PSWs: Medication Management & Math Skills

Role of PSWs in Medication Management

• PSWs support clients with medications, understanding both permitted and prohibited actions under regulations.
• It is important to identify legislation, laws, policies, and guidelines that govern PSW medication administration and support.
• PSWs need to know how medication-related tasks are assigned by healthcare professionals like nurses.
• It is essential to follow delegation protocols.
• Know the "Five Rights of Medication Administration" to ensure client safety.
• Accurately interpret medication labels for safe client assistance.
• Skills include understanding dosage instructions, warnings, side effects, and expiration dates.
• PSWs should create drug cards for quick reference.
• Access training programs, reference materials to stay updated on medication management practices.

Key Math Skills in Medication Management

• Arithmetic is needed for medication-related calculations.
• Accurately measure dosages to ensure correct conversions and proper timing.
• Understand fractions, decimals, and percentages in dosages.

PSWs Role in Medication Management

• PSWs need to know what actions they can take.
• Working under supervision of nurses and healthcare professionals is critical.
• Medication assistance also has ethical and legal considerations.

Evolution of PSW Roles

• PSWs roles have changed over time with increased responsibilites.
• PSWs may administer certain medications under the right conditions.
• Increased responsibility is due to the changing healthcare system.

Delegation by Nurses

• Tasks can be delegated by nurses and regulated healthcare professionals.
• PSWs need to understand the delegation process, including who assigns tasks, how, and their responsibilities.
• Proper documentation and reporting is required when assisting with medication.
• PSWs should refuse tasks beyond their scope or training.

Introduction to Pharmacology

• Medication administration routes include oral, topical, sublingual, inhalation, and injections.
• Understanding drug classifications includes pain relievers, antibiotics, and antihypertensives.
• Knowledge of drug actions is how medications work.
• Side effects can be mild or serious.
• Anaphylaxis is a severe allergic reaction.

Authority in Medication Management

• Nurses have the legal authority over medication-related tasks.
• PSWs need delegated authority to give medications.
• Delegation comes from nurses or regulated healthcare providers only under certain situations.
• If a delegated task is unclear or inappropriate, PSWs must not do it.
• PSWs are accountable and responsible for their own actions.
• PSWs need to stay informed with organizational and provincial guidelines because policies change.
• PSWs do not share liability with nurses and are responsible for their own actions.

Competence and Safe Medication

• PSWs must be competent before giving medications.
• Proper delegation and documentation is key.
• PSWs should feel confident in medication-related tasks.
• Ongoing training is the PSWs own responsibility.

Safety

• Ensure safe medication administration is key.
• Healthcare culture emphasizes safety.
• Follow medication administration protocols and speak up in the event of problems.
• PSWs should communicate with nurses and healthcare teams.
• Adhere to organizational policies and Ontario legislation.
• Community settings see PSWs more involved.

Medication Administration Settings

• Home care settings see PSWs more involved.
• Long-term care and hospitals have RNs and RPNs administering medications.
• Topical medications are allowed during clinical practice.
• Employer and provincial policies can dictate if PSWs can handle topical creams and prescriptions.
• PSWs must comply with delegation criteria set by Ontario legislation and employer policies.

Role of the RHPA

• The RHPA governs regulated health professionals in Ontario.
• It provides a legal framework, defines scope of practice, establishes controlled acts and ensures safety.
• The law limits high-risk procedures to qualified professionals.

Regulated Health Professionals

• Regulated health professionals include nurses, doctors, pharmacists, physiotherapists, and midwives.
• Each profession has a scope of practice defining their legal tasks
• Controlled medical procedures must be performed by qualified individuals.
• The RHPA restricts potentially harmful acts to regulated employees
• There are 14 controlled acts under the RHPA
• Special training and authorization are required before performing controlled acts.

Delegation of Acts

• PSWs can be delegated controlled acts.
• Key rules for delegation state the regulated professional must assess competence of person receiving the delegation
• The person receiving delegation must be trained, competent and comfortable performing the task
• The responsibility for patient safety remains with the delegating professional
• PSWs must follow workplace policies and Ontario regulations.

Delegation Example

• Administering topical creams and eye drops with hydrocortisone or helping a patient with an inhaler under supervision are routine,
• Medications cannot be injected by PSWs.
• Adjustments and prescribing medications are not allowed.
• Invasive procedures cant be performed without explicit delegation.

Unregulated Care Providers

• PSWs are unregulated health care providers.
• They are not regulated under the RHPA meaning they do not have a legislated scope of practice.
• PSWs cannot independently perform controlled acts unless properly delegated by a regulated health professional.
• Provincial regulations define their roles.
• Medication delegation is a huge responsibility.
• The PSW becomes accountable for performing it correctly.
• PSWs must understand what they do and must not perform if unclear, incomplete, or inappropriate.

