept) Essay Other This unit maps to Skills for Health National Occupational Standards - units CHS2, CHS3 and units HSC21, HSC 24, HSC221 and HSC236. Additional information 1.1 specialised techniques : e.g. injections, rectal administration, medication via PEG tube, inhalation, Monitored Dose Systems 5.5 national guidelines : e.g. National Service Framework, National Minimum Standards Page 20 of 25 IQB/0.2/211 Version /01/2014 Author AW

21 Unit 4: Record-keeping and audit processes for medication administration and storage F/601/9578 Guided Learning Hours: Unit Level: Unit Credit: Unit grid: Learning outcomes/assessment Criteria/Content Learning Outcome - The learner will: Assessment Criteria - The learner can: Contents: 1. Understand the audit process in relation to medication transactions and stock levels 2. Understand how information is recorded and confidentiality maintained 1.1 Describe the requirements for medication transactions and stock levels in relation to: the role of the pharmacist manufacturer's instructions organisational policies inspection and external audit legal requirements 1.2 Explain how medication is recorded on: receipt administration disposal 2.1 Describe the key aspects of record keeping in an environment where medicine is used in relation to: documentation correct recording signatures Requirements for medication transactions and stock levels: To include: role of pharmacist (dispensing prescriptions, repeat prescriptions and pharmacy collection services); manufacturers' instructions (contraindications, expiry date, patient information leaflet, side effects storage); organisational policies and procedures (national/ local guidelines, agreed ways of working, recording stock levels); external audit/ inspection by Care Quality Commission Standards, agreed ways of working to meet requirements of Medication Administration Records (MAR) and legal requirements (Care Standards Act 2000 and the Medicines Act 1968). How medication is recorded: Including: on receipt (checking date, matching the prescription name to the name on the medication, matching the medication to the prescription, expiry dates, storage, dose, timing and route of administration); administration (noting date and time, if medication is declined, any assistance given and signatures); disposal (name of medication, reason for disposal, date and method of disposal). Key aspects of record keeping: To include: following agreed ways of working; recording requests for medication, medication received, administered or destroyed; documentation (MAR completed legibly in ink, correctly and clearly to prevent misunderstanding, signatures and dates) and accurate recording at all stages (on receipt, at administration, if disposed of with signatures and dates and second signature for Controlled Drugs). Page 21 of 25 IQB/0.2/211 Version /01/2014 Author AW

22 2.2 Outline the requirements of the regulatory authorities in relation to medication record keeping 2.3 Identify what information needs to be recorded when compiling a medicine profile for a client 2.4 Explain why all records relating to medicines must be kept up-to-date 2.5 Outline the key points of legislation relating to confidentiality in relation to: who records what, where and when who has access to records individual rights maintaining confidentiality Requirements of the regulatory authorities: To include: record keeping in line with the requirements of Care Quality Commission Regulations 2009; Misuse of Drugs Act Regulations 2001 for Controlled Drugs, Controlled Drugs record book etc. Information to be recorded when compiling a medicine profile: Name; age; weight; any known allergies; all medicines prescribed (including details of dose, duration of course of treatment, administration route and special instructions); previous side effects experienced or adverse reactions and details of support required for self medication. Records relating to medicines must be kept up to date: To include: preventing errors/ harm to clients from missed or duplicate doses; informing changes in condition, side effects or adverse reactions; allowing for the correct client, medication, dose etc to be tracked; stock control and meeting legal, organisational and regulatory requirements. Key points of legislation relating to confidentiality of records: Covering relevant sections from current legislation: e.g. Access to Health Records Act 1990, Data Protection Act 1998, Human Rights Act 1998 etc. 3. Understand own role in relation to accountability and responsibility 2.6 Identify own role in maintaining confidentiality and keeping information secure Own role in maintaining confidentiality and keeping information secure: To include: adhering to agreed ways of working, showing respect for the rights of individuals, storing records correctly (including MAR) etc. 3.1 Define the terms accountability and responsibility Accountability: The requirement to account for own conduct and justify it to others. Responsibility: Making decisions on own actions, acting independently. Page 22 of 25 IQB/0.2/211 Version /01/2014 Author AW

23 3.2 Explain the importance of accountability in relation to medication 3.3 Describe the responsibilities of different people involved with storage or administration of medication 3.4 Outline the potential consequences of not following agreed ways of working as set out by an employer Importance of accountability in relation to medication: Meeting legal requirements of proper patient care; ensuring care is auditable; evidence of practice: medication given, confirming client identity, details of dose, duration of course of treatment, administration route and special instructions, previous side effects experienced or adverse reactions and details of support required for self medication. Responsibilities of different people involved with the storage or administration of medication: To include: care workers, clients, nurses, pharmacists; following agreed ways of working; working within limits of own responsibility; responsibilities for administration; record keeping; ensuring storage complies with manufacturers' instructions; auditing of stock (e.g. keep account/ audit stocks); disposal of unwanted/ expired/ damaged medications; correct storage of Controlled Drugs store; administration (following instructions on MAR, with reference to care plan) etc. Potential consequences of not following agreed ways of working: Clients not receiving full effects of medication; adverse effects or side effects increased; serious or life-threatening harm to clients; disciplinary/ legal action; organisational failure to meet Care Quality Commission Standards; organisation performs badly or fails inspection etc. Page 23 of 25 IQB/0.2/211 Version /01/2014 Author AW

24 Unit 4 Guidance on Delivery and Assessment Delivery This unit develops the learner s knowledge of the audit process in relation to medication transactions and stock levels, how information is recorded and confidentiality maintained and their own role in relation to accountability and responsibility. Assessment This unit is about knowledge based on Skills for Health National Occupational Standards. Assessment is by portfolio (internally set and marked and quality assured by IQ). An Achievement Record for this qualification is available from the website/ on request. All assessment criteria must be met and mapped and the location of the evidence must be indicated in the achievement record. All learning outcomes must be assessed using methods appropriate to the assessment of knowledge and understanding; these can be assessed by a variety of methods including: Links Question and answer test Multiple choice questions Question and answer verbal (ensure records are kept) Essay Other This unit maps to Skills for Health National Occupational Standards - units CHS1, CHS2, CHS3 and units HSC21, HSC 24, HSC221 and HSC236. Page 24 of 25 IQB/0.2/211 Version /01/2014 Author AW

25 Resources Training Resources Centres may use their own, or published learner support materials in delivering the qualification. Whatever support materials centres choose to use, they should ensure that their delivery methodology adequately prepares the learner for assessment. IQ endorses published training resources and learner support materials by submitting the materials to a rigorous and robust quality assurance process, thus ensuring such materials are relevant, valid and appropriately support the qualification. Resources and Useful websites Health and Safety Executive Health and Safety Executive for Northern Ireland The National Archives (For all UK legislation) Equalities and Human Rights Commissions Skills for Health Care Quality Commission Association of Health Care Professionals Register of Regulated Qualifications British National Formulary Electronic medicines Compendium Royal Pharmaceutical Society of Great Britain Patient UK MIMS Page 25 of 25 IQB/0.2/211 Version /01/2014 Author AW