PSWs Role in Medication Management

Role of PSWs in Medication Management

• PSWs support clients with medications within regulatory allowances.
• Relevant laws, policies, and workplace guidelines govern medication support by PSWs.
• Medication-related tasks are assigned to PSWs by healthcare professionals like nurses. Delegation protocols must be followed.

Rights of Assisting with Medication Administration

• Key principles include the "Five Rights of Medication Administration": right person, medication, dose, time, and route.
• Develop skills to interpret medication labels including dosage instructions, warnings, expiration dates for safe client assistance.

PSWs and Drug Cards

• Compile medication reference cards with essential information for frequent use, enhancing knowledge and quick reference.

Resources for Staying Current

• Explore training programs, reference materials, and resources to stay informed on updates in medication management.

Math Skills

• Arithmetic skills, accurate dosages, conversions, and proper medication timing are needed.
• Understanding fractions, decimals, and percentages for dosages is important.

Understanding the PSW Role

• It's important to know the difference in the scope of practice, what they are allowed to do and what is outside of their scope.
• Differentiate between assisting versus administering medication.
• When working under supervision, consider the delegation of healthcare professionals, like nurses.
• Take into consideration ethical and legal medication assistance.

History of PSW Medication Assistance

• PSW roles have changed over time, they are now administering certain medications under specific conditions.
• PSWs have an increasing amount of responsibilities because of healthcare demands.

Delegation in Medication Management

• Understand who delegates medication tasks and PSW responsibilities of following the instructions.
• You must document and report properly when assisting with medication.
• Refuse delegated tasks that you are not trained for or are beyond scope.

Intro to Pharmacology

• Medication administration routes include oral, topical, sublingual, inhalation, and injections
• Drug classifications: pain relievers, antibiotics, and antihypertensives.
• Medications work in the body and intended effects
• Side effects can be mild reactions like nausea and drowsiness, or serious adverse effects. Reactions like anaphylaxis require emergency help.

Authority and Medication

• Nurses possess the legal authority to perform medication-related tasks set by legislation.
• Authority to administer medication is not automatically given to PSWs.
• PSWs may administer medication only when authority has been delegated by a nurse or healthcare provider, and in specific situations.

Delegation Rules

• PSWs must not perform delegated tasks that are unclear, incomplete, or inappropriate.
• PSWs are accountable for their actions and cannot shift responsibility to the delegating nurse.
• PSWs must stay informed of organizational and provincial guidelines because policies and rules can change.
• It is false to believe a PSW "rides along on a nurse's license"

Competence

• PSWs must assess their skills before administering medications, and ask themselves are they capable
• A PSW must do the skill safely, and the delegation process must be complete.
• If not confident, PSWs must not proceed, and cannot claim "the nurse told me to do it"
• Continual training is needed in order to demonstrate competence, must decline the task if there's lack of confidence

Safety

• PSWs administer safe medication and create safe environments
• Follow standard medication protocols, and speak up if things are not followed correctly
• Communicate with nurses, healthcare team and follow Ontario laws
• If working in home care (Community Settings) PSWs may be more involved due to the need
• Registered Nurses and Registered Practical Nurses are responsible for Long-Term Care and Hospitals since PSWs are less common to administer medication.
• The application of topical medications may be administered within Clinical Practice

Regulations and Guidelines

• Comply with the delegation criteria set by Ontario Legislation and employer-specific policies for safety and accountability.

The RHPA Legislation

• The RHPA is the primary legislation governing regulated health professionals in Ontario with key functions including:
• Providing a legal framework, defining scope of practice, establishing controlled acts, and ensuring patient safety.
• Regulated health professionals include: Nurses, Doctors, Pharmacists, Physiotherapists, Midwives, Dentists, Respiratory Therapists.

Controlled Acts

• They're specific medical procedures potentially harmful if performed by unqualified individuals, restricted to regulated professionals by RHPA for safety.
• There are 14, including administering substances, prescribing drugs, and procedures below the skin and energy application.
• Each act requires training and authorization.

Delegation of Controlled Acts

• Delegation is allowed to unregulated worker (PSWs) professional if strict guidlines are followed
• Regulated professionals must assess the competence to the receiving delegation
• Patient safety still remains with the professional and PSW must follow workplace policies and Ontario regulations.
• PSWs administer topical creams; help with inhalers under supervision; apply medicated patches in home care, when delegated
• PSWs cannot inject medications, adjust prescriptions, or perform invasive procedures when there is no delegation.

