HLTHPS006 Learner Guide PDF

Student Learner Guide HLTHPS006 Assist clients with medication Copyright This document was developed by Compliant Learning Resources. © 2022 Compliant Learning Resources. Updated: by FAPA January 2024; July 2024; October 2024. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise without the prior written permission of Compliant Learning Resources. 2 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 Table of Contents Table of Contents.............................................................................................................3 This Learner Guide............................................................................................................7 Introduction.....................................................................................................................8 I. Prepare to Assist With Medication...............................................................................13 1.1 Establish Scope of Own Ability to Provide Assistance With Medication........................ 14 1.1.1 Legislation and Regulations...............................................................................15 1.1.2 Medicine and Drug Legislation..........................................................................15 1.1.3 Aged Care Legislation........................................................................................19 1.1.4 Disability Legislation.........................................................................................22 1.1.5 Mental Health Legislation.................................................................................25 1.1.6 Workplace Health & Safety...............................................................................28 1.1.7 Privacy Legislation............................................................................................32 1.1.8 Your Ability to Provide Assistance.....................................................................32 1.2 Identify Lines of Authority for This Task and Contingency Plan...................................... 35 1.2.1 Roles and Responsibilities.................................................................................35 1.2.2 Lines of Authority.............................................................................................38 1.2.3 Contingency Plans............................................................................................40 1.3 Confirm That Equipment and All Forms of Medication to be Administered are Ready for Use............................................................................................................................. 41 1.3.1 Forms of Medication.........................................................................................41 1.3.2 Commonly Used Medications...........................................................................49 1.3.3 Check Documentation.......................................................................................50 1.3.4 Check Medication.............................................................................................54 1.4 Confirm That You Have Authority to Proceed, With the Supervisor.............................. 58 1.4.1 Confirming With Your Supervisor......................................................................58 1.4.2 PRN Medication................................................................................................58 1.4.3 Schedule 8 Medications....................................................................................59 1.5 Follow Procedures for Prevention and Control of Infection........................................... 60 1.5.1 How Infection is Spread....................................................................................61 3 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 1.5.2 Standard and Additional Precautions................................................................61 1.5.3 Hand Hygiene...................................................................................................67 1.5.4 Respiratory Hygiene.........................................................................................68 1.5.5 Personal Protective Equipment (PPE)................................................................69 II. Prepare the Client for Assistance With Medication......................................................71 2.1 Clarify Specific Assistance Needed to Address Personal Needs of Each Client............... 72 2.2 Identify Level and Type of Supervision Needed by Client for Help With Medications... 74 2.3 Identify and Greet Each Client and Prepare Them for Medication................................. 77 2.3.1 Communicating With the Client........................................................................77 2.3.2 Identify and Greet Client...................................................................................79 2.3.3 Explain Administration Procedures...................................................................80 2.3.4 Prepare Client for Medication...........................................................................81 2.4 Check Individual Client Medications............................................................................... 83 2.5 Prior to Assisting the Client With Medication, Check for Changes and Report Them.... 85 2.6 Recognise Circumstances in Which You Should Not Go Ahead and Seek Advice........... 87 2.6.1 Circumstances in Which You Should Not Go Ahead...........................................87 III. Support the Clients With Their Medication.................................................................94 3.1 Prompt to Take at the Correct Time................................................................................ 94 3.2 Prepare Medications and Support Clients With Administration of Medication............. 95 3.2.1 Prepare Medication..........................................................................................96 3.2.2 Prepare Medication – Calculating Dosage..........................................................96 3.2.3 Support Clients With Administration of Medication..........................................99 3.3 Make Checks to Ensure Medication is Given According to the Six Rights of Medication..................................................................................................................... 111 3.4 Observe Clients Taking Medication and Confirm With Them That They Have Taken It 114 3.5 Implement Documented Procedures When Medication is Not Administered or Absorbed....................................................................................................................... 117 3.5.1 Medication Not Administered......................................................................... 118 3.5.2 Medication Not Absorbed............................................................................... 120 3.6 Fill Out All Medication Administration Records Needed.............................................. 121 4 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 3.6.1 Medication Chart............................................................................................ 121 3.6.2 Client Progress Notes...................................................................................... 124 3.7 Observe Client for Changes and Report Required........................................................ 125 IV. Handle Medication Contingencies............................................................................ 134 4.1 Report Any Concerns With the Process as Required.................................................... 134 4.2 Identify and Address an Individual’s Reactions to the Medication............................... 135 4.2.1 Organisational Guidelines............................................................................... 135 4.2.2 Identify Reactions........................................................................................... 136 4.2.3 Address Reactions to Medication – Immediate Actions................................... 137 4.2.4 Report the Reaction........................................................................................ 137 4.2.5 Record the Reaction....................................................................................... 139 4.2.6 Following Health Professional’s Instructions................................................... 139 4.3 Identify Unusable Medication and Dispose of It........................................................... 140 4.3.1 Contaminated Medication.............................................................................. 140 4.3.2 Out of Date Medication.................................................................................. 140 4.3.3 Disposing of Medication................................................................................. 141 4.4 Identify, Report and Record Changes in an Individual’s Condition on Time................. 143 4.4.1 Identifying Changes in Individual’s Condition.................................................. 143 4.4.2 Reporting and Recording Changes................................................................... 145 4.5 Identify Procedures to Address/Respond to Changes in the Client’s Condition or Needs............................................................................................................................. 146 4.5.1 Address/Respond to Changes in Client’s Condition.......................................... 146 4.5.2 Address/Respond to Changes in Client’s Needs............................................... 146 4.5.3 Organisational Guidelines............................................................................... 148 4.6 Report Inconsistencies and Take the Actions According to Directions......................... 149 4.6.1 Inconsistencies With the Medication............................................................... 149 4.6.2 Inconsistencies With the Client....................................................................... 150 4.6.3 Reporting Inconsistencies and Following Directions......................................... 