Medication Administration Training

this cat class is medication administration so if anybody is in the wrong spot it's your time to know this is teaching you the medicine on time system my name is Carolyn Daly in case some of you haven't met me I'm a registered nurse I've been here 18 years my background is med surg and ICU but it's been a long time since I've done that and like I said I've been here a long time and enjoy doing this this class is also informal so if you have any questions while I'm talking and going through this please stop me because I really want you to get this this is really important stuff it's important that the kids get the correct medication the correct dose at the correct time and that's why we use the system that we use and we want everybody to feel comfortable with it it's a very good system and you should have no problems with it as long as you're following the directions okay it's really not that hard and the system that we do use here is called medication or medicine sorry medicine on time okay before you you have packs for four different times of the day you can take the rubber band off so that you'll be able to look at it when we start comparing the packets to the ma RS you also have a medication on time packet there that you can keep with you that are directions for medication administration if you just are starting to give meds and you can't remember something you have your medication administration packet you also have an actual medication administration record the color-coded sheets they're actually generated from the pharmacy and you have a non prescription Medlocke as well so you have everything you need to learn how to chart with the system that we use yes you're missing the ma are grab that one yeah that'll be great and then you have the packet and good that's what I want to make sure everybody had that does everybody have that so that when we're going through it you can actually see exactly what we're doing okay so the majority of the medications and I say majority because if it's not a pill it obviously cannot be packaged in medicine on time if it's a inhaler if it's a cream if it's eyedrops ear drops obviously it can't be packaged this way this is for the pills so that's why I say the majority of the medications are packaged in these packs and it is called medicine on time if you pick one of them up and look at it if you look at the front each each day's pills at that time of day you can see in that pack so when you're checking your medications we like to tell you to check it three times so if you when you get it out of the lockup it's all locked up you look at the front and look at what you've got there and then to give medications you flip it over you're looking at it like this and then you flip it up like that and then you look in the upper left-hand corner to start giving meds all the medications are going to start from the upper left-hand corner okay and these are automatically sent to us once a month we get these once a month it won't be from the first of the month to the end of the month also by the way beddit medic medicaid only pays for 30 pills at a time therefore the the cycle might begin at different days for example this cycle is going to begin on Friday the 13th so when you get those packs and all that's the day you're going to see it's start in the upper left hand corner once again is where you look so when you glance at it on the front you're going to see information on the packets in the left-hand corner you're going to see the name of the child you're going to see the time of the day to give that medication okay do you all see that see and it says 8:00 a.m. yellow it's all color-coded yellow we're going to talk about what the different colors mean in just a few minutes we're just going to talk about this pack for a minute and then in the middle it gives the farm the information gives the pharmacies address it gives their phone number it gives the pharmacists that packaged it this one says Christopher bass it gives the date that it was dispensed it gives the expiration date or do not use beyond when you see that that's the expiration date in case you you know want to look at that especially on the PRM packs which we'll talk about you have to look at that date and then in the right hand block when you're looking at it like this you'll see the name of the medication the dosage of the medication and a description of the medication okay so you can see how this is a really good system to have all that just right there right at your fingertip so then when you start giving it for a particular day you're going to flip it up like that and then you start again look in the upper left hand corner this one says June 18th to start on this white pack okay any questions so far so you might be wondering what are the colors what are the colors mean okay so if you look at your yellow pack think of I like to say think of the Sun coming up in the morning those are the morning meds those are the meds through 10:00 a.m. in the morning okay so hopefully all of them will be incorporated in that blister if there's more medication the children is on the child is on too many medications to fit in that pack you're going to see more than one pack so when you're looking at your medications and comparing it to the MA are and all if you see there's more medications listed on the MA are you need to go look for another pack of medications okay no that's the time of day that you might you see say any and any says yellow so does that mean that we give the yellow yellow the yellow cape the yellow pal yes ma'am that's that's fine no it's fine no there's no please no there are no dumb questions in this no right now we're talking about what these plastic covers me and the yellow means 8:00 a.m. but don't rely just on the packs because honestly sometimes the pharmacy sends them like this you might see him come like this because they didn't get enough sleeves back from all the agencies that they service if they didn't get enough isn't enough sleeves back you're going to see it like this unfortunately we don't like to see it come like that but that's why we don't want you to totally rely on that you need to be looking here at the child's name 8:00 a.m. yellow it's always going to say that and look at that be careful to look at everything