Care and Administration of Medicines

|Q1. Define responsibility – what does it mean? | |Responsibility is an expectation to carry out your duties to the very best of your ability in accordance with your position and your | |level of training. | |Q2. Define accountability – what does it mean? | |Accountability is an obligation to an individual or an organization that has the right to ask. You are able to explain, to justify | |your actions and your work practice. | |Q3. Define confidentiality – what does it mean and why is it important?

| |Confidentiality is a non disclosure of personal information regarding a client, other than to those professionals who ‘needs to know’| |and for whom the client has given express consent for them to be informed. It is important to keep confidential as some records may | |contain highly sensitive information about the services users. Sharing confidential information may make the service user feel | |vulnerable and at risk. It is also good practice, and if personal Information was shared the service user will no longer have trust | |in the care that the service is given. |

|Q4. What kinds of responsibility dose the care worker have? Name four. | |As a care worker your main responsibility is for the people that you are caring for as their welfare is paramount. | |You have the responsibility to use the systems and the procedures correctly and to a high standard. | |You have the responsibility to report any flaws or gaps in the systems or procedures when they are in use. | |You have the responsibility to contribute to a safe working environment for yourself and for the service users. | |It is more than simply being aware of potential hazards.

You must take steps to check and deal with any sources of risk. | |Q5. What kinds of accountability dose the care worker have? Name six. | |As a care worker you accountable to your employer once you have received the right training for your job role. | |You are Accountable to the client by ensuring that the correct medicine is given appropriately. | |As a care work in accountable to the clients parents as the client is in your care. | |As a care worker in the care industry you are accountable to OFSTED as they inspect and regulate your service. | |You’re accountable to society as you must not engage in any criminal act.

| |As a care worker you are accountable to your profession as we follow the guidance of an appropriate professional body. | |Q6. What three factors are the foundations of a competent care workers practice? Explain why for each one. | |You must always work according to the employer’s policies and procedures. Your contract of employment states that you must adhere to | |them, in order to safeguard client care. | |Be aware of your limitations, If you knowledge or skills are insufficient to allow you to cope with certain aspects of your job role | |then you must not undertake these tasks, or assume responsibility for them.

| |You are also responsible for reporting any unsafe practice that you might witness; you have a duty of care to your clients and to | |other staff and not reporting any unsafe practice makes you just as guilty of unsafe practice as the member of staff that is doing | |it. | |Q7. Professional care values mean taking responsibility for and being accountable for your practice, what three things dose this | |involve? | |Following approved procedures. | |Taking responsibility for provision of good care. | |Providing care according to the care plan. | |These are professional care values.

| |Q8. Why are policies and procedures so important with regard to safer handling of medicines? | |Policies and procedures are so important when regarding to safer handling of medicines because they are there to safeguard carers and| |employers rights and to safeguard the rights of the clients. Having signed a contract, if we ignore these terms our employer would be| |justified in taking disciplinary action against use (employee). | |Q9. List six ways a care worker can promote professional practice to all service users, family and others? For example promoting safe| |environment.

| |Six ways that a care worker can promote professional practice to all services users, family and others can be: | |To respect the client’s dignity, choice, privacy and confidentiality. | |To provide an environment that is safe to work in and to visit and adheres to all aspects of the Health and Safety at Work Act. | |That no harm should be caused to your clients, colleagues or visitors by your actions. | |That by your actions you promote self-esteem and independence. | |To keep to all aspects of your work contract. | |To carry out the duties that has been delegated to you in the appropriate manner.

| |Q10. In the safe handling of medicines three factors are vital, the client may ask for answers to questions on these. What might they| |be? You need to have accurate knowledge on each one. | |Firstly, your service user may ask you about the nature of the medicine or drug they have been prescribed. Though your level of | |expertise may not be the same as a qualified nurse, you should still be able to give a general guidance to the client concerning the | |basic nature of their medication. | |Secondly, your client may ask you what their medicine is given for. | |Q11.