151 4.7 Document and Address all the Inconsistencies............................................................. 152 V. Finish Medication Distribution and Documentation................................................... 153 5.1 Discard Waste Products Correctly................................................................................. 153 5 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 5.1.1 Organisation’s Procedures.............................................................................. 154 5.1.2 Manufacturer’s Instructions............................................................................ 154 5.2 Collect Used and Waste Products and Place Them in the Correct Containers............. 155 5.2.1 Collecting Used and Waste Products............................................................... 156 5.2.2 Discarded Medications................................................................................... 157 5.3 Clean and Store Medication Containers and Aids......................................................... 159 5.4 Replenish Dose Administration Aids and Medication................................................... 161 5.5 Store All Medication Records as Required.................................................................... 163 5.6 Store Medications as Required and Finish Any Other Tasks Related to This................ 165 5.6.1 Legislation and Regulations............................................................................. 165 5.6.2 Storing Medication......................................................................................... 165 5.6.3 Your Role Responsibility................................................................................. 168 References................................................................................................................... 170 6 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 This Learner Guide HLTHPS006 - Assist clients with medication (Release 2) This unit describes the skills and knowledge required to prepare for and provide medication assistance and complete medication documentation. It also involves supporting a client to self-administer medication. This unit applies to community services and health workers with authority in their state or territory to assist with administering medication. The skills in this unit must be applied in accordance with Commonwealth and State/Territory legislation, Australian/New Zealand standards and industry codes of practice. A complete copy of the above unit of competency can be downloaded from the TGA website: https://training.gov.au/Training/Details/HLTHPS006 About this Unit of Competency Introduction As a worker, a trainee, or a future worker, you want to enjoy your work and become known as a valuable team member. This unit of competency will help you acquire the knowledge and skills to work effectively as an individual and in groups. It will give you the basis to contribute to the goals of the organisation which employs you. It is essential that you begin your training by becoming familiar with the industry standards to which organisations must conform. This Learner Guide Covers HLTHPS006 - Assist clients with medication Prepare to Assist with Medication Prepare the Client for Assistance with Medication Support the Clients With Their Medication Handle Medication Contingencies Finish giving out medication and filling out the records needed 7 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 Introduction Your role as a support worker will be to assist clients with practical and emotional support. Your workplace may be in one or more of the following settings: ▪ Supported in-home care – disability or aged care services where you visit clients in their homes to help them ▪ Residential care facility – a facility where the clients live in it ▪ Day service or respite centre – disability services where clients go to it during the day and participate in activities ▪ Residential rehabilitation facility or community outreach centre – treatment or rehabilitation facilities Residential facilities are where clients live during rehabilitation. Outreach centres are where clients visit for treatment and support. ▪ Community access – helps clients in the community. For example, if you are taking clients out to help with their shopping or to social activities. 8 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 A client is any person your organisation has agreed to provide support to. Sometimes (especially in the disability sector), people may refer to the client as the participant or the individual. The care plan includes the support that the client will receive from your organisation. The support can consist of a wide variety of assistance. These are the following kinds of support: Meal assistance Personal care Transportation Helping clients take part in Assistance with medication leisure activities Some clients may be taking medication. As a support worker, you may have to assist or help them with the administration of their medication. The medication can be any legal medicines included in the client’s plan. Assisting with medication is a sensitive and vital part of client care. Some laws and regulations govern what you are allowed to do. Your organisation will also have its policies and procedures for you to follow. You need to complete this unit to assist clients with medication. This unit will teach you how to assist clients with medication. It is not about administering medication to clients (e.g., injecting them with a syringe. Instead, it is about helping clients take their medicine themselves (self-administer). However, it is still crucial that you know what to do when helping clients with their medication. If medication is taken incorrectly, it can result in serious health consequences, even death. You will be helping them because they cannot do all the tasks associated with taking their medication themselves. This could be for a simple reason, such as they cannot physically access the medication themselves. It may also be because they have trouble keeping track of what they have taken or cannot work out the correct dosage. 9 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 Your role is to do the tasks needed to take ensure the clients can take the medication correctly themselves. These tasks include the following: ▪ Taking the medication from where it is stored ▪ Taking the medication from its packaging ▪ Preparing the correct dosage for the client IMPORTANT: You must always keep records of the medication given when you help a client with their medication. Before proceeding, it is important for you to be familiar with some medication terms. The table below is a good reference for some common terms. The table however is not exhaustive. If unsure, you can always look up for a term’s definition online or by asking your supervisor. Term Definition A medication is a substance placed into or onto the body to achieve any of the following: Medication ▪ cure a medical condition ▪ treat a medication condition ▪ relieve the symptoms of a medical condition. Administration is the act of placing the medication into or onto Administration the body. The route of administration describes how and where the Route of administration medication goes into or onto the body. The form of medication is the physical state or format of the Form of medication medication during administration. A prescription is a document issued by a medical practitioner that Prescription authorizes a person to be provided with medication or treatment. The dose is the specific amount of medication administered at any Dose one time. Dosage The prescribed dose and schedule of medication administration. Dose administration aids Dose administration aids are devices that help in safely (DAAs) administering one dose of medication. 10 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 Term Definition The last day when the medication is said to be effective in its Expiry date purpose. Prescription medications are medications that require a medical Prescription medications practitioner’s prescription before they can be bought and administered. Over the counter (OTC) medications are medications that do not Over the counter (OTC) require a medical practitioner’s prescription before they can be medications bought or administered. An indication is a condition or circumstance for administering the Indication medication. A contraindication is a condition or circumstance for not Contraindication administering the medication. Side effects are safe symptoms that may be experienced after a Side effects dose of a medication is administered. Adverse effects are harmful symptoms that may be experienced Adverse effects after a dose of a medication is administered. In this Learner Guide, you will learn how to do the following: Prepare to assist with medication Prepare the client for assistance with medication Support the clients with their medication Handle medication contingencies Finish medication distribution and documentation 11 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 Commonly used abbreviations Abbreviation Term BD Twice a day TDS Three Times a Day QID Four Times a Day PRN When required PO Per Oral Mane In the morning Nocte At night 12 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 I. Prepare to Assist With Medication This chapter includes the preparation of medication and any equipment needed to administer them properly. The chapter also includes the review of important documents or records, such as the client’s care plan and medication chart. After completing this chapter, you will be able to do the following: Work out the scope of your own ability to provide assistance with medication. Prepare to give medication. Confirm if you are to proceed. If you do not prepare the medication correctly, this could result in medication errors. These can have serious consequences. If you do not prepare systematically, you may waste time and not complete these tasks as accurately as expected in the workplace. This chapter will cover the steps needed to prepare to assist with medication to clients. It will also explain the legal and organisational requirements for doing so. 13 