Medication Management in Aged Care – Victoria

 Carer, Medication, Registered Nurse  Comments Off on Medication Management in Aged Care – Victoria
Feb 042016
 

To ensure that you have currency of information in respect to the legislation about medication management in aged care, it is useful to access the health.vic website where the Victorian State Government has developed a hub for health services.
The site provides a wealth of information as well as clearly details a number of medicine management areas including nursing roles and responsibilities, medication delegation and supervision, storage and security of medicines and procedural practices related to different drug schedules.
If you access the web page https://www2.health.vic.gov.au/public-health/drugs-and-poisons/medication-management-in-aged-care this information is available for your reading and review. The site also provides a resource kit that was developed specifically to support residential aged care homes in meeting their medication management requirements.

If you are seeking information in relation to specific medicine schedules, maybe advice about how they are classified in relation to the Drug, Poisons and Controlled Substances legislation, then I would suggest exploring the information detailed at https://www2.health.vic.gov.au/public-health/drugs-and-poisons/scheduled%20medicines
Remember, overall the classification of medicines and poisons into schedules is the responsibility of Therapeutics Goods Administration (better known as TGA) which is a strategic part of the Australian Government, Department of Health. Using the The Poisons Standard or SUSMP (Standard for the Uniform Scheduling of Medicines and Poisons) decisions are be made in respect to the classification of medicines and poisons. Strategic inclusion in these decisions are the safe use and storage of medicines, preventing overuse and abuse of medicines and related poisons, as well as overall supporting and maintaining the health and wellbeing of the individual and the community.
Through The Poisons Standard being a national legislative document, consistency in relation to the classifications of medicines and poisons is provided across all Australian States and Territories. In turn this also supports the directives and instruction that must be followed in relation to prescribing, dispensing and administration as detailed by relevant State and Territory legislation in their respective documents.
To learn more about the scheduling of medicines and/or The Poisons Standard go to https://www.tga.gov.au/publication/poisons-standard-susmp

Understanding Dementia and its Effects

 Carer, Dementia, Registered Nurse  Comments Off on Understanding Dementia and its Effects
Feb 032016
 

Understanding dementia and its effects can be difficult. Alzheimer’s Research UK has come up with a new approach using an orange, the help of famous media maker (Wallace and Grommet) and the voice of former Doctor Who star Christopher Eccleston. Through the 90 second film clip the finality of dementia as a disease, as well as the misunderstandings that sometimes are believed about this disease are explored. This is achieved in the film through the symbolism of the humble orange in two main ways. Firstly the weight of the orange (140gms) is used to highlight the overall difference between a healthy brain and the loss caused in the brain of an Alzheimer’s sufferer. Secondly the individual segments of the orange are used to inform the viewer about the finality of this disease.

Overall the message is very much about understanding that dementia is a disease and like any other disease, dementia suffers deserve the same hope and research in order that a cure can be found.

Available on YouTube at https://www.youtube.com/watch?v=x9MvEZskR6o&feature=youtu.be

Medicine Management – Medicines and Behaviours

 

Residents requiring residential aged care often have a variety of medical conditions that result in impaired cognition as well as a variety of behaviour management needs. Sometimes this requires specific medicines to be administered as part of their ongoing care and clinical management. These medicines can include antipsychotic drugs and benzodiazepine medicines, all of which necessitate close observation and monitoring of the resident as well as specialised clinical management. This workshop not only explores the needs of the resident who has impaired cognition but also the specific medicines, clinical care and required management practices in relation to this area of nursing care.
A medicine validation activity is used in this area of the workshop to explore specifically the use of antipsychotic (risperidone) and benzodiazepine (temazepam) medicines. The activity consists of reviewing current medication administration practices to best practice recommendations for each of these medicine groups. This provides nurses with insight in relation to the correct administration practices and also clinical points regarding ongoing monitoring and evaluation of care for the residents taking these medications. Other clinical area that are included in these discussions are behaviour management, chemical restraint, falls prevention and assessment practices.

Key topics include:
– The Registered Nurse and Enrolled Nurses role and responsibilities related to medicines
– Medication legislation, regulatory requirements and professional guidelines, including exploring recent changes.
– Understanding of medication management, supervision and delegation.
A focus on behaviour medicines, in particular:
– Different types of behaviour medicines – antipsychotic drugs and benzodiazepine medicines
– PRN medications, short term drugs, and variable drug doses used in the management of behaviour and related medical conditions
– Monitoring and evaluation of medicine outcomes.
– Medicine administration practices for different behaviour medicine forms.
– Specific needs of the resident with cognitive impairment.
– Management of issues and contingencies that arise during medication administration.
Competency Assessment:
– Completion of a written learning review workbook.
– Practical competency assessment of specific medicine administration practices.
– Completion of related case studies and related scenarios.

