9+Workshop+Four

CHCCS303A: Provide physical assistance with medication
This unit describes the skills and knowledge required by care or support workers to distribute and administer prescribed medications within a residential care facility under supervision. This function is undertaken in accordance with legislation and industry guidelines including:
 * ===Description===
 * Aged Care Act and Regulations
 * The Drugs and Poison's Act and other relevant legislation in the state/territory
 * Disability Services Act
 * The organisation's procedures and guidelines written in accordance the relevant legislation and reflecting the scope of role and accountability for the level of worker in that jurisdiction and
 * Other relevant guidance such as the Australian Pharmaceutical Advisory Council Integrated best practice model for medication management in residential aged care facilities

Element
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 * 1.Prepare for medication distribution and administration || **Performance Criteria** ||  ||   ||   ||
 * > 1.1 || Organization guidelines and protocols relating to the administration of medication, including practice boundaries, are identified. ||
 * > 1.2 || Demonstrate an understanding of organisational guidelines relating to administration of medication and the scope of the workers role in this is identified ||
 * > 1.3 || Lines of authority, accountability and actions to be taken in the case to handle contingencies are identified ||
 * > 1.4 || Check with supervisor that all dose administration aids are complete, ready for distribution and up to date ||
 * 1.5 || Check with supervisor the authority to proceed ||
 * 1.6 || Personal hygiene procedures are implemented according to organisational policy and procedure to ensure cross infection is minimised ||
 * 1.7 || Duty of care procedures are identified and implemented ||
 * 2. || Identify and prepare the resident/client for administration of medicine ||  ||   ||
 * 2.1 || Resident/client is identified, including those who self administer, according to the organisational procedures listed in the Range Statement ||
 * 2.2 || Resident/client is correctly identified, greeted and prepared for medication ||
 * 2.3 || Resident/client medication is checked according to the procedures identified in the organisational guidelines defined in the Range Statement ||
 * 2.4 || Administration procedure is explained to Resident/client. ||
 * 2.5 || Prior to giving medication the resident/client is observed to check for any physical or behavioral changes that may indicate a need to report to supervisor in accordance with organisational policies and procedures. ||
 * 3. || Administer and/or assist with prescribed medication administration following prescription ||  ||   ||
 * 3.1 || Medicines are prepared and given to client/resident according to the specific requirements of the form of the medication and in strict accordance with defined legislation and organisational procedures and according to prescriber's written instructions ||
 * 3.2 || All necessary checks are implemented to ensure right medication is given at the right time, to the right person, in the right amount, via the right route ||
 * 3.3 || Resident/client is assisted with the taking of medicines as required and according to documented procedures ||
 * 3.4 || Resident/client is supervised and observed when taking medication and ingestion or completion is confirmed ||
 * 3.5 || All required details of medication administration and other details are recorded according to the legislation and organisational procedures ||
 * 3.6 || Resident/client is observed for any of the possible medication effects listed in the Range Statement and reported to a supervisor or health professional ||
 * 3.7 || Used equipment and rubbish is collected and placed in appropriate receptacle ||
 * 4. || Comply with the organisation's procedures for handling the range of issues/contingencies which may arise ||  ||   ||
 * 4.1 || Resident/client refusal to take medication or incomplete ingestion is reported and addressed according to the organisation's procedures and protocols ||
 * 4.2 || Contaminated or out of date medicine is clearly identified and organisation's procedures for ensuing disposal are implemented ||
 * 4.1 || Changes in individual's condition are identified, reported, recorded and addressed according to organisational guidelines ||
 * 4.2 || Any inconsistencies observed (e.g. with the medication, the time or the resident/client) are reported promptly and actions taken in accordance with the organisation's procedures ||
 * 4.3 || All inconsistencies are documented and addressed according to organisational guidelines and procedures ||
 * 5. || Complete medication distribution and administration ||  ||   ||