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 1.1 Establish Scope of Own Ability to Provide Assistance With Medication As mentioned in the introduction, you must assist clients with medication instead of directly giving it to them. Scope means the range and extent of your activity. The scope of your ability to assist implies the range of things you can do when assisting. Jurisdictional and organisational requirements will determine the scope of your ability to assist. Jurisdictional requirements will be state, territory and Commonwealth legislations and regulations. This will vary dependent on what State or Territory you are working in within Australia. Organisational requirements include the policies, procedures, protocols and guidelines that your organisation implements. Organisational requirements may also be those implemented by the facilities you work in. Many of these requirements are about your duty of care. Duty of care is the legal responsibility to take reasonable care to avoid causing foreseeable harm to another person. The duty of care has a special meaning where the person who might be harmed relies on the person who might harm them. For example, a doctor's duty of care to their patients is to ensure proper medical attention. However, the doctor does not have a duty of care regarding your education. In the context of your role as a support worker, you have a special duty of care to the clients that you support. This is because your clients rely on you for support. Several laws make requirements for your duty of care to clients regarding assisting them with medication. The laws also specify requirements for your organisation’s duty of care to their clients. These include the following: These laws include specific legislation for the following: ▪ Medicines ▪ Work health and safety ▪ Privacy There are also sector specific laws for the following sectors: ▪ Disability ▪ Aged care ▪ Mental health 14 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 1.1.1 Legislation and Regulations In Australia, legislation is an Act of Parliament (a law). This is true for the Commonwealth Parliament and the state and territory governments. There will be other applicable legislation that depends on which sector you are working in. These sectors include the following: Drug and alcohol Aged care Disability Mental Health treatment 1.1.2 Medicine and Drug Legislation States and territories control the legislation about medicines and poisons, but they have closely aligned the legislation with the Commonwealth (national) legislation. The relevant Commonwealth legislation is the Therapeutic Goods Act 1989. It maintains a national system of controls for the quality, safety, timely availability and, where necessary, efficacy, of medications. The legislation updates its regulations and other related rules regularly. For example, The Poisons Standard within this was updated in 2021. The Poisons Standard consists of decisions about classifying medicines and poisons into schedules. Scheduling is a classification system that governs the availability of medications to the public. These must be included in the relevant legislation of the states and territories. The state and territory schedules are almost always in line with the Commonwealth Poisons Standard. The schedules for medication and poisons are for grouping medicines according to the rules around their use. For example, prescription medications are grouped together. You can refer to the table below for the following schedules: Schedule Description Not currently in use. Schedule 1 This schedule is intentionally left blank in the document. These are pharmacy medicines. This means that these are available on the shelf Schedule 2 of the pharmacy. Examples include paracetamol, ibuprofen and aspirin. 15 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 Schedule Description These are pharmacist only and are available from a pharmacist without a prescription. They are behind the counter and must be requested from the Schedule 3 pharmacist. Examples include pseudoephedrine and salbutamol. These are prescription-only medicine. These require diagnoses and monitoring as well for safety purposes. Only authorised medical practitioners can prescribe Schedule 4 them. Examples include amoxicillin, ephedrine, isotretinoin, benzodiazepines, etc. Caution – These chemicals are not likely to cause harm, but they require caution Schedule 5 when using or handling. They must have simple warnings and safety directions on their labels and suitable packaging. Schedule 6 These are considered poisons with a moderate risk of causing harm. These are dangerous poisons. They have a high risk of causing harm in low doses (quantities taken), with moderate to high toxicity. They have to have distinctive Schedule 7 packaging. These may cause severe injury and death. Only certain people can handle them safely. There may also be special rules for selling, using and storing. Known as controlled drugs, these are substances used for therapeutic purposes. However, these also have significant potential for addiction. So, there are special rules for them. The rules are for all aspects of dealing with them. This Schedule 8 includes production, use, distribution and disposal. The prescribing health professional may need a special prescribing permit for some of them. They include opioid analgesics, such as methadone, morphine and fentanyl. These are considered prohibited substances. They are prohibited, except when Schedule 9 used for approved medical or scientific research. The relevant health authorities must approve the use. These are poisons other than those that cause dependence. They are Schedule 10 considered so dangerous they are banned altogether. They cannot be sold, supplied or used for any purpose. Sourced from The Federal Register of Legislation at January 5 2022. For the latest information on Australian Government law, please go to https://www.legislation.gov.au/ used under CC BY 4.0. This document lists all the drugs, poisons, and substances regulated in Australia. If you need more clarifications, consult with relevant health professionals. 16 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 You can also use information sources designed for the public. One of these is the Medicine Finder provided by NPS MedicineWise. This search tool allows you to search for medicine by its brand name or ingredients. The results will show Consumer Medicines Information (CMI) for the medication. This is the information in the leaflets that pharmacists can provide for medication. You must understand how scheduling works. When assisting with medication, you will be dealing with substances that are either: ▪ unscheduled ▪ from schedules two, three, four or eight. Unscheduled medications are considered to have very well known, low-risk ingredients. Examples include vitamin supplements and sunscreens. However, you need to know that while it is generally legal for people to decide themselves to use these, you cannot always give them to clients. You can use them without a prescription or input from a health professional. But that does not mean that you can provide these to clients simply because they ask for them. You generally can only give medications already approved for a client and are listed in that client’s medication chart. This is because of the potential for allergic reactions and interactions. This principle is important and will be mentioned several times throughout the unit. Further Reading NPS MedicineWise is a non-profit organisation funded by the Australian Department of Health. NPS MedicineWise provides information about medicines and health. You can use the Medicine Finder to find medication information. This includes scheduling, ingredients and potential side effects. NPS MedicineWise – Medicine Finder 17 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 STATE AND TERRITORY MEDICATION LEGISLATIONS Therapeutic Goods Act 1989 Refer to the table below for the relevant medication legislations and regulations for each state/territory: State/Territory Medication Legislation Medication Regulation Australian Capital Medicines, Poisons and Therapeutic Medicines, Poisons and Therapeutic Territory Goods Act 2008 Goods Regulation 2008 Poisons and Therapeutic Goods Act Poisons and Therapeutic Goods New South Wales 1966 Regulation 2008 Medicines, Poisons and Therapeutic Medicines, Poisons and Therapeutic Northern Territory Goods 2012 Goods Regulations 2014 Therapeutic Goods Act 2019 Medicines and Poisons (Medicines) Queensland Regulation 2021 South Australia Controlled Substances Act 1984 Controlled Substances Act 1984 Tasmania Therapeutic Goods Act 2001 Poisons Regulations 2018 Therapeutic Goods Act 2010 Drugs, Poisons and Controlled Victoria Substances Regulations 2017 Medicines and Poisons Act 2014 Medicines and Poisons Regulation Western Australia 2016 The medication legislations above correspond to the Commonwealth Therapeutic Goods Act 1989. They are the primary legislations concerning medication administration. Each of the legislations above will also have their own scheduling, except for those of Queensland, South Australia, Tasmania and Victoria. For these state/territories, you can refer to the Commonwealth Poisons Standard found at the start of this section. The medication regulations above are legislative instruments that provide regulations for the medication administration. These regulations are under their corresponding legislations, except for those of Queensland, Tasmania and Victoria. 