that you need to check so that is through 10:00 a.m. and these are all perforated as well by the way in order to be able to pop the pills out okay so the next pack that you have is white and that is going to be 11 a.m. to 3 p.m. in the afternoon okay the sun's full full for so it's daylight think of white okay so that's the white pack again it's going to be still labeled on the front with the child's name noon and white in case this packet didn't happen to be on there and then over there you're going to see the again the name of the medication at the description and the dosage okay okay so the next pack you've got in your lineup there is orange and that's four to six maybe think of the Sun maybe starting to get ready to go down for the orange but that's the four to six medication on time and again make sure you're looking at the name and the color it'll say that so you know you've got the right pack the blue lastly are the evening meds and that's 7 to 11 so it's nighttime those are dark and those are the evening medications okay ah does anybody think we have any other colors other than these would there be any other colors you that have been here agreed right what is the green mean your PRN I've got a couple over here that I can just hold up and show you because we have a couple other colors only two more but the green is PRN does PRM stand for pills required nightly no no it's a latin term so doesn't mean anything to us in english but you've heard PRN services staffing services that's as needed or as necessary so these are typically for pain pain medications quite honestly that's what you'll see most of the time and the PRN or medications and then we have what we sometimes call sequential or special pack just to be given for a certain amount of time and that's in the red because that'll kind of alert you that this is just a temporary medication it's red and these are typically antibiotics and this is they're given for a certain length of time give them till they're gone and don't expect that you'll get any more red packs and less Moors ordered but when those are gone they're gone you would continue giving it for the correct amount of time if it's an antibiotic for example for a child that their ears they've got an ear infection they say oh my ears better I don't want to take the medication no they need to come complete the medication it's a physician order and it needs to be given the full length of time the only reason you might not continue a medication such as this or even this is if they have an allergic reaction kind of obvious you're not going to continue giving it someone's breaking out or having trouble breathing obviously so so this is the special pack and this is the PRN pack okay so since you've got your printouts your actual MA our MA our I don't know if I said it stands for medication administration record it's just shorter to say ma R and some people say more you might hear it called that Mar and I'm not sure if I said it either but you these can be called a calendar card because every day of the month is represented on the back when you turn it over so each day of the month supply will be in this pack okay okay so charting on looking at your ma RS there that you've got that's generated all the ma RS are generated from the pharmacy and you'll see them like that the only time you might see us right it'll be in handwritten or a label stuck on there as if there's a medication change okay but but and you'll see that a lot around here a lot of changes that's why I keep saying and I'll say it over and over again go buy your MA are okay when you're going to set up medications go by what it says on this sheet the color coded and the pharmacy generated sheet because this should always be correct and what I mean by that if you see something a pack that is not on your ma are don't give that medication okay call somebody and by the way you can always call the on-call social worker on the weekend who has contact with one of the nurses if you ever have any questions you're supposed to call them and they contact us so if you're uncertain also when you're first starting to give medication don't give it don't you know you're not comfortable with it you're not familiar with it an example is one time and this only happened once and I've been here 18 years but the pharmacy put the brand name on the MA R and they put the generic on the pack well that's a good question it looks like two different medications doesn't it so that was a good question call in other words and find out if you have any questions at all so looking at your ma R and looking at your pack we like we I've already said – we'd like you to check it three times so check it when you take it out look at the child's name the time of day make sure that's all correct and then turn it up and look you know where you're starting make sure you have the correct date it's not the correct date you need to get the correct date don't give a medication on the 12th when it's the 10th okay it has to be the correct date okay so then compare it then the third check is comparing this pack I would set it down if I were you on the ma R and look look at your pack look at the time of a and then the first column that you see on your ma R has the name of the medication the dosage of the medication it has the doctor the prescribing doctor and the start date on the medication so when you're giving for example your 8:00 a.m. med this is a multivitamin you've got your yellow pack and you're comparing it you set it down and you look to see that you've got enough medication for your 8:00 a.m. med okay and like I said go looking for another one if you don't have enough so compare it to that ma R and again if it is wrong if there's a discrepancy go by this ma r okay it's very important so you'll see the the directions the name of the medication the directions and then to the right of that you see a frequency column those are all color-coded to your color packs right you see yellow you see white you see orange and you see blue boxes and it's all the way across to the end of the month to the right of that you see all those little boxes those little boxes one to thirty one is where you chart after you give the medication for that particular time of day so if you're looking at your 8 a.m. make sure you've got all your 8 a.m. meds