HLTHPS007 Student Work Book V2 15.02.19

H&H accredited training australasia inc
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Student
HLTHPS007 Administer and monitor
Work Book medications
Student Name:
Assessor Name:
Unit Start Date:
Unit Code: HLTHPS007 Administer and monitor medications
Unit Name: Establish and maintain a safe and healthy environment for children
Qualification Code and Title
 CHC43015 - Certificate IV in Ageing Support
** Please note that for the purpose of you gaining a full understanding of the current subject matter and how it is
part of the workplace, we refer to ‘your work’ even though you may not be currently employed in the sector
HLTHPS007 Administer and monitor medication
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H&H Accredited Training 2|P a g e 15.02.19 (V2)

Introduction
Did you know that medication errors are possibly the number one error in health care? To be able to deliver
medication safely, responsibly, while adhering to all the clinical and legislative requirements of administering
medication, makes you a VIP (a very important person) within the ageing care and support environment.
There are a few guidelines for consideration when dispensing medication and they are:
 Be attentive and alert

 Introduce yourself to the client
 Avoid any distractions
 Talk to your client about the medication
 Talk to your client about any possible allergic reactions they may have had
 Identify your client through the use of a minimum of 2 identifiers, prior to administering any medication
 Never rely on your memory, follow a set procedure
 Always check that all medications are within the date range for use – if expired seek assistance
 Report any errors, near misses
 If a client has any questions, provide educated answers – or seek assistance
Always remember that the client is being prescribed medications to achieve the best possible result in their health
care.


Information for students
This workbook provides information to the student to be used in conjunction with the assessments relating to this
unit. When you have completed the assessment booklet, please submit to the college or your trainer/assessor for
marking. You are able to keep this workbook for future reference. All assessments, however, are held by the
college as part of our record management policy.
Student Workbook Overview
H&H Accredited Training has developed this student workbook to be provided to each enrolled student
completing this unit of competency. This workbook is to be used in conjunction with the H&H Accredited Training
Student Assessment Booklet, supplementary material and student work experience booklet.
This workbook has been written by trainers and assessors employed by H&H Accredited Training, qualified staff
members, industry consultants and management.
All information has been gathered and validated in line with the National Standards, Australian Qualification
Framework (AQF), and current information derived from training.gov.au.
Unit Description
Application
This unit describes the skills and knowledge required to administer medications to people and monitor them, as
per the delegation from a relevant health professional, in accordance with legislation and the employing
organisation’s medication and delegation policies and practice.
This unit applies to community services and health workers with the relevant authority in their state or territory
to administer medication and monitor them as per the delegation from a relevant health professional.
Ongoing requirements to demonstrate competency in drug calculations may apply, and users should refer to
relevant state/territory regulatory requirements.
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.
As a worker, a trainee, or a future worker you want to enjoy your work and become a valuable team member.
This unit of competency will help you acquire the knowledge and skills to work effectively as an individual and
within 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
adhere.



Identify situations that are a potential risk to the safe administration of medications
1.1 Access and read information to enable identification of substance incompatibilities based on care plan and
delegation
Enabling identification of substance incompatibilities
It is essential to be able to access and read a variety of information in order to identify substance incompatibilities. Be
aware that some drugs have adverse effects on health when they are combined. Such information may be obtained
from medication labels and instruction leaflets.
Relevant information can be found on the websites of the drug manufacturers; the doctor, or pharmacist, who
prescribed the medication should be able to provide details of incompatibilities.
Delegation refers to:
 Conferring of authority to perform specific medication administration activities to a worker not usually
authorised but who has been determined as appropriate for the task by the delegating health professional
 Delegation is within the context of a care plan or other written instruction
 Where delegation is provided verbally, it must be confirmed as soon as practicable according to organisation
procedures in writing and incorporated in the care plan
 The authority is specific to an individual client within a specific care context and is not transferable
Delegation instructions must include:
 medication and its purpose