18 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 1.1.3 Aged Care Legislation The main law regarding Aged Care is the Aged Care Act 1997, which as updated in January 2024. The Act sets out rules for government-funded aged care. The Act lists down the relevant responsibilities for service providers, which include but is not limited to the following: ▪ Provide care and services that respect the rights and responsibilities of clients ▪ Provide care and services according to the Quality of Care Principles ▪ Establish a process for client complaints to be received and resolved ▪ Use client’s personal information only for the indicated service ▪ Maintain enough number of capable staff to serve the clients The Aged Care Act 1997 has been amended to create the Aged Care Quality Standards. The table below lists down the Aged Care Quality Standards and how aged care service providers can comply with them: How Aged Care Service Providers Can Comply with the Aged Care Quality Standards Standards Standard 1 Reflects important concepts about a person’s sense of self Consumer dignity and choice Standard 2 Describes what providers need to do to plan care and Assessment and planning services for people using aged care. Standard 3 Applies to all services delivering personal and clinical care Personal care and clinical care in the Quality of Care Principles 2014 Standard 4 Covers the options for supporting people to live as Services and supports for daily living independently as possible and enjoy life Standard 5 Applies to the service environment provided for Service environment residential care, respite care and day therapy centres Standard 6 Requires providers to have an accessible, confidential, Feedback and complaints prompt and fair system to resolve complaints Standard 7 Requires providers to have skilled and qualified workforce Human resources for delivering safe, high quality care Standard 8 Holds governing bodies responsible for their organisations Organisation governance and delivery of care 19 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 You should familiarise yourself with the basic concepts of these standards. In particular, ‘Standard One – Consumer Dignity and Choice’ is essential to understand. The other standards are all centred on Standard One. Multimedia The following video gives an overview of Standard One. Consumer Dignity & Choice - Aged Care Standard One Another relevant document that you must be familiar with is The Aged Care Voluntary Industry Code of Practice. This code of practice aims to promote continuous improvement among service providers. Consent for Medication Consent must be given for the client to receive medication. Standard One of the Aged Care Quality Standards directly refers to the person’s right to choose their care and treatment. As long as a person receiving aged care can choose whether to take their medication, they can do so. If they are not allowed to do so, there will be a substitute decision-maker (SDM) to refer to. State laws determine who will be the substitute decision-maker. The client can often choose their SDM, but one will be appointed according to state law if they cannot. This will not be the person’s doctor. A doctor can prescribe medication based on their assessment of the person, but the SDM decides whether the medication will be administered. The consent must also be informed. Informed consent means the person making the decision is given all the relevant information. This includes the reason for recommending the medication or prescribed and potential side effects. Restrictive Practices A restrictive practice is any action that restricts the rights or freedom of movement of a care recipient. To use restrictive practices, a provider must follow a specific process. They show 20 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 they have attempted all other strategies first. You must only use restrictive practices to prevent harm, either to the client or others. They should only be used as a last resort. As this unit related to assisting clients with medication, it will only discuss the use of chemical restraints. Chemical restraint is administering medication as a restrictive practice. It restricts the client's freedom or sedates them. Administering medicines is to treat a medical condition or illness. Conditions and illnesses can both be physical or mental. But, when medication is used with the primary purpose of influencing (or controlling) a person’s behaviour, it becomes a restrictive practice. If a restrictive practice is approved, it must be in the client’s behaviour support plan. A behaviour support plan is used for clients whose behaviour indicates a need for extra support. It gives information about the client and strategies for managing their behaviours. The information provided about the client will include relevant background about the client. This helps the staff understand the client’s behaviour and deal with it. Any assessment completed on the client regarding this will be in it. It will also include any authorised restrictive practices, and how and when they must be used. If a client has a behaviour support plan, it will be part of their care plan. The client or their SDM must also consent to the behaviour support plan. In any instance of chemical restraint that is documents, medication to be used must have been prescribed by a doctor. Further Reading The following booklet provides information on the rights of people using the aged care system (consumers). Charter of Aged Care Rights The Aged Care Quality and Safety Commission is the regulator of the Aged Care Standards. The following website provides further information about the Aged Care Standards. Quality Standards The following factsheet provides more details about consent for medication in aged care. Consent for medication in aged care The fact sheet from Aged Care Quality and Safety Commission explains the requirements for behaviour support plans. Behaviour support plans 21 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 You can find the Aged Care Voluntary Industry Code of Practice in the link below: Aged Care Voluntary Industry Code of Practice 1.1.4 Disability Legislation The principal Commonwealth Acts regarding disability include the following: ▪ The Disability Discrimination Act 1992 ▪ The Disability Services Act 1986 ▪ National Disability Insurance Scheme Act 2013 The Disability Discrimination Act 1992 made it illegal to discriminate against people with disability in a wide variety of areas. The areas covered include the following: Work Accommodation Education The provision of goods and Access to premises services It also aimed to ensure that people with a disability have the same rights to equality before the law like everyone else. Based on content from the NSW Register of Legislation at December 31, 2021. For the latest information on NSW government law, please go to https://legislation.nsw.gov.au, used under CC BY 4.0. The Disability Services Act 1986 sets service standards for pre-NDIS Commonwealth disability services before the NDIS (National Disability Insurance Scheme) took over funding for those services. The Act is still applied for situations where the Commonwealth still provides funding for the services under the Act. Disability funding covers areas such as: Accommodation Independent living Information support training Print disability Recreation Respite care 22 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 NDIS Legislation The NDIS (National Disability Insurance Scheme) is the current Commonwealth funding scheme. The scheme as legislated in 2013 and revisited in 2020. It aims to help all Australians under 65 who have a permanent and significant disability. The aim is to provide them with the proper and necessary support they need to live an ordinary life. If you work in disability support, you will likely work for an NDIS provider as a support worker. Your organisation may also become a NDIS provider in the future. NDIS providers are organisations or individuals that provide services or support to a participant or the recipients of the support of the NDIS. One of the goals of the NDIS is to become a unified source of funding. Previously, the budget for disability services was spread across the states and territories and multiple funding schemes. The Act also established the NDIS Quality and Safeguards Commission (NDIS Commission) as the regulator for the NDIS. The NDIS Quality and Safeguards Commission does the following: ▪ Monitors registered providers for compliance with the conditions of their registration. Most registered providers must undergo a periodic audit. It assesses their performance against the NDIS Practice Standards. ▪ Investigate complaints and reports of non-compliance with the rules. The rules include the following: o NDIS Practice Standard o Code of Conduct o Other quality and safeguards requirements where they apply ▪ Investigate any matters relating to registered and unregistered providers and workers. It can impose penalties in the most serious cases: o Banning workers o De-registering providers o Seeking civil penalties Based on content from the Compliance and Enforcement Policy V2.0 – December 2021, used under CC BY 3.0 AU © Commonwealth of Australia NDIS Regulations In the context of this unit, the main NDIS rules or regulations you must follow include: ▪ the NDIS Code of Practice 23 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 ▪ the NDIS (Restrictive Practices and Behaviour Support) Rules 2018. Some parts of the Code of Practice are unlikely to apply directly to assisting a client with medication. You must familiarise yourself with the Code of Practice and use it in every part of your role. The Code of Practice requires workers and providers who deliver NDIS supports to do the following: ▪ Act with respect for individual rights (in accordance with relevant laws and conventions) to: o freedom of expression o self-determination o decision-making. ▪ Respect the privacy of people with disability. ▪ Provide support and services in a safe and competent manner with care and skill. ▪ Act with integrity, honesty and transparency. ▪ Promptly take steps to raise and act on concerns about matters that might have an impact on the quality and safety of support. ▪ Take all reasonable steps to prevent and respond to all forms of: o violence o exploitation o neglect o abuse of people with disability. ▪ Take all reasonable steps to prevent and respond to sexual misconduct. Based on content from the NDIS Code of Practice (NDIS Providers), used under CC BY 3.0 AU © Commonwealth of Australia The rules regarding restrictive practices are also critical. The NDIS Rules 2018 emphasises that no medication should be used for the primary purpose of behaviour management. You are only allowed to give medication