Unregulated Health Care Providers

• PSWs are not regulated under the RHPA or have legislated scope of practice like nurses, doctors, and pharmacists.
• PSWs cant independently perform controlled acts unless delegated.
• Roles depend on policies, agreements and guidelines.

PSW Responsibilities

• If a PSW is asked to delegate, they are accounted for its correctness
• PSWs must understand what they are required to do and refuse if unclear or incomplete. The nurse would not be used as an excuse for errors. The PSW must refuse if they aren't confident, and that task will require more training

Challenges in Delegation

• Some nurses might not fully understand the delegation process and PSW's limitations.
• Some nurses may assume PSWs can perform unsafe delegation, communicate with nurses and remind about delegation protocols.
• Politely clarify when a task is outside the PSWs role.
• You must ask for proper training before accepting delegated tasks, and you must ensure there is clear communication on what PSWs can and cannot do.
• Workplace policies and Ontario's legal guidelines should be followed with delegation
• Delegation of Medication Administration comes with the Nurse and the PWS

Nurses Accountability

• Nurses safely administer the medication to PSWs, where delegation is playing a crucial part
• In the Nurse's role, the cleint must be assessed for stability and see if the medication outcome is predictable before the actual delegation of medication. Delegation is inappropriate if the cleints are unstable.

Ensure Proper Delegation

• Medication administration must be safe within the PSWs competence, and the necessary knwoledge is known by the nurse.
• It is important for the PSW to understand responsibilities , and know who to ask when complications arise, as well as how to report the outcomes.

PSWs Accountability in Delegation

• It is important to take responsibility for their acts within competence and job description once the task is complete
• Make sure the employers policies and alignment is there, and cannot accept delegation if its unauthorized\
• You have the right if the delegation is unsafe, and decline the task if there is no proper training or the clients condition is changing. The PSW must ensure actions and tasks are correct for patient safety.

Clients Are Different

• Make sure each situation is assessed individually, and not automatically be preformed if it was from another client.

Delegation Decision by the Nurse

• The regulated health professional assesses if delegation is appropriate to a PSW. If unsure, the PSW should express concerns before accepting the delegated task.

Communicating Concerns

• If there are feelings of being unsafe, uncomfortable or uncertain, express concerns with the nurse to ensure safety
• This will allow clear commination and administration

Definition of Assisting vs Administering with medication

• Assisting: helping a client take their medication and reminding them, while following the correct procedures and schedule
• Administering: actively giving the medication like eye drops, injections and recording the actions

Medication Management

• Ensure labels are followed carefully which leads to accurately taking the medication
• Checking the 10 rights is the responsibilities of PSWS, even when familiar to the person.

10 Rights of Medication

• Right Medication: Always confirm that you are administering the correct medication as prescribed, and ensure names are correct.
• Right Person: Ensure that is for the correct patient, matching the name and following the identification policies.
• Right Dose: Always confirm the dose, and the correct amount with household and metric values. Do not estimate dosages.
• Right Route: The medications differ in the way they are taken, and always follow the procedures. Common routes include oral, sublingual, Injection and topical.
• Right Time: Make sure that administrations are specific so that the side effects can be avoided.
• Right Education: Why the clients are taking the medication, with a certain procedure like certain foods, alcohol and tobacco consumption must be avoided. Also, ensure the order of the medication
• Right Day: Ensure that administration of medication is based on correct dates
• Right Reason: Ensure that the medication is on the right condition that they are being given, and must report immediately if misused or confused
• Right Expiry: Make sure the best before of any medications are noted before administration, as the expiry date is important. If unsure, consult a supervisor.
• Right Documentation: It is essential that the medication is administer properly, and recorded.

Documenting Administering Medications

• You must properly record the medication, and it must be done by a caregiver
• You may have to report to the supervisor if you have questions.

The Institute for Safe Medication Practices

• The ISMP focuses on safety and reducing harm
• Provide many documentations, resources and safety practices
• Use ISMP practices best practices
• When looking at abbreviations on medications, use the correct meaning as it can be confusing.

Military Time

• Military time is measured on the 24 hour scale, not like a civilian
• To convert, remove the leading zeros and put AM
• To do noon to afternoon, take away 1200 from the millitary time to get PM

Resources

• Drug classifications and responsibilities are found in Table 45-2 of the textbook (pages 1064-1066).
• Can be written in notes, index cards or any other format as long as long
• Drug cards need to be simple to read and quick to follow.
• When writing a card, ensure key points are including like drug classification, drug action, name of medicine and PSW responsibilities