 medication form and instructions eg. enteric coated - do not crush
 dosage and related instructions
 route
 contra-indications
 any other relevant instructions or information, especially information specific to the client
Substance incompatibilities come under the following categories:
 therapeutic incompatibilities
 physical incompatibilities
 chemical incompatibilities
Examples of substance incompatibilities include:
 Warfarin and aspirin – Aspirin is a drug that is commonly taken to treat pain, fever and inflammation. Warfarin
is taken for the treatment and prevention of blood clots. However, the combination of these medications
increases the risk of extreme bleeding, bruising, headaches, and dizziness
 Medication and diet – There are a wide variety of medications which may have negative effects when
combined with different types of food and drink. It is well known that grapefruit and pomegranate minimise
the health benefits of cholesterol medications. Vegetables and salads such as Kale and Spinach are known to
reduce the effectiveness of blood thinning drugs. Clients are commonly advised to avoid alcohol while on
medication
 Medication and sunlight – There are different types of medications that are known to increase people’s
sensitivity to short and long wave rays from the sun. Individuals being treated for HIV are known to be at
unusually high risk. Those people taking antibiotics, antihistamines, and antidepressants are also advised
against spending long periods of time in direct sunlight

 Medication and alcohol – There are a large number of medications which are incompatible with alcohol.
Examples include antibiotics, pain relievers, and sleeping pills. The alcohol may have the effect of reducing the
health benefits, or causing deterioration in the client’s condition.

1.2 Identify environmental and time management issues that may impact on or contraindicate administration
of medication
Environmental issues
Be aware that there are a variety of environmental and time management issues that may impact on, or
contraindicate the administration of, medication. Environmental factors relate to the physical situation in which
the medication is administered.
There might be difficulty locating medications in hospitals with considerable stocks. Staff members responsible for
administering medication might feel under pressure due to a lack of privacy and space in the medical
environment.
Other environmental factors may include:
 Heating
 Noise
 Lighting
 Difficulty reading medication labels
 Design of medical environments
Health environments may include
 Residential aged care facility

 Community settings
 Hospitals
 Clinics
 Short and long stay centres
 Client’s home
Time management issues
Time management is a key issue with regards to the administration of medication. There may be a need to ensure
that clients receive their medications at specific points during the day. Therefore, there may be a need to
prioritise the administration of certain medications for people with severe conditions.
It is essential to administer these medications on time:
 Antibiotics
 Insulin
 Immunosuppressants
 Pain medications
If these medications are not administered in accordance with strict schedules, then the clients are likely to
deteriorate quite rapidly; making them at an increased risk of health complications and death.
However, be aware there is some flexibility in the timing of other medications. Ensure responsibilities can be
fulfilled and account for emergency situations which might occur during shifts.
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1.3 Report potential risks related to medication administration to delegating health professional
Reporting potential risks
It is important to identify and report potential risks related to medication administration to the delegating health
professional. The individual should account for risks to their own health, and that of the client who is receiving
the medication.
The worker must account for the diets and alcohol consumption of clients, to ensure that they are at minimal risk.
Certain forms of medication will have different effects and levels of benefit for clients. It is even possible for
medications to cause adverse effects; be confident that the advantages of medication administration far outweigh
the risks.
It should be possible to carry out a risk assessment, which will involve the identification of various risks and
evaluation of their likelihood. Also, consider the potential impact of negative scenarios and the availability of
resources to minimise the negative impact.
Report the findings of the risk assessment to a delegating health professional. This report may be completed
verbally, or in writing. Follow organisational guidelines and ensure that the health professionals have a full
understanding of all the points being made.
Client identification
Be aware that there is a risk of incorrect client identification. This may happen as a consequence of treating
clients with similar names. There is the possibility of clients making incorrect claims about their identities.
Appropriate medication
There is a risk of making mistakes when it comes to the selection and administration of medications. The
medication bottles may be mislabelled, or there may be difficulty understanding handwritten instructions. Always
be aware of the risk of making mistakes regarding the dosage of medications. Such mistakes may be due to
misreading labels or the inclusion of incorrect instructions.
Allergic reactions
There will be some variability in the reactions of clients to different forms of medication. Be aware that clients
may be allergic to specific medication elements. The types of reactions vary from hives and fevers to highly
serious anaphylaxis.
The chance of such reactions will be more significant for clients taking antibiotics, aspirin and anti-inflammatory
drugs. Also, be conscious that the risks are greater among clients who are prone to allergies and have had allergic
reactions to drugs in the past.
Other risks may include:
 Immunisation status
 Intravenous medication incompatibilities
 Contra-indications for intravenous drug administration
 Intravenous therapy