as prescribed by a doctor. So, it is not up to you to decide what medications should be given to a client. The same conditions apply to aged care and follow the same basic principles. Using a chemical restraint and other restrictive practices are only allowed where other options have been exhausted. However, if a NDIS provider wants to implement a behaviour support plan, they must lodge it in the online NDIS Commission Portal. If the NDIS Commission accepts, the provider must continue lodging reports monthly. National Standards for Disability Services 24 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 Another relevant document to be familiar with is the National Standards for Disability Services (NSDS). The NSDS aims to guide a nationally consistent approach to disability services. Consider the six National Standards and how they can be applied when providing disability services: National Standards How They Can Be Applied When Providing Disability Services Rights The service must promote the different rights of the client. The service must create meaningful opportunities to encourage Participation and inclusion the client to participate in activities. It should also promote the client’s inclusion in relevant activities. The service must be assessed, planned, delivered and reviewed Individual outcomes according to the client’s strengths and goals. The service must seek feedback and use this information for Feedback and complaints service reviews and improvement. Service access The access to service must be fair, transparent and equal. The service must have effective and accountable service Service management management to maximise the individual’s outcomes. Further Reading The following website has an overview of the NDIS, including how and why it was established. What is the NDIS? Linked below is The Regulated Restrictive Practices Guide from the NDIS Commission. It describes the NDIS rules around restrictive practices in detail. Regulated Restrictive Practices Guide The following website has an overview of the National Standards for Disability Services (NSDS). National Standards for Disability Services 1.1.5 Mental Health Legislation Although there is Commonwealth legislation for mental health, the States have the main power to legislate. The purpose of the Mental Health Acts, in all regions, is to establish the 25 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 rules for the care and treatment of persons with mental illness. In most cases, the modern acts have been updated to reflect contemporary views on mental health treatment. The New South Wales legislation will be discussed here. You must check if there are any differences in the legislation in your state or territory. Mental illness can be considered a form of disability. If you are working in the mental health sector, some clients may be considered to have a disability. So, it would help if you also familiarised yourself with disability legislation. NSW Mental Health Act 2007 The Act was updated in 2024 to be more person focused. The changes included giving the right to access information about their medication. This is for both clients and their carers. Regarding medication administration, you need to know the clients' rights and the responsibilities of the people giving them their medication. The clients’ rights regarding their medication include the following: ▪ Clients have the right to information about their medication, including involuntary patients. A designated or principal carer can also request this information for involuntary patients. ▪ A voluntary patient may refuse medication. However, an involuntary patient may not. As per the Act, a person detained in a medical health facility may not refuse medication. A person under a community treatment order (CTO - see below) may not have the right to refuse medication. If their treatment plan requires them to take the medication, they do not have the right to refuse. The responsibilities of the people administering medication consist of the following: ▪ They must not give medication as a punishment or for the convenience of others. Doing this would be considered a restrictive practice. ▪ Medication must be prescribed at doses consistent with proper care to ensure that clients can communicate with their legal representatives. A community treatment order (CTO) may be made by The Mental Health Review Tribunal or, in some circumstances, a magistrate. The CTO sets out the client's terms to accept medication, therapy and other services while living in the community. A community health service will implement this. Medications that the client must take will be included in their treatment plan. If clients refuse or fail to comply with their CTO, they could breach their CTO. Your organisation must follow the procedures for this in the Act. Your organisation will have its own, more detailed policies and procedures for implementing CTOs. These will be in line with the legislation. The table below lists the relevant mental health legislation for the different regions: 26 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 Region Mental Health Legislation Commonwealth Mental Health Act 1996 Australian Capital Territory Mental Health Act 2015 New South Wales Mental Health Act 2007 No 8 Northern Territory Mental Health and Related Services Act 1998 Queensland Mental Health Act 2016 South Australia Mental Health Act 2009 Tasmania Mental Health Act 2013 Victoria Mental Health Act 2014 Western Australia Mental Health Act 2014 Further Reading HETI is an NSW government organisation that provides training to the NSW health workforce on mental health matters. This page provides summary information about the Mental Health Act 2007, including video podcasts from a health worker’s point of view and the Mental Health Act Guide Book for more in-depth information. Access all these using the link below. NSW Mental Health Act (2007) 27 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 1.1.6 Workplace Health & Safety The Work Health and Safety Act 2011 (Cth) is the basis of the WHS laws that have been implemented in most jurisdictions in Australia. Most states have worked with the Commonwealth government to implement consistent legislation. Victoria is the only jurisdiction that has not implemented this by 2023. There can be some minor differences in the legislation between the states, but it is mainly harmonious. Section 28 of the Commonwealth WHS Act 2011 requires workers to do the following while at work: ▪ Take reasonable care for their health and safety (including reporting potential hazards to their employer.) ▪ Take reasonable care that their acts or omissions do not adversely affect the health and safety of other persons. ▪ Adhere to reasonable instructions to uphold compliance with the act. This means that the worker will comply, so far as the worker is reasonably able, with any instructions given by the person conducting the business or undertaking to allow the person to comply with this Act. ▪ Co‑operate and collaborate with communicated reasonable workplace health and safety policy or procedure of the person conducting the business or undertaking. These are instructions relating to health or safety at the workplace that they have been given. The Act does not define ‘at work’. A workplace is defined as anywhere a worker goes or is likely to be while at work. Sourced from The Federal Register of Legislation at January 5, 2023. For the latest information on Australian Government law, please go to https://www.legislation.gov.au/ used under CC BY 4.0. 28 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 In practice, this means that your workplace would be anywhere you are working in your role as a support worker. Here are the following examples: ▪ Your organisation’s site, where you work, is a workplace. For example, the site could be residential aged care, residential rehabilitation facility or day centre. ▪ The home of the clients you support in their homes is a workplace for you. ▪ Anywhere you go in the community with clients while supporting them is a workplace for you. However, your organisation does not have the same responsibilities outside their sites as they would on their site. For example, if there were a safety hazard on their site, such as uneven stairs, they would be responsible for ensuring it was fixed. However, when a client receives in-home care, the organisation must do a risk assessment before the workers start work. If there are issues to be addressed, the organisation will work with the client to address these. The client will usually be responsible for organising payment for necessary repairs or alterations for their home. The ‘other persons’ mentioned that you have to take care not to impact the health of (as discussed above in the altered extract from the Act) will include the following: ▪ Clients of your organisation ▪ Other staff in your organisation ▪ Visitors to your organisation’s site, including volunteers, friends and family of the clients ▪ People you encounter in the community while you are supporting your client Relevant Regulations and Codes of Practice Risk management is one way of addressing the duty of care. The Commonwealth Work Health and Safety Regulations 2011 has the following requirements for providers to manage risks to health and safety: Eliminate risks to health and safety so far as is reasonably practicable Minimise risks to health and safety so far as is reasonably practicable if they cannot be eliminated Sourced from The Federal Register of Legislation at January 5, 2022. For the latest information on Australian Government law, please go to https://www.legislation.gov.au/ used under CC BY 4.0. When it is not practical to eliminate the risks, the same regulations require the following: ▪ Substitute (wholly or partly) the hazard giving rise to the risk with something that gives rise to a lesser risk ▪ Isolate the hazard from any person exposed to it 29 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 ▪ Implement engineering controls ▪ Implement administrative controls ▪ Ensure the provision and use of suitable personal protective equipment Sourced from The Federal