before you start taking them out out of the packs and they're all perforated so that's how you just dispense them as you tear it off ok they're all perforated these can be sent if they go on a home visit by just tearing them or if they're going to school with it it can be torn and and brought to the school for them to be get for it to be given at school ok so those little boxes that you see 1 through 31 that's where you chart that you gave the medication you put your initials there ok so if it's an 8 a.m. med you're going to chart in the yellow block for whatever day you're giving if it's the first you put your initials in that block for the first ok and then before you start giving medications make sure you turn over on the back and put your initials where it says initials and your signature they have asked you to actually print and sign there because sometimes it's hard to read people's writing so print and sign and put your initials because when someone wants to check who gave the medication for a particular time or day your initials should be in the block and on the back so we can see who gave the medication so that's really important to make sure some people when they come in check meds each month will put their initials and name then but at the beginning of the shift at the beginning of the med cycle just make sure your initials and your name are on that back because that is important okay so these blocks that are all the way across have to have something in them every month when those meds come back to the clinic those boxes all have to have something in it and your program manager is the one usually checking that to see if there's something missing they're going to be coming after people that worked on that day if there's a signature missing or for whatever reason there's not something in that box they'll be asking you about it yes at night we don't give medication as much as autumn so do we use photo Sundays mm-hmm oh yeah everybody does everybody needs to because if your initials if you do happen to give something say a PRN medication that might be the most typical thing you might give for pain a child's had oral surgery and you have to give them a pain medication in the middle of the night you would have to have your initials on there see but do you have to get little medication you know put em on but do we see us of course that it's better to go ahead and have your name on there that way if you should give them if it's on there and you haven't given anything no harm done I'd rather see it on there than not on there because when there's an initial and we turn over in the back we don't know who to go ask about it and your your program manager doesn't know who to ask either so that is important and licensing looks for things like that too so important to have something in that block so typically when you give a medication your initials are going to be in that block right but what if a child refuses a medication we're going to put our initials and we circle it that means they refused it but then you must turn over on the back of the ma r and communicate that put put the date the our your initials the medication what happened that they didn't get the medication okay that's important and you have to fill out an instrument port if they refuse okay so that's a refusal you would be your initials and it would be circled okay the other thing that could be in that box would be a diagonal line a diagonal line means they did not get the medication for whatever reason you didn't have it perhaps you know they came home from a home visit or an outing and it just was way off the timeframe you have an hour to give it but if it's you know perhaps too late and you've called somebody you do have to call if it's over the hour timeframe of giving a medication to see if you should give it you should call the on-call person who will again call the nurse and find out about giving it but for whatever reason that you didn't give it you put the diagonal you forgot you might have even forgotten so you got to put a diagonal and then again turn over on the back and write what happened if you're not sure what to write on the back we like to see more on the back than less so write it on the back and fill out an incident report if they're not getting their medication at school where you see a lot of meds coming back from school fill out an instrument for it just to communicate that there's a problem and then we can talk to the school the other yes go ahead child by vomit after you get you know some kids don't tape heels with and the child bum is out there they take a pill do you do them another one off well the the pills like for pain pills antibiotics they should be given with some food if they're they vomit that's probably why because it's very irritating to the stomach so try to give them something with it so that's a good question so I was able to say that yeah give them some food but call someone and say this is what's happened you know and then we can we can advise you on it you know they don't feel like you have to make that decision you should just call the on-call a social worker and then they'll call me or they'll call whoever's on call and ask that question and you know we might come and you know see the child or say no don't give them any more but if it's for pain they're probably going to need something so you don't need to worry about making that decision you would just call someone and say this child has vomited so but because it could also be an allergic reaction but make sure you give them food too before you give them any of these two type medications the PRN or the sequential the red one oh that's a good question that's that's good okay the other two things that would be in possibly in that block are going to be s because they take it at school a lot of the stimulants are given at school at 12 noon so you would have sent those to school you don't send them with the kids by the way obviously you take them to the school and give them whoever is going to be administering them and so there might be an H in that block because you're not giving the medication don't sign off on a medication that you did not give so you'd put an H they went home on a home visitor you know with a visiting resource whatever it could be an H in there for a home or s for school so those are