The identified risks may be reported to the following health professionals:
 Complementary medicine therapist (subject to government and organisation policies)

 Dentist
 Dietitian
 Medical practitioners (General Practitioners and medical specialists)
 Occupational therapist
 Pharmacist
 Physiotherapist
 Podiatrist
 Psychiatrist
 Psychologist
 Registered nurses

1.4 Confirm client identity and if any allergies exist
Confirming client identity
It is essential to confirm the identity of each client prior to the administration of medication; have different
systems in place to ensure accurate identification. At least two forms of identification should be referred to when
dealing with each client.
The clients may be provided with identification numbers, and may be asked their names, by visiting medical
practitioners. They might be provided with ID cards and wrist bands. It is common practice for medication labels
to include the client’s name.
It should be possible to consult client records before administering medication.
Organisation guidelines for client identification may include:
 Actions to be taken if a client who is self-administering fails to identify themselves correctly

 Confirmation from nursing/care staff or client's family or friends
 Referral to identification such as photographic identification of client in client cards
 Response by client
 Visual recognition
Confirming allergies
A series of checks should be carried out to ensure that clients are not allergic to the medication that is to be
administered. Such checks should be carried out at the earliest opportunity to enable the identification of
alternative medications where necessary.
The clients should be asked questions about their reactions to different forms of medication. They should be
asked to provide details of their medical history. Additional skin and blood tests may be carried out by an allergy
specialist.
Details of allergic reactions should be included in the client’s medical notes, and these should be referred to
before administering any medication.


1.5 Identify drugs and poisons schedules and classifications as determined by law
Identifying schedules and classifications
Be aware that there are strict laws relating to the provision of medications and poisons to clients in Australia.
They are categorised into different schedules according to the level of regulatory control and availability.
Be aware of the following drugs and poison schedules:
 Schedule 2 (Pharmacy medicine) – these types of medications are typically available from supermarkets
and pharmacy shelves. Examples include aspirin, paracetamol, and ibuprofen.
 Schedule 3 (Pharmacist only medicine) – these medications are kept behind the counter and may be
provided upon approval by a pharmacist. Examples include acetaminophen, pseudoephedrine, and
codeine.
 Schedule 4 (Prescription only medicine or prescription animal remedy) - these types of medications may
only be provided upon presentation of a prescription to a high-street or hospital pharmacist. Examples
include diazepam, nitrazepam, and temazepam.
 Schedule 8 (Controlled drug) – these types of medications have been tested and found to be associated
with potential addiction and abuse. Doctors must have a schedule 8 license to prescribe such medications.
Examples include fentanyl, methadone and morphine.
The poisons standard
The poisons standard applies to the classification of drugs and poisons within the different states and territories
of Australia. It includes guidelines and instructions regarding medication labelling and controls. Access the latest
version of the poison’s standard at https://www.legislation.gov.au/Details/F2016L01071.


1.6 Pro-actively identify any limitations in own capability in relation to undertaking delegated medication
administration function and report to delegating health professional
Identifying limitations
It is important that the individual can identify and recognise their limitations and capabilities in relation to the
administration of medication; a worker should not undertake tasks or provide professional advice, if they do not
have the necessary qualifications or are not complying with legislation.
Understanding how to act when unsure of a job role, or work instruction, will enable the worker to seek referrals
and report to the delegating health professional.
Job description
The worker must refer to their job description as a means of establishing the scope of professional practice. This
should outline the name of the job role, its classification and the department it is within. Additional details may
include the industrial award/agreement, its duties, and the job selection criteria.
Duties
Find a list of duties within the job description; this should enable clarification of expectations relating to the
administration of medication. The individual may have authority for providing certain types of medications;
however, always refer to a supervisor or guiding health professional if further clarification is required.
The following duties may fall under the scope of responsibilities:
 Checking and preparing medication for administration