Medicine Management – Care of the resident with diabetes

 

Residents in residential aged care often have a variety of medical conditions that require specific care planning, monitoring and observation. Diabetes, either type 1 or type 2, is one such condition and often the treatment of this health condition requires related medication treatment including oral hypoglycaemic drugs and / or insulin administration via subcutaneous injection. Nurses must be competent in these related medicine administration practices as well as understand the specific care practices required for this medicine administration including ongoing assessment and evaluation of medicine outcomes, care practices and related management plans.
A medicine validation activity is included in this workshop and used to explore specifically the administration of oral hypoglycaemic medicine, common prescribed medicine types and their actions as well as subcutaneous injection practices related to the administration insulin and use of an insulin pen. The activity consists of reviewing current medication administration practices to best practice recommendations for each of these medicine groups and administration routes. This provides nurses with insight in relation to the correct administration practices and also clinical points regarding ongoing monitoring and evaluation of care for the residents with diabetes and requiring these medications. Other clinical area that are included in these discussions are BGL assessment and monitoring, related urine testing assessment practices and care of the sick resident with diabetes.

Key topics include:
– The Registered Nurse and Enrolled Nurses role and responsibilities related to medicines
– Medication legislation, regulatory requirements and professional guidelines, including exploring recent changes.
– Understanding of medication management, supervision and delegation.
– Care of the resident with diabetes
– Management of hypoglycaemia and hyperglycaemia
A focus on hypoglycaemic medicines, in particular:
– Different types of hypoglycaemic medicines – insulin/ subcutaneous injection and oral hypoglycaemic drugs
– PRN medications – insulin sliding scales used in the management of diabetes and hypoglycaemia
– Monitoring and evaluation of hypoglycaemic medicine outcomes.
– Medicine administration practices for different related medicine forms.
– Specific needs of the resident with diabetes.
– Management of issues and contingencies that arise during medication administration.
Competency Assessment:
– Completion of a written learning review workbook.
– Practical competency assessment of specific medicine administration practices, including subcutaneous medicine administration and the use of insulin pens.
– Completion of related case studies and related scenarios.
– Medicine calculations related insulin and sliding scale medicines

S8 Medication Management

 

The workshop is designed to further develop and challenge the medication knowledge and skills of Registered Nurse and Enrolled Nurse in relation to the medicine management and administration of S8 medicines. The workshop will include an update in relation to the appropriate legal and regulatory requirements pertaining to S8 medications and closely examine the specific responsibilities of the nurse in relation to medication administration and reporting.
A practical competency assessment of S8 medication administration practices is completed through simulation scenarios allowing for the reflection and observation of skills pertaining to the management of a range of contingencies that may arise in relation to S8 medicines. This includes S8 medicine refusal, S8 medicine receival of stock, S8 medicine disposal destruction, and documentation practices (including correction of written errors) in the S8 register. The practical assessment is intended to review both the individual’s understanding and practical skills of medication administration.

Key topics include:
– The Registered Nurse and Enrolled Nurses role and responsibilities related to different medicine schedules, in particular S8 medicines
– Medication legislation, regulatory requirements and professional guidelines related to S8 medicines, including exploring recent changes as relevant to this area.
– Understanding of medication management, supervision and delegation in relation to S8 medicines.
– Medicine schedules and their meanings

A focus on S8 medicine management and related practices, would include:
– Different types of S8 medicines
– Different S8 medicine prescribed orders including PRN medications, short term drugs, and variable drug doses
– S8 drug register recording and reporting requirements
– S8 medicine safety and security including monitoring of stock and related storage areas
– Monitoring and evaluation of S8 medicine outcomes.
– Medicine administration practices for different S8 medicines and drug forms.
– Specific needs of the resident requiring S8 medicines.
– Management of issues and contingencies that arise related to S8 medicines.

Competency Assessment:
– Completion of a written learning review workbook.
– Practical competency assessment of specific S8 medicine administration practices.
– Completion of related case studies and related scenarios.