the things that could be in there so we said your initials which means you gave it your circled initials which means the child refused it the diagonal which means they did not get it an H because they're off-campus or an S because they're at school and the school gave it okay and Bible yes you can put H it just that just means it was you know away from campus so that's fine some people put H V home visit it really doesn't matter just as long as H is in there so we know that you did not give it so that's fine and by the way with charting chart after you give the medication please don't chart before I say that because it's happened I've been in the cottages when they tried to chart before the medication was given and I was actually there to make a change so I was a little alarmed I said wait a minute it's six o'clock and this seven o'clock medication is already you know or eight o'clock medications already signed out and they said oh yeah I was you know just getting ready for it don't do that because like I said someone could come in the nurse and make a change and then you've already charted on it so so that's not good good medication administration policy because it's a legal issue so also so chart on it after you give the medication okay and don't wait til the end of the shift even chart as soon as you can after you give that medication okay I've gone in the next day and the day before meds weren't charted on so it looks like they weren't given and if you've got licensing coming through there that particular day and they see you know wow it doesn't looks like they got medication for the whole day or whatever that's not good and it's just not legally it's not the way to to chart so chart put your signature after you give that medication okay all right any questions so far okay there are a lot of medication changes throughout the month we have who about four different doctors that come in dr. Feldman is here on Monday afternoons and Thursdays so he makes a lot of changes and then our pediatricians come in on Tuesdays we have three different pediatricians that come and they add medicine to the ma RS as well so there are a lot of changes on your ma are so when you see the pink the pink marker and you little say medication discontinued will will write it as well will put the day that we're discontinuing and sometimes we put the time and we put our initials okay so if you see pink on that ma are that a medications discontinued don't give it okay even if perchance the packet happens to still be in there set it aside don't give it in other words you will not go wrong if you go by the MA are even if it was the nurses mistake you can say I was going by the MA are and we keep saying that so go by the MA are and you will see a lot of changes so the pink means discontinued so don't give that medication you might see medication dosage changes you see that a lot he'll increase or decrease the medication discontinuing it all together and start a new medication so you will see a lot of stickers like I said the pharmacy will give us a sticker if they don't give us a sticker we write it you'll also see handwritten medications in there and if they go somewhere on the weekend and have a antibiotic or something like that it needs to be started you will need to write it in there okay so you write it in this big square that's to the left of the frequency column that's where you write it and you just look at the label it will be in a bottle typically on the weekend but make sure you write it in there so that you can chart on it okay it's really important so many times everybody waits till we're here on Mondays you know but if child is in pain or they need their antibiotic we have to go ahead and and put it on there so make sure we put it on there if it's a medicine that started like on the 15th you'll see a line drawn through the frequency column there the the dates up until the date that it should start and if you don't see that you can do it too you can draw a line just make sure you chart on the correct date again that correlates with the day of the month like if it's the 10th put your initials on the 10th don't put them on the first ok it's kind of common sense a lot of it's common sense and and it's and it's not hard as long as you're following you know your your directions following your directions on your ma are ok it should all be on the ma r again if you see something pink tout that means discontinued some cottages like to maybe label in other colors of magic marker if it's a half a pill or if it's two pills that type of thing you can do that in any color but not pink don't put any pink highlighting on there because that always means discontinued ok if you want to highlight in yellow or green or whatever but not pink also just an example to appeals that aren't inhibit well there's only one that won't be in medication on time is birth control pills birth control pills are started at different times throughout the month typically on Sundays but when you start a new pack of any medication that you're starting that's not in the MOT I can't think of anything other than the birth control oh also if they're on the prednisone packs those can be outside of the medication on time as well but put when you're starting it ok turn over on the back put the date the hour your initials the name of the medication because that signifies that you're starting it you know and just put a little note starting you know whatever day you're starting it is all you do okay so we didn't talk about how to chart on the prm's yet so charting on the PRN s is the same as charting you just put whatever day that you're giving it make sure you put your initials in the correct day but on the pr ends you do have to turn over on the back and again write the day the hour your initials the name of the medication put the reason you're giving it if it's for pain typically or fever whatever you're you put the reason they'd like you to come back and and check with the child 30 to 45 minutes later to see if what the results were okay and if they're not getting relief you need you know you can call the on call if there's a problem you know that it's not working or whatever then you put it there wasn't wasn't effective or something okay all right these these medications come once a month from the pharmacy and the nurse