APPENDIX 4 Medication Competency Assessment Tool 1
Competency Assessment Tool Name of Trainee Name of Assessor Area Date of Assessment Competency Tool number: or 2 Joint Learning Disabilities Service ENVIRONMENTAL FACTORS YES NO COMMENTS 1. Free from distractions 2. Well lit area 3. Clean and tidy 4. Telephone/ Alarm system in place 5 & 6. Appropriate lockable case(if required) PREPARATION PRIOR TO ADMINISTRATION 1. Sort out medicine charts Safe environment Preparation of all equipment Knowledge of individual s and medication changes 2. Check communication book/diary/ care plan for drugs to be withheld Omit individual s on leave and mark Medicine charts with leave 3. Check all Medication Administration Charts; Identity/Individuals name Consent to treatment (MCA) Signatures, legibility, written correctly Dates/times Route of administration Names of drugs to be administered Special precautions 4. Prepare medicine tots/spoons or other equipment required 5. Offers glass of water or other appropriate drink checking no interactions YES NO COMMENTS 2
PREPARATION PRIOR TO ADMINISTRATION 6. Delegate someone to ask the individuals to be available to take their medication 7. Wash hands ADMINISTERING THE MEDICATION 1. Select designated area One individual at a time 2. Greet each Individual by name check identity with other staff if required 3. Select individual s medicine charts and nomad/boots system/bottles Check that the chart/cassette/bottles corresponds with the individuals name 4. Check week commencing dates on the nomad/boots system Right day/right time Check each tablet matches the description on the back of the medication cassette if applicable 5. Once the seal is broken transfer the medication into a medicine tot, If bottles dispense into lid then into tot. (Without touching the medication) 6. Before administering the medication make one final check that you have: the right person the right medication the right day/ time the right dose the right route 7. Offer the individual their medication, checking consent, offering them a drink of water or alternative method as identified in their care/support plan. YES NO YES NO COMMENTS COMMENTS 3
8. Administering medication in liquid form. Check expiry date on the bottle Always ensure that new bottles are marked with the date of opening (Record the new expiry date as per local policy) Check the MAR chart as with other medications and follow the procedure Check the label on the bottle corresponds with the Mar chart before administering. Before pouring always shake the bottle vigorously so that the correct strength of liquid is administered (Unless otherwise stated) When pouring liquids always pour away from the label Ensure you have dispensed the correct amount in mg/mls Pour the liquid into the correct medicine tot that is marked in mls Clean the bottle before replacing in the medicine cupboard To administer follow all previous steps for administration of medication. 9. Applying external/topical applications Ask the individual where they wish to have the application applied (Bedroom/Bathroom) Ensure curtains are closed and the room is warm The individuals may wish to apply the application themselves and should be supported in doing so by the staff member. Check the MAR chart as with other medications and follow the procedure Check the label on the box and tube corresponds with the Mar chart before applying Check expiry date and always date any new applications opened record new expiry date Joint Learning Disabilities Service 4
Check the instructions of how to apply Wash hands before and after application Gloves are to be worn After application clean any spillage off the tube or bottle. 10. Sign the MAR chart for each medication administered when you believe that it has been swallowed. Sign for any external applications 11. If any medication is not administered what ever the reason, complete the MAR chart as stated on the bottom of the chart. Fully document the reasons for this in the individual s care plan Inform the staff member in charge of the shift Inform all staff when handing over to next shift Observe the individual for any ill effects of refusal of treatment and record in the individual s care plan Staff should contact the pharmacist/gp or on call manager for advice. Follow procedure for spoilt medication. 12. Giving of PRN Medication: PRN medication may only be given under the guidance of the prescribing GP. The use of PRN medication must be clearly outlined in the individual s care plan. Staff members must follow the guidelines set up in the individuals care/support plan Prior to administering PRN medication all alternative strategies must be implemented If PRN medication is given : Fully document in the individual s care/support plan Sign the Mar chart and the individuals PRN chart, counting the stock level and record appropriately 5
HOUSE KEEPING YES NO COMMENTS 1. Tidy medicine cupboard and ensure that all medicine bottles are clean. Check medicine cupboard is locked, stocked and secured. 2. Wash and dry any equipment used glasses spoons etc.. 3. Check all medication administration charts are correct and that you have signed appropriately. 6