What six questions could the service user ask you about medicines or tablets? | |Six questions that a service user may ask you about their medicines or tablets can be? | |What is wrong with me? | |How long a, I going to have to take this? | |What are the side effects of this medication? | |Do I need this? | |Why did the doctor give me this? | |Why this medication? | |Q12. Annie is a resident in the care home where you work, she doesn’t like taking her medicine and refuses to do so as she believes | |they are harming her. a) What action must you take? b) What information do you record on her care plan?

| |If a service user refuses to take their medication I would not insist that they should take it. I would seek the guidance of someone | |in authority and I would record the incident and the action that I took in the services users care plan. I would also make contact | |with their GP / prescriber for advice if need. | |On the services users care plan I would record: | |The medication the service user refused to take. | |The reason for the refusal. | |The time of day this occurred. | |What action has been taken. | |What was done with the refused dose. | |Q13.

What is your workplace’s policy on client/service user refusing to take their medication? | |If a client refuses their medication an X will need to be put in the box on the medication sheet. Then on the back of the medication | |sheet two staff will need to write why the medication was refused and sign it. Then it will also have to be put on the clients | |contact sheet. The client’s GP will also have to be called and staff will need to tell the GP about the refusal of the medication and| |the GP will advice if the client’s health is at risk. | |Q14. What actions do you take in the event of the wrong medication being given?

Think about your workplace’s policies and procedures | |in your answer. | |If the wrong medication is given to a client advice must be sought immediately from there GP or pharmacist. If the clients GP cannot | |be contacted then the on call GP will have to be. As soon as the client is at no harm from ill health then the duty officer will have| |to contact the line manager and give a full debrief. On the back of the clients medication sheet it will have to be put that a | |mistake was made and if any action or advice that was given, it will also have to be signed by the two staff that gave the wrong | |medication.

The parents or the guardians of the client will have to be informed and to be kept up dated. The client’s social worker | |will also have to be notified. | |Q15. The National Care Standards Act (2000) Name three requirements of this act in regard to the safe handling of medicines. | |The three requirements of The National Care Standards Act (2000) are: | |Records must be clear, consistent and up to date. | |The pharmacist who supplies the home with medication works closely with designated officer and helps to maintain records about the | |current medication for each resident.

| |Only medication supplied for a particular client may be given to that client; medication for a particular client must not be shared | |with another individual. | |Q16. Case Study You have joined a care home as a new member of staff. You have had three years experience as a care assistant and | |have an NVQ level 2 in Health and Social Care. You are working on night duty with another care worker responsible for administering | |medication for the morning drug round. She decants medication from the drug trolley into plastic pots with strips of paper with the | |client’s names on.

These pots are then left overnight in the kitchen. You know from previous experience that this is bad practice, | |you have told your superior but she has dismissed your worries. Explain why this is bad practice, what are your responsibilities | |regarding this matter? Who is accountable and why? | |All medication must be kept in a locked medication cabinet (as this is bad practice not to do so) and a locked room. All medication | |must not be left around or prepared in advance, all medication must be prepared when the client is ready to administer and done one | |at a time.

This is because if several medications are prepared early they could easily get mixed up or perish. It is our duty as | |carers to report any bad practice by reporting to the approiate person/persons as we would be accountable because we know this was | |happening, and the other care worker would also be accountable for carrying out this bad practice in which could lead to the ill | |health or even death to the client. | |Q17. What six things must be included in a confidentiality policy? | |Your obligations as a carer in respect of client confidentiality.

| |The penalties carers or other staff members will incur for breaching the code of confidentiality. | |What can be written down about a client. | |Where the information concerning clients is to be stored. | |What a client’s rights are in respect of what is written and recorded about them. | |The rules concerning what information care workers can disclose about their clients when on and off duty. | |Q18. List the people who may have access to confidential information and explain why? | |Care Colleagues | |To ensure continuity of care.

This information should be up to date and accurate. | | | |Police | |If they are working directly with the client’s case. | | | |Medical Professionals | |This list could include GPs, nurses, health visitors, occupational health practitioners, physiotherapists etc. | | | |Relatives and Friends | |They might need or want details of their relatives’ health. If feasible you might obtain your client’s permission to give out this | |information. Don’t forget – not all families have good relationships. | | | |Social Workers | |If they are working directly with the client’s case. | | | |Courts | |With a court order when evidence is needed | |Q19.