is in the clinic check these medications before they come to you so we are busy trying to get these all checked and then someone from the cottage a lot of you probably have come to check meds or some of you probably have come to check meds with us and what you do is you bring the old ma RS the ones you're currently charting on and then we compare the new ones that we have with the old ones and we're actually doing a count we're checking each of these packs to make sure it's all correct by the time you start the new meds cycle so it should be correct we find all kinds of things in doing this that's why we do it sometimes maybe one of the pills it's a one and a half dose and a little half will be left out or they'll be put two pills they'll be that kind of mistake so it's really worth doing so it's gone through two checks by the time it gets to your cottage okay so that's how we do it once a month we check them okay the actual procedure now for setting up your medications we're at the point it's time to set medications up everything is double lock – so you should have a set of keys so you need to unlock obviously to start setting up wash your hands okay that's that's the first thing everybody should remember we've got to not we got to stop the spread of germs in the hospital they've you know found as you know how in proper hand-washing is the biggest way that the germs are spread so wash your hands with soap and water there's always saying about doing it for 20 seconds and that's happy birthday twice if you want to say that to yourself wash them wash them good in other words don't allow kids to be around you when you're setting up medications they should not be in the locked area any they should be outside the door but really you shouldn't have a responsibility for the kids at that time when you're setting up medications okay you got to be able to concentrate you can't be directing traffic while you're there trying to set up these meds this is an important time it's important that they're set up correctly so try and you know have it a quiet time when you're setting up your meds okay that really is important I can't stress that enough we've had more mistakes with that excuse that oh I was there was so much going on I was trying to do know this should be your only responsibility at that time setting up these medications okay again set them up according to the MA are and we tell you to check them at least three times if you want to check them more than that that's fine but check them at least three times when you take them out of the cabinet look at them if there's anything you have questions about even at that point ask somebody maybe someone that's been giving meds for a while and if you're not satisfied call again call the on-call person so check them then and then compare them compare the MA our compare the pack to the MA our and then you've checked them here and then turn them over here and check them and then compare them to you and they are so at least three times check them it's important read the MA are carefully check the dosages carefully some pills there's two pills some there's one and a half some there's a half pill so make sure that's what's in the blister to give okay make sure you have the right amount there are seven rights of med administration the first one is make sure you have the right child okay they don't have armbands on like they do in the hospital to be able to check and if you're new and a child is trying to fool with you and you know give you the incorrect name make sure you have the correct person if you're not sure ask someone that's been there a while make sure you've got the right child okay it's very important so make sure you have the right person make sure you have the right medication obviously for that time of day I've seen him give the morning meds at night and the night meds in the morning believe it or not so make sure you've got the right time of day that you're given that medication the right dose of the medication again I stress that it has to be the right dose if for some reason there's a discrepancy in dosage the dosage is different call and find out about it ask because that's that's not right to have one the pack say something in the mir say something so make sure you have the right dose I think I already said the right time of day the right route that means if it is it by mouth is it an airdrop it is an eye drop is it an inhaler make sure you're administering it the proper way to the child has a right to refuse obviously we can't make anybody take medications so they have that right and then they have a right to education okay if they say I've had this happen before I don't know about this medication we tell them about all new medications that are started sometimes they're not listening or for whatever reason they say I don't know about this medication I don't want to take it and we're perfectly comfortable with talking to them you know when we're there on the following week if it's on the weekend type of thing so if you you know can't talk them into to taking it and you don't know anything about it don't worry about it they have the right to refuse okay can't force anybody again don't set your medications up more than an hour ahead of time and even if you are setting them up an hour ahead of time you've still got to check them before you give them okay if you've got them all set up you're ready to go and then you just give them without looking at the MA are that's not correct either because we could have slipped in you've got them set up somewhere else we've slipped in we've made a change we've discontinued that medication for example that you have set up you'll make an error if you're just giving them from what you've got set up don't give them from memory don't give them from just these packs I know it's very tempting and in the sake of time and this is how honestly the majority of the medication errors have then they're just taking these out looking at it getting the right date tearing it off and giving it and then going to chart without even looking at the MA r or not charting even tell you the truth not charting and just going about their merry way and then the mistake is made found when up that medication was discontinued or the dosage was changed so make sure even if you're setting them up that hour ahead