1.1 Identify current legislation, guidelines, policies and protocols relevant to the administration of medication
As far as medication administration goes, it is crucial to anchor our practices in a framework of legislation, guidelines, policies, and protocols. This foundation ensures the safeguarding of individual care and professional accountability.
Legislation
Firstly, let’s consider the Medicines Act 1968, which serves as a cornerstone for prescribing and supplying medicines. It categorises medications into three broad groups: prescription-only, pharmacy medicines, and general sales list drugs (Pharmacy Regulation Authority [PRA], n.d.). The ramifications of this act directly influence how healthcare professionals administer drugs safely.
Additionally, there’s the Misuse of Drugs Act of 1971, pivotal in classifying drugs based on their potential for abuse and harm. This translates to stringent controls over certain medication management aspects (UK Government Legislation, 1971).
Guidelines
The National Institute for Health and Care Excellence (NICE) offers comprehensive guidelines that embody best practices in medicine management (NICE, 2014). These guidelines endeavour to marry clinical evidence with expert opinion to aid decision-making; contributing not just to safety but also efficacy in drug administration.
Policies And Protocols
Healthcare settings then distil these national directives through localised policies that articulate how staff should undertake medicine administration. A crucial element here is the health provider’s own Medication Policy, which typically covers the assessment of the patient’s needs, consent, administration processes, record-keeping, storage, and disposal.
Finally, yet important are clinical protocols like those outlined by organisations such as the Royal Pharmaceutical Society. Their Medicines Ethics And Practice documents provide a blueprint for protocol-driven action by healthcare professionals (Royal Pharmaceutical Society [RPS], 2016).
In conclusion, navigating medication administration is predicated on understanding this intertwining legal framework quilt—and adhering strictly to its guidance supports both patient well-being and professional integrity. With each piece of legislation or guideline observed diligently, we ensure our practices not only pass official scrutiny but more importantly hold patient trust with the utmost regard.
However, legislation evolves; thus constant vigilance is needed to stay current with changes impacting our practice.
2.1 Describe common types of medication including their effects and potential side effects
Understanding medication is paramount to ensuring the provision of safe and effective support for individuals who require them. Among the common types of medication are analgesics, antibiotics, anticoagulants, antihypertensives, statins, bronchodilators, and anti-inflammatories.
Analgesics, such as paracetamol and ibuprofen, are routinely deployed to attenuate pain. While generally safe when used as directed, they can occasion side effects; excessive consumption might induce liver damage or gastrointestinal issues like ulcers.
Antibiotics—like amoxicillin or doxycycline—are used against bacterial infections but misuse may foster resistance. Patients sometimes report nausea or allergic reactions.
Anticoagulants like warfarin are employed in averting blood clots. It’s vital to regularly monitor blood levels with this type because of risks like bleeding complications due to their very delicate balance between efficacy and danger.
Antihypertensives (e.g., amlodipine) control high blood pressure yet may lead to dizziness or headaches.
Statins offer a defence against cardiovascular disease by lowering cholesterol levels; however, muscle aches represent potential side effects.
Bronchodilators help ease breathing in conditions like asthma; salbutamol is an example but tremors or heart palpitations could complicate its use.
Each type carries its valuable contributions toward maintaining health alongside unwanted results that might negatively impact well-being through side effects.
2.2 Identify medication which demands specific physiological measurements
In adult care, the precise administration of medication is not merely about dosing and schedules but also involves stringent monitoring of physiological parameters for several types of medications. These drugs can deeply influence bodily functions, thus necessitating periodic measurements to ensure therapeutic efficacy and safety.
Firstly, antihypertensives, such as beta-blockers and ACE inhibitors, typically require monitoring of blood pressure to avoid hypotension (Atkins & de Lacey, 2019). As hypertension treatment seeks a fine balance in vascular pressures, healthcare professionals must vigilantly track these readings.