Challenges in Delegation

• Many nurses may not fully understand the delegation process or the PSW’s limitations
• Some nurses may assume that PSWs can perform tasks outside their role, leading to miscommunication or unsafe delegation.
• PSWs are responsible for educating nurses about delegation protocols and their own professional boundaries.
• When the task is outside their role, they must politely clarify
• PSWs can ask for proper training before accepting a delegated task.
• They should ensure there is clear communication with nurses about what PSWs can and cannot do.
• PSWs must advocate for safe delegation by following workplace policies and Ontario’s legal guidelines.

Nurse Accountability

• Nurses play a crucial role in ensuring safe and appropriate delegation of medication administration to PSWs.
• Key responsibilities include assessing client stability.
• The nurse must determine, that the client is stable and that the medication has a predictable outcome before considering delegation
• Delegation is not appropriate if client's condition is unstable or complex

Proper Delegation Process

• Proper delegation is safe and within the PSWs competence.
• Nurse is confident the PSW has the knowledge, skill, and judgement.
• The nurse must confirm the PSW understands the responsibilities in performing the task, including when to ask for assistance and whom to contact when complications arise.

PSW Accountability

• PSWs must take responsibility for their actions and ensure that they are acting within their competence and job description.
• They must also verify employer policies and job description:
• The PSW must ensure the delegation aligns with their employers policies and scope of practice
• PSWs can refuse unsafe delegation and decline the task if they lack proper training or if the clients condition changes.
• If a PSW feels uncomfortable, untrained, or feels the task is beyond their ability, they have the right to refuse the task.

Each Client Is Different

• Each situation must be assessed individually to determine if delegation is appropriate.
• Important notes state that PSWs are accountable for their actions and the task must be performed correctly to ensure patient safety.
• The regulated health professional (nurse, doctor, or pharmacist) must evaluate each case to determine whether or not it is appropriate.
• If there is any doubt, the PSW should discuss concerns before accepting the task.
• Clear communication also helps prevent errors in medication administration.

Assisting vs Administering

• Assisting medications involves helping a client take their prescribed medication by reminding them, opening containers, or ensuring the correct schedule.
• Administering medication involves actively injecting or applying medication (e.g. applying eye drops and topical creams).

Importance Of Medication

• Medication involves reading labels carefully and following the 10 rights of medication administration to ensure safety.
• PSWs are responsible for checking the "rights" even if regularly assisting them.

Medication Rights

• Right medication: Verify correct drug by checking the name of the medication on the prescription label
• Check the care plan and MAR, read the label carefully to avoid mixups
• Right Person: Confirm you are giving to the right person by checking the label on the container
• Be aware of clients with similar names
• Be sure to follow facilities policies
• Right Dose: Confirm the correct amount and that the prescribed dosage is listed on the medication label care plan and MAR
• Right Route: Medications are administered through different routes. Common ones are oral, sublingual, injection, topical and inhalation.

Safe Administration

• Administer medications exactly as prescribed within the appropriate time frame.
• Medications must be taken at specific times to maintain effectiveness and avoid side effects.
• Know to take medication before or after meals.
• Always notify a supervisor when a client is confused about when to take their medication.
• If in doubt, clarify with supervisor.

Right Education

• Ensure clients are educated on why they are taking medications.
• Some medications need to be taken on an empty stomach while others should be consumed with food or milk to avoid stomach irritation.

Right Day & Reason

• Be sure to confirm the medication is being given for the appropriate reason, and to report any misuse or confusion about medication to a supervisor immediately.
• Right Expiry Date: Ensure it is not expired.
• Check labels and consult supervisor
• Right Documentation: Be sure to properly record medication administration.

Importance of Documentation

• Documentation is of any administered medication is required according to agency protocol.
• A medication administration record is used for documenting medications and is the responsibility of all caregivers assisting a client taking the medication.

The ISMP

• The institute for safe medication practices prevents errors.
• It is a leading authority on medication safety and is recognized by many in the medical field and governments.
• ISMP's goal is to reduce the risk of patient harm due to medication misuse and to improve medicine.
• They also offer valuable resources such as documents and tools.
• They should be used as a resource for safety and best practices by regularly checking the website
• ISMP can be found on the D2L website.

Military time

• Military time based and civilian time-based systems differ.
• The conversions are as follows
• Medication administration times are documented in military time to prevent confusion.
• Knowledge of military time is important to facilitate correctly.

Drug Cards

• Reference Materials for drug cards are found in the textbook table 45-2.
• Drug cards serve as a guide for creating the medication.
• Legibility is key when writing in a notebook or on index cards.

Medication Card Details

• Drug classification by function is important.
• Understanding different effects depends on certain actions by certain drugs.
• Trade and generic drug names are relevant.
• Understanding instructions from both the personal support worker perspective as well as side effects and symptoms is the goal when teaching common side effects.