 * 5.1 || The trolley and/or used medicine containers are managed in accordance with industry and the organisation's infection control guidelines ||
 * 5.2 || Arrangements and procedures for the replenishment of dose administration aids and supplies are followed ||
 * 5.3 || Medication charts are securely stored according to organisational procedures to ensure safety, security and confidentiality ||
 * 5.4 || All workplace drug storage procedures are routinely applied to ensure compliance with legislation, maximise security and prevent deterioration of drugs ||

Range statement
Delivery of this service to clients will be always in accordance with the organisation's guidelines, procedures and best practice and will be in accordance with the legislation relating to handling Drugs and Poisons in the State and Territory
 * Health Professionals include: ||  ||   ||
 * Registered Nurses
 * Medical practitioners
 * Pharmacist
 * Complementary Medicine Therapist (subject to organisational policies)
 * Dentist
 * Supervisor may include: ||  ||   ||
 * Health Professionals
 * Hostel supervisors or team leaders with experience and appropriate qualifications covering medication administration
 * Disability Support Workers
 * Supervision may be provided on site or through an on call system
 * Required medicines may include: ||  ||   ||
 * Medicines prescribed for client / resident by doctor or health professional and dispensed by pharmacist in dose administration aids
 * PRN medications as prescribed (and identified in drug sheet and/or care plan) and staff initiated medicines according to relevant legislation, organisational guidelines and doctors orders
 * Industry Standards include: ||  ||   ||
 * Aged Care Accreditation Standards
 * Disability Service Standards
 * Required equipment may include: ||  ||   ||
 * Nebuliser / Spacer
 * Gloves
 * Paper towels/ tissues
 * Lubricant
 * Mortar & Pestle
 * Tablet divider
 * Tea towel
 * Water pitcher
 * Tumblers
 * Aprons
 * Container for dirty spoons/dishes
 * Medicine dishes
 * Measuring cups
 * Drug sheets
 * Key to medication trolley/medication cupboard
 * Organisational guidelines for resident identification may include: ||  ||   ||
 * Referral to identification
 * Recognition by response
 * Confirmation from nursing/care staff
 * Dose administration aids may include: ||  ||   ||
 * Blister packs - single dose packs and multi-dose packs
 * Organisational guidelines for checking medication may include: ||  ||   ||
 * Checking medication is free from contamination
 * Checking that medicine, time and resident / client correlate with documentation
 * Checking dose administration aids for evidence of tampering
 * Prepared for medication may include: ||  ||   ||
 * Discussing procedure with resident
 * Encouraging resident participation
 * Adjusting posture
 * Seeking assistance from other staff
 * Providing privacy
 * Exposure of treatment area (in the case of lotion application)
 * Current needs may include: ||  ||   ||
 * Provision of approved PRN order or staff initiated medications according to relevant legislation, organisational guidelines and doctors orders
 * Assistance in taking medication such as assisting with grinding or dividing tablets
 * Assistance in securing resident cooperation
 * Medicine is prepared may include: ||  ||   ||
 * Dispensing tablets from dose administration aids into a medicine cup
 * Measuring liquid medicines into measuring cup / spoon
 * Dissolving powder in water
 * Placing medicine in nebuliser / spacer
 * Necessary checks include: ||  ||   ||
 * Checking medication against the requirements
 * Checking the patient details
 * Checking the chart
 * Checking for authorisation
 * References may include: ||  ||   ||
 * MIMS annual or drug reference guide
 * Drugs hotline/Drug Information Line
 * The form of the medicine may include: ||  ||   ||
 * Capsules
 * Ear-drops
 * Eye-drops
 * Inhalants
 * Liquid
 * Lotion and cream
 * Nose-drops
 * Patches
 * Powder
 * Tablets
 * Wafers
 * Possible changes in condition of the client that must be immediately reported to a supervisor or health professional may include, but are not limited to: ||  ||   ||
 * Changes to airway (e.g. choking), breathing (including slowed, fast or absent breathing, colour changes) or circulation (including unexpected drowsiness, colour change and absence of pulse)
 * Rash
 * Inflammation or redness
 * Swelling
 * Headache
 * Skin tone
 * Feelings of dizziness
 * Slurring of speech
 * Nausea and vomiting
 * Blurred vision
 * Confusion
 * Changes in behaviour
 * Anything that appears abnormal about the resident/client
 * Others as advised by a doctor or health professional
 * Incomplete ingestion includes: ||  ||   ||
 * Inability or difficulties in swallowing whole or divided tablets