Secondly, for individuals on diuretics like furosemide, both blood pressure and electrolyte levels are critical. Diuretics promote fluid excretion which can alter potassium and sodium levels—key players in cardiac rhythm regulation (Page et al., 2020).
Third are anticoagulants, specifically warfarin. Patients using this drug need their blood clotting time or INR (International Normalized Ratio) regularly checked to prevent either haemorrhage or thrombosis (Ansell et al., 2008).
Antidiabetics such as insulin demand regular glucose monitoring. The fine-tuning of insulin doses hinges on glycemic control metrics; too much or too little can have serious consequences (American Diabetes Association [ADA], 2021).
Those on Digoxin, used primarily for heart failure and arrhythmias, should have serum digoxin concentration checks due to its narrow therapeutic window alongside continuous surveillance of renal function as it is renally excreted (Vaisman & Penmetcha, 2017).
Moving onto respiratory care—patients on bronchodilators such as salbutamol must undergo peak flow testing to ascertain lung function improvement post-administration while avoiding overdosing situations that could lead to tachyarrhythmia and muscle tremor issues (National Asthma Council Australia [NACA], 2020).
Also, we cannot overlook the importance of liver function tests for patients taking statins, given potential hepatotoxicity risks alongside CPK enzyme measures to detect any onset of myopathy due to drug-related muscle injury (Stone et al., 2014).
Working within this framework will ensure that patients receive optimal care whilst minimising adverse effects.
2.3 Describe the common adverse reactions to medication, how each can be recognised and the appropriate actions required
Adverse reactions to medication can range from mild discomfort to severe complications, making the recognition and management of these reactions crucial in adult care. Allergic reactions are amongst the most serious adverse effects, manifesting signs such as hives, swelling, and in severe cases anaphylaxis – a potentially life-threatening condition (National Health Service [NHS], 2021). Immediate medical attention is critical when anaphylaxis is suspected.
Another common adverse effect is gastrointestinal issues, including nausea, vomiting, diarrhoea, or constipation. These symptoms are relatively easy to recognise and may often be managed with supportive treatments like hydration or dietary adjustments (Mayo Clinic, 2020). For persistent cases, consulting a healthcare professional for alternative medications or therapies is advisable.
Likewise, many medications can cause neurological effects such as drowsiness, dizziness or confusion. Patients experiencing these symptoms should be monitored closely to prevent falls or injuries; it may also necessitate dosage adjustment or a review of the current medication regimen by a healthcare provider (American Pharmacists Association [APA], 2019).
Some drugs are known to cause cardiovascular reactions like palpitations or changes in blood pressure. Such responses demand immediate attention to ensure patient safety and might require modifications in medication by a doctor (World Health Organization [WHO], 2018).
Lastly, cutaneous reactions – those involving the skin like rashes or itching – while often less serious, still merit careful observation as they could indicate more significant underlying allergies (British Journal of Dermatology [BJD], 2017).
In all instances where adverse reactions occur:
- The first step is always to stop administering the medication if severe side effects arise.
- Documenting symptoms precisely assists health professionals in determining the next actions.
- When in doubt of severity or appropriate response measures – seek guidance from experienced colleagues.
- Engaging with pharmacists provides insights into possible drug interactions that could be mitigated.
Ensuring prompt identification and addressing of such drug-related complications aligns with best practices for safeguarding patient well-being.
2.4 Explain the different routes of medicine administration
Medication administration is an integral component of healthcare provision. Different routes of medicine administration are chosen based on the drug’s properties, the desired speed of action, and patient factors such as age, consciousness level, and organ function. Understanding these routes is crucial for any professional within adult care.
Oral Route
The oral route is the most common and preferred due to its convenience, safety, and cost-effectiveness (World Health Organization [WHO], 2019). Pills or liquids are ingested by mouth, absorbed in the gastrointestinal tract, and metabolised by the liver before entering systemic circulation. However, drugs administered orally must have a robust pharmacokinetic profile to survive gastric acids and enzymes.