of time double check before you actually administer the medication to that child okay it's very important it's a legal issue so we want to make sure we do it the correct way on most all of these I mentioned the expiration date in the middle where it says do not use beyond date these are the the monthly meds should all be correct you have to be careful of are these in the green pack say a child has medication for cramps and they don't take it as often you really need to check the expiration date before you give them that medication if it is expired send it back to us and we'll we'll get it corrected we'll send it back to the pharmacy and get it corrected it's just not as effective as if it's expired it's not going to hurt the child so if it should happen don't think you're going to hurt them you're not going to hurt the child but it's and when licensing comes through they don't want to see expired medication so keep an eye out for anything actually that can be checked that expires like contact lenses or pepto-bismol whatever you've got over-the-counter the acetaminophen the ibuprofen whatever can be checked needs to be checked too over-the-counter medications for expiration date okay see where we are always double check again for correct dosage and if there's 2 or 1/2 or 1 just make sure you have that give them a glass of water ok don't send them to the water fountain believe it or not years ago people were doing that they'd give them their pill and say go the water fountain and take it no you can see how that could give a lot of problems if they cheek in the back or they lose the the pill down in the water fountain so give them a glass of water it helps the pill dissolve better too so give them a glass of water with their pills okay don't send them to the water fountain or send them anywhere actually you should be watching them take that pill and swallow it some of the kids you're actually going to have to ask them to open their mouth because they will cheek it and they'll save it up and you'll find a whole pile of it in their room it has happened so really watch that they take that pill and swallow it okay don't line them up either to give medications call them individually to where you are to take it that way you can watch them you can know that it's the right child and all because if they're fooling around all lined up they might you know might be telling you they're a different child or whatever do it one at a time have them come and give the pill to them one at a time if a child says that their medication doesn't look right they actually don't manipulate in that way typically if they've been taking it for a long time and they say well this this doesn't look right take that seriously and find out about it we've only had it happen once but the pharmacy actually did dispense an incorrect medication so take that seriously and call the PAC's if it is a different color that they're packaging like you'll see this you might see this a good bit actually there might be three rows of a red pill and then the rest of the rows have an orange pill they will have a sticker on it that will say same medication different color shape or whatever they will explain that and so kids need to see that if they know their medication these kids if they've been on it for a long time and I say no my pills not really is usually green it's blue so you're able to show them that sticker okay and if you don't see that you can call the on-call or if it's something you even can call the pharmacy but really just call on-call and they'll they'll they'll get a hold of us and we'll get it straightened out I take that seriously from the child if they say this just doesn't look right to them and we'll we'll make sure that it is right for them okay on refills that the pills I mean the medications that are not in the medication on time packets for example birth control pills or inhalers those need to be refilled obviously when they're empty or when they're close to being empty so we ask you to let us know by Thursday of every week if you need refills if you forget and let us know Friday that's fine we want to make sure all the kids have their medications in a timely manner you might have to go the pharmacy and pick it up because they won't deliver after about if we don't tell them before like one o'clock on a Friday so it's okay we can still order it but you might have to go pick up that particular medication but we do like you to check your medications you know before the week ends and make sure you don't need refills or if you do to let us know what refills you need let's see see where we are we're available obviously during office hours and we're also available after hours when you call the on-call social worker I think I've said that a couple times but I want you to know you're not alone in this you have backup support okay so you you call and ask a question if you have any questions before giving medications if there are anything expired on any of the medications even the over-the-counter ones don't don't don't keep them in your cabinets get rid of them send them to health services and we'll we'll get you some more the other law that you see you have there is the non prescription vlog these are the over-the-counter medications and this is a list of the active ingredients that are in the over-the-counter medications that are approved by our medical director dr. Fievel Minh so these are the only non prescription meds that you actually can give and those are also locked up okay and those you would dispense according to the package direction like it's on the tylenol on the ibuprofen dispense it according to package directions but we also have a back part of your non prescription Medlock that has a place to initial and sign so it's important to initial and sign on that to also you make an entry and kalida care for these over the counters no the non prescription just on here unless unless there's a medication on there sometimes there is a non prescription medication on there and if it's on here yes you're absolutely correct you would document it on here like this is acetaminophen is on here sometimes our pediatric doctors come in and order it you know three times a day for four days or whatever for back pain or knee pain or whatever so that's a good question if it is on here you document it on