Register of Legislation at January 5, 2022. For the latest information on Australian Government law, please go to https://www.legislation.gov.au/ used under CC BY 4.0. The Work Health and Safety (How to Manage Work Health and Safety Risks) Code of Practice 2015 defines hazards and risks as the following: ▪ A hazard is something that may cause harm to a person. ▪ The risk is the possibility of a person being harmed when exposed to a hazard. The same code of practice enumerates the following steps in managing risks: 1. Identify the hazards by finding out what could cause harm 2. Assess risks by understanding the nature of the harm that could be caused by the hazard, how serious the harm could be and the likelihood of it happening 3. Control risks by implementing the most effective control measure that is reasonably practicable in the circumstances 4. Review control measures to ensure they are working as planned Sourced from The Federal Register of Legislation at January 5, 2022. For the latest information on Australian Government law, please go to https://www.legislation.gov.au/ used under CC BY 4.0. Good housekeeping practices make the work environment safer. The Commonwealth Work Health and Safety (Managing the Work Environment and Facilities) Code of Practice has the following requirements for good housekeeping practices: ▪ The workplace must be well laid out for the movement of people ▪ The workplace must have sufficient space for storage ▪ Space close to workstations should be allocated to allow for the storage of tools and materials that are used frequently ▪ Workers must be trained in and cooperate with good housekeeping procedures ▪ Suitable containers for waste should be conveniently located and regularly emptied ▪ Other options for carrying out the general cleaning of the workplace should be considered, for example, engaging cleaners Sourced from The Federal Register of Legislation at January 5, 2022. For the latest information on Australian Government law, please go to https://www.legislation.gov.au/ used under CC BY 4.0. The same code of practice believes that an appropriate work area allows a worker to perform properly. The following are the considerations for determining space needed in work areas: 30 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 ▪ access to workstations ▪ the need to move around while working ▪ the physical actions needed to perform the task ▪ whether the task is to be performed from a sitting or standing position ▪ the equipment to be handled and the personal protective equipment that may be worn to perform the work Sourced from The Federal Register of Legislation at January 5, 2022. For the latest information on Australian Government law, please go to https://www.legislation.gov.au/ used under CC BY 4.0. Risk Factors In general, two of the main WHS risk factors for support workers are: manual handling aggression from clients. Take particular care to learn your organisation’s WHS procedures regarding these risk factors. This is because clients may have to be moved to take their medication, such as sat up in bed or relocated. Taking medication or being allowed to do so can trigger some clients. Further Reading The Queensland Government developed this guide about managing work health and safety for community workers working in clients’ homes based on the WHS Act 2011. Click the link below to access this: A guide to working safely in people's homes The commonwealth Work Health and Safety Act 2011 is adapted by states and territories to provide equal protection and standards to workers in each jurisdiction. Use the link below to see each state/territory’s work health and safety legislation Australian WHS State and Territory Comparison Table Download 31 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 1.1.7 Privacy Legislation Privacy legislation is important for your role as you will have access to your clients personal information. Your organisation and you as its employee must maintain the privacy of your clients. In general, you should not discuss a client’s private information with people outside your organisation. You must also take reasonable care that the clients’ confidential information remains private. Further Reading See the Federal Register of Legislation for further information about the Privacy Act linked below: Privacy Act 1988 1.1.8 Your Ability to Provide Assistance In this section, you will consider your ability to provide this assistance. Think back to the legal and regulatory requirements from earlier in the chapter. You must take reasonable steps to ensure you can carry out the procedure to assist clients with their medication safely. This is so you can meet your duty of care. There are three aspects to your ability to assist with medication that you should consider. They are your: ▪ formal qualifications ▪ knowledge and skills ▪ physical requirements to carry out the procedure. 32 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 Formal Qualifications You must be appropriately qualified to assist with medication. To be qualified, you must have completed this unit, as well as any other qualifications required for your role. For example, your role may require that you have at least a Certificate III in Individual Support. You may also need to have a current First Aid certificate to work as a support worker. This will prepare you to provide first aid if the client needs it (e.g. if they choke on their tablet or react to their medication). Your role is to assist with medication, and you must not go beyond the scope of your role. For example, you must follow the prescribing medical practitioner’s orders. You cannot alter the dose or any other aspect of how the medical practitioner ordered the medication to be administered. Knowledge and Skills To ensure you have the knowledge and skills to assist clients with their medication, you must have studied and passed the assessments for this unit. It is imperative that you understand the procedures of assisting with medications. You must read the relevant documents, including the client’s medication chart and care plan. Your organisation may have variations in their procedures and there may also be variations in the process for assisting specific clients. If you are unsure, seek guidance from your supervisor. When you are sure that you understand the procedure, ask yourself if you know and can do everything you need to follow this procedure. Here are the following examples: ▪ The medication may be stored in a bottle with a tamper-proof lid you have not seen before, and you do not know how to open it. ▪ The medication may be in a different form from what you have used before. For example, you have not helped someone take liquid drops taken through the mouth before. Physical Requirements There may be physical requirements for assisting a client with medication. For example, a client may need to be repositioned in their wheelchair or even transferred to a sitting position from bed to take their medications. This is important for both your safety and the client’s safety. If you attempt a task but you cannot do it safely, you put yourself and the client at risk. This breaches both WHS regulations and your duty of care to your client. Your organisation will have procedures for manual handling and other tasks that may be of higher risk. 33 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 You must familiarise yourself with them, ensuring you utilise provided equipment correctly, follow the training you have been provided in manual handling. 34 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 1.2 Identify Lines of Authority for This Task and Contingency Plan Lines of authority refer to the chain of command. For example, you, your supervisor and your supervisor’s manager are a line of authority. The lines of authority for this task will designate who is authorised to delegate the task of assisting with medication. Delegate means to assign a task to someone else. 1.2.1 Roles and Responsibilities The people involved in administering medication for a client have specific roles. These include the following people: ▪ Service provider (your organisation) ▪ Medical practitioners ▪ Pharmacist ▪ Registered and enrolled nurses ▪ Support worker ▪ Client Service Provider Service providers must create policies and procedures for the administration of medication. This includes: ensuring that their staff understand the lines of authority relevant to them ensure their staff are qualified and trained to complete their tasks. must not ask their staff to complete tasks beyond what they can do competently. Medical Practitioner All medication must be prescribed by an authorised medical practitioner (a doctor). This person will often be a General Practitioner (GP) but may also be a medical specialist. Occasionally, a dentist will also prescribe medication. These are health professionals who specialise in oral health. Doctors usually send prescriptions directly to the pharmacist when clients receive medication regularly. The pharmacist prepares to send the medication to the organisation supporting the client. The prescribing medical practitioner will also have the following responsibilities: ▪ Ensure that the client’s past medical history is compatible with the medication 35 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 ▪ Ensure that the medication has no contraindications with the client ▪ Ensure that the correct dosage of the medication is prescribed Pharmacist Pharmacists are responsible for dispensing, distributing and disposing of medication. A pharmacist’s responsibilities in dispensing and distributing medication may include the following: ▪ Ensuring that the prescription or doctor’s order for medication is authentic ▪ Ensuring that the prescribed medication is appropriate for the client ▪ Alerting the doctor if they think there may be any issues, such as drug interactions ▪ Filling dose administration aids, such as Webster-paks and single-dose sachets by: o sealing these packs according to the doctor’s order ▪ Providing information about possible drug side effects, warnings and interactions ▪ Ensuring that they dispense the correct medication and dosage ▪ Distributing medications to services and homes Registered and Enrolled Nurse Enrolled and registered nurses who work in similar environments have similar tasks. However, a registered nurse has completed a higher qualification than an enrolled nurse. A registered nurse will have a bachelor’s degree, while an enrolled nurse will have an Advanced Diploma or Diploma level qualification. Both kinds must be registered with the Nursing & Midwifery Board to practice. Both can have any of the following responsibilities below: ▪ Review the medication order before administration ▪ Prepare medication and equipment before administration ▪ Monitor the client for any adverse effects or reactions after administration ▪ Complete the client’s medication documents before and after administration Their differences in qualifications and skill level contribute to distinction in authority. Registered nurses have authority over the enrolled nurses in the workplace. Registered nurses are therefore able to delegate tasks to enrolled nurses. Registered nurses can also perform tasks that require a higher skill level. These may include diagnostic tests, administering medication and mixing medications. Support Worker The support worker must read all the relevant information in the client’s care plan and medication sheet to assist the client with medication. 