Topical Route
Topical medication application includes creams, ointments or transdermal patches applied directly onto skin or mucous membranes (Benson & Namjoshi, 2008). This route provides localised treatment with minimal systemic absorption but may be slower acting compared to other methods.
Inhalation Route
Medication can be delivered via inhalation into respiratory pathways using nebulisers or inhalers. This method offers rapid delivery for conditions like asthma because it targets tissues directly involved in respiratory pathology (Laube & Janssens et al., 2017).
Injectable Routes
When immediate drug effect is required or when substances cannot survive gastrointestinal metabolism, injectable routes are employed:
- Intravenous (IV): Faster onset as medication enters directly into blood circulation.
- Intramuscular (IM): Delivery into muscle tissue ensures a sustained release.
- Subcutaneous (SC): Injection beneath the skin allows for slow release and constant drug levels.
Although these methods offer efficient delivery systems bypassing first-pass metabolism effects seen with oral drugs (Barrett & Barman et al., 2020), they do require professional administration.
Rectal Route
Suppositories provide a useful alternative when oral intake is not feasible due to vomiting or unconsciousness. Their absorption rate varies widely among patients though making dosing precision more challenging.
Finally, while understanding each route’s pros and cons helps ensure optimal patient outcomes; professionals should stay abreast with evolving practices that may introduce newer routes tailored towards increasing effectiveness and comfort during treatment.
3.1 Explain the types, purpose and function of materials and equipment needed for the administration of medication via the different routes
Each route, from oral to injectable, demands specific tools tailored to ensure proper dosage, efficacy, and patient safety.
Oral Route
Oral medications are commonly prescribed due to their ease of use and patient compliance. This route requires items such as:
- Tablet Crushers: For patients with difficulty swallowing, tablet crushers pulverise pills into a fine powder that can be mixed with food or liquid.
- Medicine Cups: To measure liquid medications accurately.
- Pill Dispensers: These aid in organising medication schedules to prevent missed or double doses.
Injectables
When rapid action is necessary or when substances can’t be correctly absorbed by the digestive system, injections are administered. Equipment here includes:
- Syringes: Different sizes are required to measure varying amounts of medication precisely.
- Needles: They vary in length and gauge depending on injection sites and the viscosity of the medication.
- Alcohol Swabs: Used for sterilising the injection site prior to administering the shot.
The basis is ensuring sterility at every step.
Topical Applications
For localised treatment directly through the skin or mucous membranes:
- Applicators: Often come pre-packaged with creams/ointments for single-use application without cross-contamination (Drug Safety Guidelines).
- Gloves: Necessary when administering medication like dermatological agents while protecting both caregiver and patient from potential contamination.
Inhalation Devices
Drugs administrated through inhalation offer fast transport into the bloodstream via the lungs:
- Nebulisers: Convert liquid medicine into mist form for patients who struggle using metered-dose inhalers (MDIs).
- Spacer devices: Attached to MDIs for better control over drug dispersal during inhalation.
The usage entails ensuring atomisation quality since particle size affects drug deposition location within respiratory pathways.
These materials must serve their purposes—precise dosages and smooth administration—without introducing risks like infection or incorrect dosage. Functions range from measurement accuracy (safety) to reinforcing compliance via clear organisation tools. It’s a practice aligned with compassionate care principles alongside scientific exactness built on procedural reliability guidance provided by regulatory authorities (National Institute for Health Care Excellence, n.d.).
3.2 Identify the required information from prescriptions/medication administration record
It is vital to carefully identify the required information to ensure the safe and effective delivery of care services, including medication. This information forms the basis for accurate dispensing, administering, and monitoring of medications within adult care settings.
The information typically found on prescriptions includes:
- Patient Identification: This encompasses the full name, date of birth, and sometimes address of the patient.
- Date Issued: The date when the prescription was written by a healthcare professional.
- Medication Name: Both generic and brand names should be noted to prevent any confusion during dispensing.