Who is responsible for giving permission to disclose confidential information? | |Information about clients is privileged and the client must give permission for information about them to be passed to a third party. | |If the client is happy that the information can be passed on, then the carer can do so. If, however, the client is incapable of | |giving consent for the release of confidential information, the carer must seek the advice o a senior person.

For instance, it may be| |that a close relative or solicitor has Enduring Power of Attorney for such clients and their permission will need to be sought for | |the disclosure of information. | |Q20. Explain what the following terms mean in regard to confidentiality? | |Trust | |In a care situation trust is essential; if a carer does not keep information confidential then there can be no trust between the | |carer and the client. If there is no trust the client may be unable to express their feeling. The client may become frustrated and | |this will damage their quality of care.

| | | |Safety of information | |The security of the client’s records. This information is the client’s property. Personal information can be used to exploit and | |manipulate an individual, and this is why the law protects the security of client records in care situations. | | | |Self esteem | |If clients feel valued and respected they will have a strong belief in their own worth. If carers respect client confidentiality they| |demonstrate that they value and respect their clients. Valued and respected clients are happier and happier clients. | |Q21.

Is it ever justified to breach confidentiality? Explain why. | |Confidentiality can be broken when it is clear that keeping confidences may lead to an individual’s welfare or safety to be at risk, | |or if a criminal action has been committed. | |Q22. What should you do if the client states they wish to see their own notes/medical records? | |Under the Access to Health Records Act and the Data Protection Act the client has the legal right to know what has been written about| |them in their files or recorded, so if they wish to see their own notes/medical records then they have a right to do so.

| |Q23. Access to Health Records Act (1990) | |Data Protection Act (1998) | |Briefly explain what you understand the requirements to be for both these acts. | |Access to Health Records Act (1990) | |This is an act to establish the right of access to health records by the individuals to whom they relate and other persons; to | |provide for the correction of inaccurate health records and for the avoidance of certain contractual obligations and for connected | |purposes.

| | | |Data Protection Act (1998) | |This act sets rules for processing personal information and it applies to paper records as well as data that is held on computers. | |The main requirements that this act states is that all data held in respect of any individual must: Be secure at all times. Not be | |kept for longer than is necessary. Be fairly and lawfully processed. Be accurate. Not be transferred to other countries without | |adequate protection. Be processed in line with people’s rights. Be processed for limited purposes. Be adequate, relevant and not | |excessive.

| Unit 2 Medicines supply, storage and disposal |Q1. What are the four acts of legislation that you need to know about in regard to the safe administration of medicines? | |The four acts of legislation that you need to know about in regard to the safe administration of medicines are: | |Health and Safety at Work Act (1974) | |The Medicines Act (1968) | |The Misuse of Drugs Act (1971) | |The Care Standards Act (2000) | |Q2. What dose COSHH mean? What must an employer do in regard to this? | |COSHH means Control of Substances Hazardous to Health Regulations (1999).

| |With regard to this the employer must take all reasonable measures to protect their employees from the potentially dangerous | |substances or materials that the employee may come into contact with at work. An employer’s failure to act on these regulations is | |likely to result in prosecution. | |Q3. Are there hazardous substances where you work? List 4 examples. | |In my place of work four of the hazardous substances are: | |Cif Cleaning Cream | |Toilet Duck 3 in 1 Cleaner | |Flash All Purpose Floor Cleaner.

| |Hob Brite Ceramic & Halogen Hob Cleaner | |Q4. How would hazardous substance be stored where you work? | |In my place of work all hazardous substances are stored in a locked COSSH cupboard. All medication is stored in a locked medication | |cupboard. | |Q5. What is the name of the person responsible for ordering, storing and receiving medicines in a care home? | |In a care home the name of the person responsible for the ordering, storing and receiving medicines is the ‘designated officer’. | |Q6. What is meant by ‘Controlled Drugs’? Give 6 examples.