 * Ejection of medicine
 * Vomiting
 * Refusal to take medications
 * Documentation for inconsistencies may include: ||  ||   ||
 * Incident reports
 * Medical charts
 * Progress Notes
 * Drug storage procedures include: ||  ||   ||
 * Acting in accordance with defined job role
 * Locking and storing drugs according to organisational policy and procedure
 * Industry Guidelines may include: ||  ||   ||
 * Australian Pharmaceutical Advisory Council //Integrated best practice model for medication management in residential aged care facilities//
 * State and Territory Health Department legislation, policies and guidelines
 * Organizational policies and procedures
 * Internal facility medication audits
 * Internal facility medication audits

Evidence guide
All workers will be assessed against their ability to provide administration of medications according to their defined job role and to always comply with legal and organisational policies and procedures including principles of best practice relating to: Competency in this unit should be assessed using all the relevant resources commonly provided in the residential care service setting. Specific tools may include: Assessment will include:
 * **Critical aspects of assessment:** ||  ||   ||
 * **Critical aspects of assessment:** ||  ||   ||
 * Following medication instructions
 * Occupational Health and Safety
 * Infection control including correct hand washing
 * Managing and reporting contingencies as they arise
 * Applying standard and additional precautions in infection control
 * Correct documentation of medication administered
 * All work will be in accordance with doctor's or health professional's instructions
 * **Essential skills:** ||  ||   ||
 * Skills listed below require specific levels of literacy and numeracy and physical capabilities. The skills required are the ability to correctly:
 * Read 'Patient Information sheets' for administration requirements for medicines
 * Use dose administration aids
 * Observe, report and record discrepancies in medicines, instructions and/or resident/client
 * Report any obvious changes in client's condition as listed in the Range Statement before, during and after self-medication to a supervisor and / or health professional so remedial action can be taken
 * Negotiate the physical assistance that can be provided
 * Use equipment listed in the range statement effectively and appropriately
 * Distribute medicines in a timely, appropriate and effective way to clients / residents with differing needs and according to form of medicine
 * Demonstrate communication and documentation skills
 * **Essential knowledge:** ||  ||   ||
 * Cross infection and prevention strategies including correct hand washing techniques, glove usage and awareness of how infection is spread
 * Understanding of potential hazards in a health environment including appropriate chemicals in cleaning and sanitising in relation to medicine residue in containers
 * Basic knowledge of commonly used medicines
 * The effect of medications being administered, the consequences of incorrect use of medication and of main reasons for errors in medication administration
 * Basic knowledge of body systems and how illness affects people in the context of their life stage and support needs (eg. age, intellectual disability, sensory disability, etc)
 * Appropriate storage of medications
 * How and when to use the equipment listed in the range statement
 * Administrative procedures for medicines listed in the range statement
 * Organisational procedures for the documentation of medication and the use of medication charts
 * **Resource implications:** ||  ||   ||
 * Medication charts and documentation
 * Medicines and equipment
 * Relevant policies and procedures manuals
 * Other documentation relevant to the work context such as:
 * Organisational charts
 * Floor plans
 * Instructions for the use of equipment
 * Specific instructions for staff
 * Client list
 * Relevant equipment and cleaning agents currently used in the workplace
 * Relevant guidelines and legislation
 * **Method of assessment:** ||  ||   ||
 * Observation of work performance
 * Supporting statement of supervisor(s)
 * Authenticated evidence of relevant work experience and/or formal/informal learning
 * Case studies and scenarios as a basis for discussion of issues and strategies to achieve required infection control outcomes in specific work environments and communities
 * Written assessment of functional English language, literacy and numeracy skills appropriate to the level of responsibility of the care worker
 * Annual reconfirmation of the essential knowledge and competency by the employer within a performance management framework is desirable
 * **Context of assessment** ||  ||   ||