here if it is not on here because obviously kids have stomach aches headaches fevers on the weekend and they need access to over-the-counter medications so this is those that the ones that aren't on there but are in your cabinet this is where you document on those and you also have to document in kalida care we've kept the paper trail because so many people you know we're saying well how to either have to go and kalida care and find out when the last PR over-the-counter medication was given and this is easier to look at a paper that you have there and so you chart the date the time the medication given the reason for the medication the amount and temperature if that applies okay if a child doesn't feel well that is actually the first place to start is check in their temperature and if you're giving the tylenol for a fever you need to document the temperature right that way when you go to give them some three or four hours later if it's they're still running a fever you know it's not working okay so you would need to let somebody know and we can take care of that we'll tell you what we'll give you instructions from there what to do so these are all the medications the active ingredients so check the active ingredients if there's any question if it's something you're not sure that they should get and it should be listed on here okay so follow the package directions for the non prescription Medlock's we only give tylenol you should start with Tylenol or acetaminophen that's the generic and brand name for a fever okay we you won't see aspirin in the cabinets okay we might tell you to just to give them ibuprofen as well but really only do that if someone a nurse or a doctor says to give them that for the fever we don't use aspirin you won't see aspirin in the in the lockup at all for a fever for children when noting your non prescription met on the back put what the name of the medication is okay if that's tussin diem for cough listed as such don't say cough medication okay list whatever the name of the medication is that's important too and then again don't forget the kalida care entry they're saying that you have to enter that there and then there are resident notes that you keep on the kids and non prescriptions are supposed to be reflected in those notes as well okay any questions about the over-the-counter non prescription and again those you need to check expiration dates right make sure that they're not expired on those over-the-counter medications that can stay locked up for a while so it's important to check those okay other reminders you've got keys to to the lock up I have mine in my pocket keep them on your body at all times okay don't lay those keys around we have had kids get the keys and get into the cabinet so keep your keys on you at all times make sure medication is kept locked up at all times here they're all double locked actually they're behind 2 locks so make sure that you keep them that way and keep kids out of the lockup room where you're setting up your meds they should not be allowed in those rooms and most of them I've seen signs on the door you know that residents are not allowed you know past that point so keep those medications locked up a lot of them are scheduled two medications which that's my law they have to be locked up if a child goes on an appointment is transported on the weekend somewhere and you have a prescription again call on call social worker let them know that there's a prescription typically they take the kids actually on the weekends but if you should have to make sure that prescription is filled or if they come home say they come from a home visit and they've been diagnosed with an ear infection and they've come back with a prescription it has to be filled on the weekend okay we can't wait until Monday to do that it must be filled so let them know they will possibly fill it or they will let you know how to go ahead and get it filled and then again when you have that bottle make sure you write it on the em AR okay put the name of the medication the dosage and the directions one tablet every six hours as needed for pain whatever the directions are on there okay and you can also I do like to see the doctor's name should be on the prescription as well so it's a good idea to put the the doctor's name and then there's a start date see where it says start in the column put that to put the start date the day you're starting it okay and then draw the line up to whatever day it is you're starting if you're starting it on the 15th draw the line up through the 14th and then start charting on the weekend on that medication okay if you would also any forms that come back from visits like that we have to have them in the clinic so either give them to us the first thing on Monday or if you have access to put them in our box in the social services make sure it's in the box but we keep medical records on all the kids so we have to know you know when they've gone on a visit and we have to know maybe if there's follow-up visits so let us know in the clinic as well if something like that should happen on the weekend typically when you call the on-call social worker if a child needs to go somewhere they come in and take the child if there's a reason they can't they might have you once in a while do that but typically they will come and take the child document completely this is a legal document just like any legal document okay so we don't scribble through anything where it's not legible you write one line through it you write your initials and you write error or delete you can do either one but that way we know it's an error the line is drawn and you put your initials we don't use pencil we use pin you can use blue or black but make sure you use pen don't use pencil don't use ditto marks okay it's a legal document and document completely the saying that if you didn't write it you didn't do it applies okay so again make sure after you give your medication that you chart on it and and write it if you need to fill out an instant report for something you know that happened on the Mir do that as well make sure you don't turn over on the back we've all we've said already for the medications too like the pr ends that you need to chart on or the refusal or if they did not get their medication don't put c incident report i know it's you know