| |Six examples of controlled drugs are: | |Ritalin | |Methadone | |Morphine Sulphate | |Diamorphine | |Fentanyl | |Oramorph | |Q7. Define the role of the ‘designated officer’ in a care home. | |The role of the ‘designated officer’ in a care home is that they take responsibility for the ordering, storage, and receipt of | |medications and checking all the details of the medication e. g. drugs, clients name, details, dose etc. | |Q8. Who administers medicines where you work? | |In my place of work there are two people who can administer medicines and they are: | |The Registered Officer | |The Designated Officer |

|Q9. Who administers controlled drugs in your workplace and where are they stored? | |In my place of work there are two people who can administer controlled drugs and they are: | |The Registered Officer | |The Designated Officer | |Q10. What is meant by the following and what are the main features of each one? | |Medicines Act (1968) | |The local retail pharmacist is the person given responsibility for supplying medication to care homes. The pharmacist can only do | |this on receipt of a prescription from an authorized person e. g. a GP or a district nurse.

| | | |The Administration and Control of Medicines in Care Homes and Children’s Homes Act (1971) | |It’s to record all the medication used in the care homes, safe practice of medication to appoint a register or designate a designated| |officer and relates to the receipt and storage and administration of medicines. | | | |The Misuse of Drugs Act (1971) | |It regulates the use of medicines that are potentially addictive and, therefore, classed as ‘dangerous’. These drugs are known as | |controlled drugs (or CDS). They require strict legal control. | |Q11.

Explain the process that happens when a supply of medicines is required by a care home? | |The process that happens when a supply of medicines is required by a care home is: | |A prescription renewal is obtained from the designated officer and sent to the GP. | |The GP will authorize the prescription. | |The prescription is then forwarded to the local pharmacist for dispensing or returned to the care home from where it is taken to the | |local pharmacist. | |When the drugs are delivered the designated officer must check that the supply is the same as ordered.

Any discrepancies must be | |referred back to the pharmacist. The drugs must be stored in the correct manner for that place of work | |Q12. Explain the policy of your workplace with the pharmacist when medication is delivered. | |In our care home we go to the GP surgery with a repeat prescription for the drugs required then to the pharmacist in which is in the | |surgery. We then arrange a time to collect the medication. The pharmacist makes sure that the medication is labeled with all the | |relevant details. Name of mediation, dose, name of client and date checked.

| |Q13. What is the role of the pharmacist in dispensing medicines to a care home? | |The local pharmacist will dispense the medication once they have received the authorized prescription. The pharmacist will then | |prepare the medication for the collection or, in some cases, will have arranged to deliver the medication directly to the care home. | |The pharmacist will check the medication and run through a check list. | |Q14. What 10 things must be provided by the pharmacist when medication in containers is dispensed?

| |Ten things that must be provided by the pharmacist when medication in containers is dispensed are: | |Name of drug | |Dosage | |Amount of the drug to be taken | |Name of the recipient | |When the drug should be taken | |Route of administration | |Special instruction | |Warnings or cautions | |Name of pharmacist | |Use by date, keep out of reach of children | |Q15. What dose MAR means? | |MAR means Medication Administration Record. When a doctor or nurse prescribes medicine for a particular client that information is | |immediately recorded on the clients MAR sheet.

| |Q16 What does the term ‘client specificity’ mean? | |The term ‘client specificity’ means only those medicines prescribed for a specific client must be used by that client. | |Q17. When a medication order arrives at the workplace what information should be recorded in a care home? | |All the medicines arriving in a care home must be checked and recorded by the designated officer. The care home records must show the| |following: | |Dates of receipt | |Names and strength of the medicines | |Quantity received plus and carried over from previous cycle.

| |Residents for whom the medicines have been prescribed | |Signature of the staff member who received the medicines | |Q18. How should medicines be stored? List 3 examples. | |Medicines should stored in: | |The drugs trolley | |The medicine cupboard | |The medicine fridge | |Q19. What is the ideal storage area for medicines in a care home? | |The ideal storage area for medicines in a care home is a room which cannot be accessed from the outside. If this is not possible, | |then bars at the windows of the storage room must be installed. | |Q20.

What must be stored in the allocated room? | |The things that must be stored in a allocated room is the: | |medicine trolley | |controlled drugs | |drugs fridge | |all lotions | |Q21. Records of receipt, storage, disposal and administration of medicines are very important, explain why. | |It is important that records are kept are kept relating to the receipt, storage, administration and disposal of medication for the | |safety of the client, the care home. The care home has to act within The Medicines Act (1969) and Misuse of Drugs Act (1971), The | |Care Standards Act (2000).