36 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 You must follow the instructions from the medical practitioner about the medication. You must never bypass the medical practitioners and choose medication (including over-the- counter drugs) yourself. You may be tasked to prepare medication, equipment and documents. Before meeting the client, you must obtain the authority to proceed from your supervisor. You must also ensure you give the correct client the medication and understand the process. They must know what you are giving them and how to take (or apply) it. Support workers are not responsible for administering the medication to the client. This means that a support worker cannon place medication directly into or onto the client’s body. Support workers are limited to assisting the client to successfully self-medicate. Assistance must be consistent with your duty of care and may involve actions such as the following: Provide instructions on how to properly self-administer medication Measuring the amount of liquid required in a medicine cup Measuring the amount of cream or onto the client’s fingers Removing tablets or capsules from dose administration aids Placing medication into nebulisers or spacers Opening bottles or dose administration aids Offering or providing fluids to aid in swallowing medication Dissolving medication in water Adjusting posture or position Providing privacy 37 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 Client With your assistance, the client can take or administer the medication themselves by: picking up the dose cup and swallowing the tablets spreading the lotion you have dispensed onto their hand onto the part of their body where it is needed putting the wafer you have given them in their mouth and waiting for it to dissolve placing an eye drop in their eye while you help them hold their eyelids open. The client or their SDM must always consent for medication to take it. Their SDM must agree on their behalf if they cannot give consent themselves. Clients will also have responsibilities to ensure successful medication administration. These responsibilities can include the following: ▪ Answer questions honestly for the doctor to properly prescribe medication. ▪ Follow the correct medication self-administration and dosage. ▪ Cooperate with the administering personnel during medication administration. ▪ Report any adverse effects that they experience after medication administration. 1.2.2 Lines of Authority The person responsible for a task is the person who must ensure it gets done and is answerable for it. Each of the people in these roles must answer for what they are responsible for within their role. This is what they are accountable for. Outside Your Organisation The prescribing medical practitioner is accountable for their assessments and their prescriptions. The medical practitioners have their legal requirements for duty of care that they must follow. Refer to the process below: 38 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 The doctor prescribes medication. The pharmacist gets the prescription from the doctor and dispenses medication. The pharmacy has an agreement with the service provider to distribute the medication. The staff in the organisation administer the medication to clients. When the pharmacist has the prescription, they are responsible for dispensing it appropriately. Pharmacists usually have a service for distributing medication (e.g. to service providers (organisations) that provide support services). When the organisation receives the medication, they become responsible for storing and administering it properly. They are also responsible for ensuring any unused medicine is returned to the pharmacist for disposal. The process illustrates the lines of authority. The pharmacist must dispense the medication as the doctor has prescribed. The organisation's staff can only administer the medicine that the pharmacist has provided them. Inside Your Organisation You must identify who can delegate this task to you and to who you can delegate the task. Usually, your supervisor will be able to delegate this task to you. However, support workers may delegate this task to each other if they are busy doing other tasks or there are too many people for one person to assist. Note that for Schedule 8 medications, a second person will often need to be present, and you may require another support worker to help you with this. There may also be other people who can delegate the task to you, such as a registered nurse. You can refer to the image below for an example of an organisational chart and its subsequent delegations and lines of authority: 39 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 You should always familiarise yourself with your organisation’s procedures for administering medication. You will follow these more appropriately once you have understood them. 1.2.3 Contingency Plans In general, a contingency is a situation that could occur in the future, especially one that could cause problems. This unit refers to contingencies as anything that does not go according to plan. A medication contingency is a contingency that has to do with the medication, such as: ▪ the client reacting to the medication ▪ the medication being unusable ▪ the client has a change in their condition (that causes concern about administering the medication). There may be other contingencies that are not related to taking the medication. For example, an unexpected event could happen, so you cannot give the medication at the usual time (e.g. a fire alarm). A client may also not have received their medication from the pharmacy when they were supposed to. Your organisation will have plans in place for contingencies that are likely to occur, or that would be serious if they did occur. Ensure you ask your supervisor or health professional if you are unsure what to do. 40 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 1.3 Confirm That Equipment and All Forms of Medication to be Administered are Ready for Use In this subchapter, you will learn to confirm you have the physical materials for assisting with medication. This includes checking you have the equipment and medication that you need. It also includes checking if the equipment and medication are ready for use. 1.3.1 Forms of Medication The table below gives an overview of the most common forms of medication. It includes a description of the form of medication and its administration route. The administration route is how the medication is taken into the body. For example, capsules are taken orally. That means they are taken via the mouth and into the digestive system. Refer to the table below for the descriptions of each form of medication: Form Description and Administration Route These are solid medications taken orally. Capsules Some have a gel coating to make it easier to swallow. These are liquid medications taken in drops. Drops They can be for eyes, ears or taken orally. These are substances taken by inhaling (breathing in). They come in or with a device for Inhalants inhaling them. Commonly used for asthma or breathing issues Liquid medications (other than drops) are taken Liquids orally. The liquid is poured into a measuring container to measure the dose. Lotions and creams are both applied topically Lotions and Creams (on the skin). Creams are thicker than lotions, usually due to lower water content. 41 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 Form Description and Administration Route Ointments are similar to lotions and creams but Ointments are oil-based and generally thicker than the other two. They are also applied topically. Transdermal patches are patches (similar in appearance to a large band-aid) applied to the Patches skin and must be left on while the drug is absorbed into your body. Powders are a dry medication product in the Powders form of separate particles. They may be taken topically or orally. Tables are solid medications that are moulded Tablets into shape. These are taken orally. These thin films are used as carriers for Wafers pharmaceutical agents. It is taken orally but does not need to be swallowed. This is a small, soluble block or tablet inserted Pessary into the vagina. This solid medical preparation is designed to be Suppository inserted into the rectum to dissolve. It is roughly conical or cylindrical. Capsules Capsules are a solid dosage form in which the drug is inside a soluble container (‘shell’). Usually, the shell is made of gelatine. They come in a variety of shapes and colours. They may be clear so that you can see the medication inside, which could be in powder, liquid or granular form. When handling, you must consider the capsules’ unique fragility. Capsules may crumble or dissolve when in contact with water, air, or physical force. The shell must be intact when you administer the medication. If not, some drugs may have leaked out or become contaminated. Capsules cannot be split. They are considered smoother and easier to swallow than tablets. They tend to go faster into the bloodstream than tablets. 