Medication Management PDF

## Medication Management - Preventing a symptom is more effective than responding to a symptom crisis - Medication doses should be tailored to meet the person's goals for symptom management. - Keep doses as low as possible to minimize side effects. - Administer regularly around the clock to effecti...

## Medication Management - Preventing a symptom is more effective than responding to a symptom crisis - Medication doses should be tailored to meet the person's goals for symptom management. - Keep doses as low as possible to minimize side effects. - Administer regularly around the clock to effectively manage ongoing symptoms - Provide as needed as a breakthrough dose when a symptom recurs between scheduled doses - Administer using the simplest delivery route, usually by mouth - If the person cannot take medications orally, use buccal, rectal, subcutaneous injection, transdermal patch, or topical administration. - Combine with other medication as needed to manage challenging symptoms or side effects. - Record and report side effects, fears and concerns about medications. - Nonpharmacological comfort measures may help improve comfort. - The person's responses to medications and nonpharmacological comfort measures must be included as essential parts of ongoing assessments, recordings, and reports to the team. ## Following Up After Medications of Comfort Measures One step in the Canadian Hospice Palliative Care Association (CHPCA) process of proving care is following up to check on the effectiveness of a treatment or comfort measure. In some facilities and community care, it may be the PSW's responsibility to complete the follow-up. When following up to determine whether the treatment has improved the person's comfort, gather information by asking the person or their family these questions: - Did the medication or comfort measure help to increase comfort? - How long was the treatment effective? - Did the symptom reoccur before the next dose or treatment? - Did side effects occur? If yes, record the side effects and changes made to the treatment. - Record and report responses to the team: - Promptly communicate changes in the person's condition and their inability or unwillingness to take medication or receive comfort measures. - Share the person and the family's concerns with the nurse or physician. - PSWs working in community care may not be with the person long enough to follow up on the effectiveness of treatments. Communicate with the team when this is the case so that follow-up can be arranged. ## A Nurse's Perspective When asked to see a person who is experiencing pain (or any other symptom), review their chart to gather information about the pain, the medications that have been used, and the effectiveness of the medications. The chart should include a brief statement about pain. It is especially helpful if the charting also includes when the pain started, the location, what it feels like, the severity of pain, and the treatments (e.g., medications or comfort measures) that have been tried. It is essential that the person's response to medications and comfort measures is recorded after enough time has passed for the treatment to have taken effect. This information helps us to know whether more or less medication is needed, and which comfort measures are effective or ineffective, so that we can prepare to talk with the physician/nurse practitioner.