It is also a good safe working practice and it also prevents any misuse or accidents with medication. | |Q22. In a hospital where would controlled drugs be stored? | |In a hospital the controlled drugs are stored in a cupboard-within-a-cupboard which is mounted on a wall. On opening the inner | |cupboard an alert light is displayed at the nursing station and on the cupboard itself. | |Q23. What procedure must be followed when administering controlled drugs? | |The procedure that must be followed when administering a controlled drug is that two carers must check the drugs name, date and | |expiry and the dose.

Then calculate how much medication remains for the client, then the register is then updated and both of the | |care staff has to sign and check. | |Q24. In order to reduce the risk of errors when dispensing medication what checks must be done? | |The medication checks that should be done when dispensing medication are the drug’s name, date of expiry and dosage and must then | |calculate how much medication remains. | |Q25. What type of medicines should be stored in a medicines fridge and why? | |Some of the types of drugs that should be kept in a medicine fridge are medicines like Antibiotics and insulin.

If these are not kept| |at a set temperature they can lose their effectiveness. | |Q26. Give some examples of drugs that should be kept in a fridge? | |Some drugs that should be kept in a fridge are drugs like: | |Antibiotics | |Insulin | |This is because they can lose their effectiveness if not kept cool. | |Q27. What is the procedure for the safe disposal of drugs? Who is involved? | |The procedure for the safe disposal of drugs is that the drugs need to be taken back to the pharmacy and the pharmacist will dispose | |of them safely. | |Q28.

What should happen to unused medication? Why is this important? | |Any unused medication well need to be taken to the pharmacy for the pharmacist to safely dispose of them and this is important | |because keeping any unused medication can make greater risk of an accident or misuse of the medication. | |Q29. Why would unused drugs have to be disposed of? | |Any unused drugs have to be disposed of to avoid any misuse or any accident in the care home. | |Q30. What is the procedure when a client passes away and you need to dispose of their medication?

| |When a client passes away their medication should be kept in the care home/unit for seven days, once seven day are up then the drugs | |should be returned to the pharmacist, this is just in case there is a coroner’s inquest. | |Q31. What happens to spillages and spoiled medicines? What is the policy where you work? | |In my place of work the policy when a spillage or spoiled medicines occur we have to put the tablet into an envelope and return it to| |the pharmacy and ask for a replacement and tell them why we were returning the medication. | |Q32.

If dispensing from a monitored dose system and a spillage occurs, what should you do? | |If dispensing from a monitored dose system and a spillage occurs the care home would need to ensure that a replacement was obtained. | |In returning the medication to the pharmacy the designated officer can indicate that a replacement is needed and this will be quickly| |supplied. | |Q33. How do you monitor expiry dates where you work? | |In my place of work we monitor expiry dates of medication by checking every day and every time we use a medication the expiry date on| |the box and on tablet strip before administering to the client.

In my place of work we do this twice a day. | |Q34. Why should you not use medicines beyond its ‘sell by’ date? | |You need to use medicines by their sell by date because once past they are likely to develop harmful bacteria that may cause the | |client harm or ill health. | Unit 3 Medications and Prescriptions |Q1. What does the Committee on Safety of Medicines do? What is their role and responsibility to the public? | |The Committee on Safety of Medicines review the safety of medicines that are available to the public. | |Q2. What doses N. I. C.

E stand for and what is their function? | |N. I. C. E stands for The National Institute for Clinical Excellence and their function is that they recommend what medications doctors | |can prescribe on the National Health Service. | |Q3. What legislation applies directly to care settings? List 3 examples. | |1. Medicines Act 1968. | |2. Misuse of Drugs Act 1971. | |3. Misuse of Drugs (Safe Custody) Regulations 1973. | |Q4. What is the policy where you work for the safe handling and administration of medicines? Attach a copy of this policy if you have| |it?

| |The Manager/ Duty Officer is responsible for the administrating the medication, all medication must be correctly labled with the | |doctor’s prescription and initially accompanied by consent forms, the medication cabinet must be locked at all times and the key is | |to be held by the Duty Officer and two people (staff) to check medication quanty and dates, and two staff to record written | |administered and ordered. | |Q5. Give four examples of classifications of medicines and give an example of each one. | |The four classifications of medicines are: | |1. Antibiotics – Penicillin | |2. Analgesics – Paracetamol | |3.