42 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 When administering, you must consider that capsules are solid objects that are administered orally. Capsules are usually taken quickly in one swallow to prevent them from crumbling or dissolving. Capsules must not get stuck in the mouth. Capsules usually come in bulk containers like bottles or individual containers like blister packets. You must store them in these clean, sealed containers which they came in with. You must also store these away from direct sunlight. Drops Drops are liquid medications taken in doses and measured by drops. These can be eye drops or ear drops. However, some drops are to be taken orally. Generally, they come in a bottle that allows you to administer drops. There may also be a dropper you can take out of the bottle, or there may be a built-in applicator. Dosage may be given in drops (e.g. two drops). Care must be observed to prevent breakage, blockage and contamination. During administration, medication passes through the dropper and the air. The medication then reaches the intended surface (eye, ear, skin, mouth, etc.). Contamination must be avoided throughout, specifically in not holding the tip of the dropper with dirty hands. One can do so by not allowing the dropper to touch the intended surface and ensuring you always place the dropper cover back when the medication is not in use. Storing must also avoid breakage, blockage and contamination. Inhalants Inhalants are substances taken by inhaling (breathing them in). The medication itself is either a powder or liquid. These are turned into minute particles, becoming a very fine powder, mist or spray. The most common forms of inhalants you will come across are asthma medications. These commonly come in the form of an inhaler (puffer). These are small handheld devices, usually 43 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 with a metered dose. This means that the inhaler measures the dose. A specific, measured amount is given each time the inhaler is activated. When handling inhalant medications, one must consider that they come in containers with a mouthpiece and to ensure that there is not any unnecessary objects placed in the mouthpiece. Care must then be observed to prevent breakage, blockage and contamination. Inhalant medications are administered orally. The container will usually have a switch mechanism that the person must trigger, followed by the oral inhalation through the mouthpiece. A good practice commonly taught is that the person must exhale deeply before placing the mouthpiece into their mouth. This will allow a full inhalation of the medication. Clean the mouthpiece as per manufacturer’s instructions after every use. Liquids Liquid medication, other than drops, will be measured by pouring the medication into a measuring container/or dispensing cup or spoon. Be careful when pouring liquid medication. It can sometimes be quite thin and easy to spill. Some medicines are only available as liquids, but some are also available as either a liquid or a solid form, such as a tablet. Liquid medications can have a faster effect than taking the same medication in tablets. For this reason, some people may choose to take some medicines in this form. They may also take it because it is easier for them to swallow than a tablet or capsule. Liquid medications are usually stored in a glass bottle container. Care must then be observed to prevent breakage, blockage and contamination. When handling for instance, be extra careful not to drop containers made of glass. For storing, always place the bottle cap properly after every use. Ensure the measuring container/or dispensing cup or spoon to be used is clean before use and cleaned correctly after use. Lotions and Creams 44 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 Both creams and lotions are applied topically (to the skin). Creams are thicker than lotions, usually because they have lower water content. Creams and lotions are often used to treat skin conditions and will usually be applied to the affected area. Lotions and creams may come in bottles or tube containers. Care must then be observed to prevent breakage, blockage and contamination. When handing, for example, squeeze tube containers gently to prevent tears and leakage. For storing, regularly check for tears and leakage in tube containers. Lotions and creams are generally administered gently by hand or cotton on the intended surface. If doing so by hand then ensure you are wearing gloves when administering medical lotions or creams. Ointments Ointments are similar to creams and lotions but are oil- based instead of water-based. Generally, they look clear and are thicker than creams. They are usually less easy to wash off. Some ointments are meant to be applied to the skin, but some are to be applied to the eyes or mouth. When handing, squeeze tube containers gently to prevent tears and leakage. For storing, regularly check for tears and leakage in tube containers. Handling, administration and storage considerations for the ointments are similar to lotions and creams discussed earlier, including when administering by hand then ensure you are wearing gloves when administering medical ointments. Patches Transdermal patches are patches applied to the skin. They are similar in appearance to a large band-aid. They must be left on while the drug is absorbed into the body. Nicotine patches are a commonly used type of patch. There are also other types of medications that come in this form (e.g. some pain killers). Not all medicines can be administered through a patch. The advantages of a medication route include the following: ▪ The medication is absorbed through the skin into the bloodstream. 45 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 ▪ It ensures steady delivery. ▪ It can easily be removed to stop the medication. This makes it a good option for some types of pain relief, where a steady supply of the medication gives consistent relief. If the client reacts to the medication, the patch can be removed immediately. If the skin is also cleaned immediately, the drug will stop going into the person’s body. The patch must stay on for the entire time required for the client to get the correct dose. Patches have two sides. One side contains the medication itself. Care must be observed to prevent breakage, blockage and contamination of this side. When administering, it is important to ensure that the correct side of the patch is used and that you do not touch the side of the patch that is medicated. Patches will mostly come in individual packages. The package is only opened when the administration is imminent. Care must also be observed to prevent breakage, blockage and contamination. During storage, for instance, regularly check for tears and leakage in individual packages. Powders Powders are a dry product in the form of separate particles. Common examples of medicines in powder form are digestive and antifungal powders. Powders are either taken orally (mixed with liquid) or topically. Some powders will be mixed into a suspension by the pharmacist. For example, Amoxycillin Sandoz suspension will be mixed by the pharmacist. A suspension is a powder mixed into a liquid. If you are mixing the suspension for someone, you must stir it well and ensure the powder is fully dissolved before giving it to the client. If it comes in a container (e.g. a bottle) from the pharmacist, you must shake it well before giving it to the client. Topical powders are applied to the skin. Resolve Tinea Powder is an example of a topical powder. It is an anti-fungal powder that is applied daily to the affected skin. Powder medications are stored in bottle containers or single-dose packages. Powders may also be blown away. Care must be observed to here, make sure that there was no strong gust of air when handling opened containers of powders. Powders are prone to clumping and wetting in some conditions. The powder container or package is then only opened when administration is imminent. When storing, make sure that the humidity of where the container is stored is dry. 46 HLTHPS006 Leaner Guide v101024 FirstAidPro Australia RTO: 31124 Tablets Tablets are solid forms of dosage moulded into shape. Shapes vary (most often circular or oval-shaped). They last longer and can sometimes be split (often broken in two across an indented line) to split the dosage. Some of the tablets in this image have these indented lines to ease splitting when necessary. You will need to check with your supervisor or health professional before splitting a tablet. Tablets, when orally taken, are swallowed in one quick process to prevent them from crumbling or dissolving. Some tablets orally taken may also be chewed (ONLY when directed to do so on medication instructions) Tablets usually come in bulk containers like bottles or individual containers like blister packets. Be careful not to drop tablets once removed from their containers. These containers must be considered when storing. One good storage practice is to not put heavy objects on tablet blister packets Wafers Medication wafers are thin films used as carriers for pharmaceutical agents. It is taken orally but does not need to be swallowed. It dissolves in the mouth. You need to check the instructions on the packaging for dissolving the wafer. Some are to be dissolved in different parts of the mouth. The wafer should be completely dissolved before swallowing. You must consider the wafers’ unique fragility. Wafers may crumble or dissolve when in contact with water, air, or physical force. You must have dry hand or gloves on when handling wafer medication. Wafers usually come in individual containers like blister packets. When storing then, keeping them away from sharp objects is a good practice. Multimedia This video will explain how a specific type of wafer medication,

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