Questions for the Administration of Medication Assessment 1 Storage and Administration: (to include consent issues and covert use of medications) 1) How should medicines be stored? 2) What checks should be made before administering medicines? 3) What action would you take if the service user refused the prescribed medicine? 4) Why is it important not to touch medicines when administering them? 5) What are the key points to observe when administering liquid preparations? 7
6) What are the key points when applying creams / ointments? 7) What would need to have happened before covert administration of medicines would be permissible? 8) What do you understand by the term PRN medication and what information would you need before administering this? 9) What would you do if a service user dropped a tablet on the floor? 10) Why must we record that medicines have been given? Action points/additional Comments..... Signed Assessor Signed Trainee Thank-you for completing this audit of your practice. 8
Questions for the Administration of Medication Assessment 2 Safety Issues and Procedures: 1) What would you do if you lost the key to the medicine cupboard? 2) What would you do if a service user left home to go to day services before he had been given his medication for the morning? 3) What would you do if a service user told you she had bought a bottle of Night Nurse to help them sleep? 4) What would you do if you noticed that the tablets in a service user s cassette were a different colour than usual? 5) What is the procedure to follow if a medication error is made? Who needs to be informed? 6) What would you do if the fire alarm went off while you were administering medicines? 7) What is the procedure to follow if you notice that a service user s supply of medication is running low? 8) What would you do if a service user vomited half an hour after having his or her medication? 9) What would you do if a service user who was not prescribed Paracetamol asked for some for toothache? 10) What would you do if a service user s mother said she gave her son some of her sleeping tablets if he couldn t sleep when he went home for the weekend? Action points/additional Comments...... Signed Assessor Signed Staff member Thank-you for completing this audit of your practice. 9
Questions for the Administration of Medication Assessment 3 Uses and Effects of Medication: 1) Why must no more than eight Paracetamol be given in 24 hours? 2) How would you find out what a medicine is for and its side effects? 3) Why are some medicines given before meals and some with or after meals? 4) What is an anticonvulsant? 5) What action would you take if someone appeared to be suffering side effects of a newly prescribed medicine? 6) If a person who is prescribed an anticonvulsant does not have his / her medicine what is likely to be the effect? 7) Why is it important to ensure that someone who has been prescribed antibiotics completes the course? 8) Why would a person be prescribed Lactulose? 9) Why should we ensure that service users medicines go with them if they are admitted to hospital? 10) Why would the following medicines be prescribed and what are the common side effects? The following is only an example, please substitute these medicines with actual medicines used in your area. Sodium Valproate Frusemide Fybogel Chlorpromazine Action points/additional Comments...... Signed Assessor Signed Trainee Thank-you for completing this audit of your practice. 10
Competence Assessment Tool Name of Trainee Name of Assessor Area Date of Assessment The assessor must complete the following; Joint Learning Disabilities Service Questions Yes No Comments 1. Has this person completed all the practical sections of the competency tool successfully? 2 Has this person sufficient knowledge to ensure safe administration of medicines 3. Did they use safe practices through out the administration procedure 4.Did this person complete all the 3 assessment question sets correctly 5 Was this person able to read all medication labels correctly and read then back verbally? 6. Was this person able to understand all directions given by the labels and MAR charts 7. Was this person able to calculate mgs into mls for liquid medication Signed Assessor Signed trainee If you have answered YES to all of the above questions please complete section A below If you have answered NO to any of the above questions please complete section B below 11
SECTION A: I have supervised:. They have successfully administered medication to the individuals (Minimum of 1 individual) covering all of the criteria in the competency tool on this occasion. ( This tool must be done on 2 separate occasions and recorded on the tracker form) Therefore I feel that they are competent to administer medication. SIGNED ASSESSOR: FULL NAME AND DESIGNATION DATE; SIGNED TRAINEE: FULL NAME AND DESIGNATION: DATE: SECTION B: I have supervised:. They have NOT successfully administered medication to the individuals (Minimum of 1 individual) covering all of the criteria in the competency tool on this occasion. Therefore I feel that they are NOT competent to administer medication. SIGNED ASSESSOR: FULL NAME AND DESIGNATION DATE; SIGNED TRAINEE: FULL NAME AND DESIGNATION: DATE: NOW COMPLETE Administration of Medication Action Plan 12
Joint Learning Disabilities Service October 2011 13