- Dosage Form and Strength: This describes how the medicine is administered (e.g., tablet, liquid) and at what concentration.
- Dosage Instructions: Detailed guidance on how frequently and in what quantity the medication should be taken.
- Quantity Supplied: The amount of medication dispensed or required for administration.
- Prescriber Information: The credentials and signature of the prescribing practitioner ensure validity.
As for MARs which are used for recording medications that have been administered, crucial details include:
- Name: What medication was given?
- Dosage: How much was given?
- Date: When did administration occur?
- Time: At what time were medications given or due?
- Route: How was the administration done?
- Signature: Who administrated the medication? A signature is normally required post-administration as a record.
A study conducted by Alldred et al. (2009) underscores these measures in reducing errors, particularly among elderly patients who often face polypharmacy challenges.
Furthermore, additional notes regarding allergies, refills, brand substitution permission, and special instructions like “take with food”, may also appear on these documents; this mirrors guidelines provided by NICE (2014) emphasising clarity in medical documentation to minimise risks associated with drug interactions or adverse reactions.
Also, any discrepancies between what a prescriber has recommended on a prescription versus entries on a MAR call forth immediate consultation with colleagues or re-evaluations together with supervising medics.
3.3 Explain the actions to be taken if an individual does not consent to prescribed medication
When an individual does not consent to prescribed medication, it is imperative to respect their autonomy and decision-making capacity. The Mental Capacity Act 2005 in the UK underlines the principle that adult individuals have the right to make their decisions regarding medical treatment unless they lack the capacity to do so (Department of Health and Social Care, 2019). In such a scenario, professionals must take actions that align with legal and ethical frameworks.
Immediate Steps:
- Documentation: Record the individual’s refusal accurately in their care records, detailing date, time, communication methods used, and possible reasons for refusal.
- Explore Reasons: Engage in a respectful dialogue with the individual to understand any underlying causes for refusal – this may include fear of side effects or misunderstanding about the purpose of medication.
- Information Sharing: Provide clear and accessible information about the benefits/risk ratio of taking or not taking medication.
- Ensure Understanding: Assess comprehension; it may be necessary to use different forms of communication suited to individual needs.
- Review Consent Continuously: Consent is dynamic; regularly revisit discussions.
Further Actions If Refusal Persists:
- Consult with healthcare colleagues such as a pharmacist or GP who may offer alternative treatments or address any misconceptions held by the individual about their medication (National Institute for Health and Care Excellence [NICE], 2021).
- Seek advice from ethics committees or legal advisors if concerns about capacity arise (Social Care Institute for Excellence [SCIE], n.d.).
One must recognise that adults have sovereignty over their bodies which includes refusing medical intervention even if it goes against clinical advice. Any action taken should balance respecting personal liberty while ensuring that duty of care is met through risk assessment strategies.
Professionals have obligations not only to advocate for best practices but also to honour informed choices made by those they support.
3.4 Explain ways to ensure appropriate timing of the medication
Ensuring the appropriate timing of medication is crucial in adult social care settings, as it directly impacts the efficacy and safety of the treatment regimen. Medication adherence refers to whether patients take their medicine as prescribed, including at the right time. For care professionals, this entails a combination of knowledge, communication skills, and organizational strategies.
Firstly, one must familiarize oneself with the medication schedule for each individual under one’s care. Each medication has its intended dosing frequency which can range from once daily to multiple times per day (Marek & Antle, 2008). Understanding these schedules ensures timely administration and optimises therapeutic outcomes.
Secondly, integrating technology can be highly beneficial. Utilising electronic medication administration records (eMAR), for instance, helps track medication schedules electronically, sets reminders for caregivers and reduces errors associated with manual charting (Helmons et al., 2009).
Additionally, establishing a consistent routine is essential. If medications need to be taken with food or on an empty stomach this information should also be documented clearly in care plans (Elliott & Liu, 2010). This approach promotes adherence by creating predictable patterns around medication times that integrate seamlessly into the daily routine.