different places you have to do things but put what it is that happened and also fill out the incident report okay that's important when kids go off campus like they went you know on the trip they didn't take the whole pack of medications they take they pull this apart and they tear off whatever they need okay so if they're gone from the 18th through the 21st you would peel off four of the pills okay for each whatever time of day so you make sure you send the and it's a great system because these are all labeled with everything they need and then make a copy of this ma are this ma are should not go off-campus or any reason I'm unfortunately they took it off to the emergency room one time no because then people that are left back have nothing to chart on okay if you want to make a copy of this to take if you've got to take someone off campus that's perfectly fine make a copy and if you're sending it home or to school you can make a copy of this that way they have directions as well and they can chart on it too and send it back but make sure you make a copy don't send the original yes they gotta go to the house Killick how you having a portrait are good they don't give outside medications usually they just want a list of the medications they want to know what they're on and if they we have had that happen when they asked for us to bring certain medications for them to get they will let us know about that but you don't have to worry about that take a copy of the AR or take a list of the medications that's always what they ask everybody that's taken a child somewhere knows they want to know what medications are they on do they have any allergies okay so those are important questions also if you have to transport a child take a copy of the Medicaid card you might not have a hard copy but you'll have an eligibility statement that everybody all the kids should have in your unit you should have a copy of so if you do have to transport them somewhere you have their information on their insurance okay so send a copy not the original when taking medications from one location to another don't stop somewhere okay go right from the clinic back to the cottage and lock it up for obvious reasons you don't want to come to the dining hall and have it sitting around the table you know people will pick it up so it's important to transport it from one place to the other don't send kids to the clinic for medications we're not going to send medications with a child in some circumstances we might send gloves a pack of loves with children that can be trusted that type of thing but we won't ever send medication so don't you know have them come and speaking of kids when they need to be seen in the clinic give us a call at the to eight to five number always call that number we all have different extensions but to eight to five will get to us if you leave a message at that at that number will always get it and will respond to you if possible to call us ahead of time and let us know a child needs sing because if you're just bringing them up there we might be working with a doctor and we might you know there might not be anybody accessible to you so if possible give us a call and let us know what's going on and how we can help we always respond to emergencies so if we're if it's during clinic hours and you have something going on that you need help with you just call us you're not out there alone are there any questions I know it's a lot of information but again a lot of its common sense exactly does anybody have any questions at all though okay ah there is a test so I'm going to give you the test and then we're going to go over it don't get nervous it's not a hard test and we've gone over everything that I believe you'll no need to know for it about it okay the first question if a child has a fever what should the staff give which one of those is correct be right acetaminophen or Tylenol good when dispensing prescription medications you should always set up the medications according to what right the MA are very good always go by the MA are an incident report should be completed when which one of those is correct all of them right if a child refuses a medication if they miss a medication at school we said if a wrong medication is given absolutely instant report number four a physician has ordered ear drops for an ear infection which is to be given for ten days after a few days the child's ear feels better but the medication has not been discontinued so which one of those should you do right continue giving the medication the prescribed number of days the only reason we said is if there's an allergic reaction okay number five when administering non prescription drugs which one of those should you do all of it right you check the expiration date you follow the package direction concerning the dosage and you check the active ingredients which are on that list so all of the above okay this is a little bit of a trick question I hope you guys caught it when giving a non prescription you should check the inactive inactive ingredients to make sure they are approved by the medical director now false yeah just a little trick one because its inactive we said active ingredients correct we're not really that concern about the inactive it's the active ingredients that have to be in that medication okay PRN I gave you all this one already PR n stands for pills required nightly false right it's a latin term it doesn't mean anything to us PRN is as needed or as necessary okay number eight if a child refuses a medication you should initial the dose on the ma R and Circle your initials true right that's correct and number nine when administering medication you should read the label three times right at least three times good and number ten you should give aspirin to a child with a fever of 101 or greater false hopefully you won't see aspirin in there so anybody have any questions at all okay well thanks for attending and like I said if you have any questions when you start giving meds don't give them a call and get it clarified okay you


  1. Found a great Online Med Tech course at Elite Medical Academy.

    Very comprehensive program!

  2. Informative, thank you so much for being articulate. You summarized the course in a simpler way. Excellent.

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