Medicine Management – Pain management

 

This education workshop is designed to promote an understanding of pain management and the related medicine and no medicine management strategies that are used in the clinical management of this symptoms and related health conditions which are associated with it. In order to ensure appropriate pain management and quality of life outcomes for the resident learning in this workshop includes areas pertaining to appropriate clinical assessment, medicine related treatments, available non medicine care strategies and ongoing monitoring and evaluation practices.
A medicine validation activity is included in this workshop to explore specifically the use of analgesia medicines including different schedules of medicines within this group of drugs and routes of administration. The activity consists of reviewing current medication administration practices to best practice recommendations for different analgesia medicines and routes of administration. This provides nurses with insight in relation to the correct administration practices and also clinical points regarding ongoing monitoring and evaluation of care for the residents taking these medications. Other clinical area that are included in these discussions are pain management protocols, pain assessment and related resource tools, and related analgesia side effects including constipation and the risk of falls.

Key topics include:
– The Registered Nurse and Enrolled Nurses role and responsibilities related to medicines
– Medication legislation, regulatory requirements and professional guidelines, including exploring recent changes.
– Understanding of medication management, supervision and delegation.
– Understanding of pain and its different types, routes and schedule

A focus on analgesics and pain management, in particular:
– Different types of analgesia medicines
– Pain medicines prescribed as PRN medications
– S8 pain medicines
– Monitoring and evaluation of medicine outcomes.
– Medicine administration practices for different pain medicine forms.
– Specific needs of the resident requiring pain management and related health conditions.
– Management of issues and contingencies that arise during medication administration of analgesics.

Competency Assessment:
– Completion of a written learning review workbook.
– Practical competency assessment of specific medicine administration practices including administration of medicines via injection.
– Completion of related case studies and related scenarios.

Medication Competency Assessment System

 

IMGP2837_Red-001Competency is an observable measure that demonstrates not only the ability to perform a skill to a required standard of practice but involves the consistent and committed application of knowledge to ensure repeated procedures are similarly to this expected level. In competency assessment appropriate evidence is collected upon which professional judgements are made that reflect the meeting of required standards of practice and knowledge levels. It is the assessor’s responsibility to collect this evidence and upon evaluation conclude whether the achievement of competency has been established.

Specific resources are needed to not only detail the expected standards of competency that are required but also to document and provide evidence in relation to the assessment undertaken and achieved outcome. The Medication Management Competency Assessment System is designed to meet the needs of Residential Aged Care Facilities in accordance with assessing the competency of staff aligned to medicine administration and management. The system has been developed in accordance with legislative and regulatory requirements as well as professional standards and guidelines, with appropriate references provided for further review and reflection.

Overview – Resources for Medication Competency Assessment
Pathways medication competency assessment system includes the following resources:

  • Competency Assessment Policy and procedure – these are the foundations for the competency assessment system and cover all competency practices within the organisation.
  • The medication competency assessment tools are made of three parts including:
    • Competency Standard (CS) – Presents an overview of the area of competence that is to be assessed, including the assessment environment and any related professional, legislative or statutory guidelines that need to be maintained.
    • Practical Competency Assessment Guidelines (CAG) – Detail the expected competency that is to be achieved throughout the assessment area, including the individual elements that must be met by the participant in order for a judgement of competence to be made. Guidelines are reflective of the required performance standards of relevant legislative and regulatory authorities, as well as organisation performance requirements.
    • Practical Competency Assessment Form (CAF) – This is the documentation on which individual recording and reporting of the competency assessment outcomes are documented by an Assessor.
  • For each of the medication competency assessment guidelines there is a library of competency assessment resources that provides suggested tools to assess the knowledge and attitude (commitment) to the elements contained within the assessment form. These include case studies and scenarios that can be easily completed in a mock setup in the workplace.
  • A range of competency assessment tools for specific modes of administration including injections. This enables performance management of staff following a medicine incident (involving a particular mode of medicine administration) or where staff were unfamiliar with some of the different medicine modes.
  • Learning Review Workbook Resources – These are used to assess the knowledge and understanding of related competency areas as well as evaluate skills in accordance with a range of scenarios and different settings. Different assessment methodologies are used in the workbooks including multiple choice, true or false, case studies and short answer questions. Answer guides assist the assessor in reviewing and marking the learning review resources, as well as ensuring conformity across the organisation. These are available for Registered Nurses and Enrolled Nurses and a separate book for Personal Carers.

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Download the free Sample Handwash Competency here

 

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Download the Medication Competency assessment system – Table of Contents here

 

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