Another significant measure is effective communication with other professionals, such as pharmacists and prescribing doctors regarding any potential interactions or side effects that might necessitate adjusting timing – both presently noted or emerging concerns.
Also, involving service users in decisions about their own care fosters ownership over their medicinal routines (patient-centred care). Educating individuals about their medications’ importance while considering personal preferences can lead to better cooperation and adherence.
By implementing these steps carefully within adult social care practices in the UK we uphold not only our duty but also our commitment towards holistic well-being centred around respectfulness and empowerment.
References
NICE. (2020). Managing medicines for adults receiving social care in the community. Retrieved from https://www.nice.org.uk/guidance/ng67
UK Government. (n.d.-a). Medicines Act 1968. Retrieved from https://www.legislation.gov.uk/ukpga/1968
UK Government. (n.d.-b). Regulate Activities Involving Drugs: Role of the Care Quality Commission [Web page]. Retrieved from https://www.cqc.org.uk/guidance-providers/all-services/must-do-when-providing-care
American Diabetes Association. (2021). Pharmacologic approaches to glycemic treatment: Standards of Medical Care in Diabetes—2021. Diabetes Care, 44(Supplement_1), S111–S124.
Ansell J., Hirsh J., Hylek E., Jacobson A., Crowther M., Palareti G. (2008). Pharmacology and management of the vitamin K antagonists: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest, 133(6_suppl),160S–198S.
Atkins P.J., & de Lacey G. (Eds.).(2019). The Therapeutics Handbook: Adult Medicines Management Guidelines (3rd ed.). Norfolk Community Health and Care NHS Trust.
National Asthma Council Australia.(2020).Australian Asthma Handbook. Melbourne: National Asthma Council Australia Ltd.
Page C.P., Curtis M.J., Sutter M.C., Walker M.J.A., Hoffman B.B.(Eds.).(2020).Integrated Pharmacology(3rd ed.). Elsevier Health Sciences.
Stone N.J., Robinson J.G., Lichtenstein A.H..et.al.(2014) .2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: A report by the American college cardiology/ American Heart Association task force practice guidelines.Journal Of The American College Of Cardiology,63(25_PA):2889 –2934
Vaisman I.D.L.S.& Penmetcha R.(Ed.) .(2017).Medication Fact Book For Psychiatric Practice(5th Ed) .The University Psychiatric Hospital Vrapce
Barrett K.E., Barman S.M., Boitano S., Brooks H.L. (2020). Ganong’s review of medical physiology. McGraw-Hill Education.
Benson H.A.E., Namjoshi S. (2008). Proteins and peptides: Strategies for delivery to and across the skin. Journal of Pharmaceutical Sciences
Laube B.L., Janssens H.M., de Jongh F.H.C., Devadason S.G.et al.(2017). What the pulmonary specialist should know about the new inhalation therapies
World Health Organization [WHO]. (2019). Medicines: Rational use of medicines.
Alldred D.P., Kennedy M.C., Hughes C., Chen T.F., & Miller P. (2009). Interventions to optimise prescribing for older people in care homes. Cochrane Database Syst Rev(1).
Hughes R.G., & Blegen M.A. (Eds.). (2008). Patient Safety and Quality: An Evidence-Based Handbook for Nurses [Internet]. Rockville (MD): Agency for Healthcare Research and Quality
National Institute for Health Care Excellence [NICE]. Medicines management | topic | Guidelines. NICE; 2014
Department of Health & Social Care, (2019). Mental Capacity Act 2005 Code of Practice. Available at https://www.gov.uk/government/publications/mental-capacity-act-code-of-practice
National Institute for Health and Care Excellence (NICE), (2021). Decision-making and mental capacity. Available at https://www.nice.org.uk/guidance/ng108
Social Care Institute for Excellence (n.d.). Capacity Assessment. Available at https://www.scie.org.uk/mca/introduction/mental-capacity-assessment