Antidepressants – Prozac | |4. Other drugs – there are many types of other drugs available for example cardiac problems are treated with a group of drugs that | |slow down and steady the heartbeat. | |Q6. List seven examples of drugs from the ‘other drugs’ classification. | |1. Antacids | |2. Insulin | |3. Steroids | |4. Laxatives | |5. Diuretics | |6. Hormone Replacement Therapy | |7. Anti-coagulants | |Q7. What is meant by homely remedies? Give 3 examples. | |Homely remedies are simple remedies that can be given to a client without having to be prescribed and can be bought from the | |pharmacist.

For example: | |1. Glycerine and lemon | |2. Cod Liver Oil | |3. Evening Primrose | |Q8. How are these remedies recorded? | |Homely remedies have to be record that they have been given in the same way as you would when administering a prescribed medication. | |Q9. What dose ‘approved name’ mean? | |The approved name is the pharmaceutical term or what is known as the generic name for a drug. | |Q10. What dose ‘proprietary name’ mean? | |The proprietary name is the brand name for that particular drug. | |Q11. Where can you get information to help you to find out about drugs?

Give three examples. | |You can get information to help you find out about drugs from three main sources, which are: | |1. Information that is supplied with the drug. | |2. Reference information. | |3. Client information. | |Q12. What two publications provide key information on choice, prescription and administration of drugs? | |The British National Formulary (BNF) is an excellent book that provides key information on choice, prescription and administration of| |drugs and the other publication is the Monthly Index of Medical Specialties (MIMS).

This is also a good book that gives you this | |information. | |Q13. Where are there other sources of information about medicines? | |The other sources of information about medicines can be found at your local pharmacist and your GP’s surgery. | |Q14. List 6 painkillers/analgesics that can be bought at a chemist or supermarket. | |Anadin | |Paradol | |Nurofen | |Sudafed | |Sinutab | |lemsip | |Q15. From your list above note down the proprietary and approved or generic name of each drug. | |Anadin = Aspirin | |Paradol = Paracetamol

| |Nurofen = Ibuprofen | |Sudafed = Phenylephrine | |Sinutab = Paracetamol Phenylpropanolamine | |Lemsip = Paracetamol Phenylepltrine | |Q16. Look up the following drugs and complete the answers. | | | |Drug | |Dose | |Frequency | | | |Ampicillian | |250mg | |125mg – child up to 10 years | |Every 8 hours or doubled in severe infection | | | |Lactulose | |15ml initially | |2-5ml child under 1 year | |5ml 1-5 years old | |10 ml 5-10 year old | |Twice daily | | | |Brufen | |200mg tablets | |100ml syrip | |600ml granules | |As directed on packaging.

| | | |Anusol | |1 x suppository | |1 at night 1 in the morning 1 after bowel movement. | | | |Canestan | |Apply to affected area 1% | |2 to 3 times daily | | | |Q17. Complete the following answers in the table, showing the different ways that medication can be dispensed. Some can be dispensed| |in more than one way. Ask your manager for a copy of BNF or MIMS to help you. Place a tick in the appropriate box. | | | |Name Of Drug | |Tablet | |Syrup / | |Inhaler | |Injection | |Patch | |Topical | |Spray / | | | | | |  | |Powder | |  | |  | |  | |  | |Drops | | | |Dispirin | |

| |  | |  | |  | |  | |  | |  | | | |Becotide | |  | |  | | | |  | |  | |  | |  | | | |Calpol | | | | | |  | |  | |  | |  | |  | | | |Pirton | | | | | |  | |  | |  | |  | |  | | | |Diamorphine | |  | |  | |  | | | |  | |  | |  | | | |Insulin | |  | |  | |  | | | |  | |  | |  | | | |Flixonase | |  | |  | |  | |  | | | |  | |  | | | |Otrivine | |  | |  | |  | |  | |  | |  | | | | | |Fematrix | |  | |  | |  | |