 Administering prescribed medication
 Updating and maintaining client records
 Ensuring correct client identification
 Supervising self-medicating clients
 Managing medication stocks and making orders
 Establishing responses to medication and reporting to the delegating health professional as necessary
Job criteria
This should specify the required skills, knowledge, experience and qualifications, necessary for expected levels of
performance in a particular role.
They may include:
 Industry qualifications
 Previous work experience
 Current driving licence
 Communication and teamwork skills
The individual should not carry out any work, or use any equipment, unless they have the required skills and
knowledge. Specialist training and qualifications will be needed for the successful completion of various tasks.
It is important to understand the risks of attempting to use equipment without the necessary authorisation, or
qualifications. There may be serious consequences for the worker, the client and the organisation.


Prepare for medication administration
2.1 Confirm delegating health professionals authority to proceed with delegation of medication administration
according to organisation policies, guidelines and protocols and jurisdictional legislative and regulatory
requirements
Confirming authority to proceed
The Registered Nurse (RN) in charge of medication is allowed to delegate the administration of medication, and
the supervision of other workers, within their professional judgement. They must ensure that the person they
delegate a task to is appropriately qualified, to safely perform the job, and put in place supervision and
monitoring arrangements.
The worker involved with the task is accountable for their actions and for following systems and procedures as
per their level of training.
Authority to proceed refers to:
 Ensuring all organisation guidelines are followed

 Ensuring that all documentation in relation to a client's medication has been checked
 Ensuring that the prescribing health professional has documented all medications and instructions
 Ensuring the client has been assessed by a health professional for the level of assistance required and
they or their decision-maker understands and can make the request for assistance
 Ensuring the client has up to date and current documentation on the level of assistance and support
required in relation to medication
Enrolled Nurses (without a Nursing and Midwifery Board of Australia approved qualification in medicines
administration) and personal care workers (with medicines administration training) can administer medicines
under supervision, via the delegation of a Registered Nurse.
Residents outside of high-level care are usually competent to administer their own medication, with assistance as
needed.
Following is a simple hierarchy of the nursing structure:
Nursing Director
Nurse Practitioner
Clinical Nurse, Clinical Nurse Manager/Specialist
Further advancement - all higher positions are promotions
Registered Nurse (level 1-9)
Graduate Registered Nurse (ANF level 1)
Advanced skills Enrolled Nurse
Enrolled Nurse (level 1-4)

Use the following Commonwealth and State/Territory legislation as a reference:
 Aged Care legislation

 Community care legislation and policies
 Disability Services legislation (Commonwealth and State)
 Drugs and Poison's Act and Regulations and other relevant State/territory legislation, regulations and
policies
 Legislation, regulations and policies relevant to each State or Territory
 Nurses Registration legislation
Duty of care
Recognise that there is a duty of care for the clients being assisted with the administration of medication. It is
essential to apply all skills and knowledge and not make any decisions which could place the clients under undue
risk.
If the appropriate level of care is not provided, and the client’s best interests are not considered, then there may
be claims of negligence.
Work health and safety (WHS)
Workplace Health and Safety (WHS) legislation replaced Occupational Health and Safety (OHS) legislation in 2011.
WHS legislation stipulates that employers must provide their staff with:
 Safe premises
 Safe machinery and materials
 Safe systems of work
 Information, instruction, training and supervision
 A suitable working environment and facilities
Ref: www.business.gov.au
Employees are obliged to ensure that they work safely and do not endanger the safety of their colleagues, clients
and others.

How WHS affects an individual and their work in health, will vary according to the job role and industry. In order
to work safely and legally in a role the worker will have been trained to do so by their organisation - this is a legal
requirement.
Where possible (or actual) WHS breaches are identified, they will need to be reviewed and amended to be
compliant immediately before they are used again.

2.2 Clarify own role and limitations in providing assistance with medication administration with delegating
health professional
Clarifying own role and limitations
It is essential to have an understanding of the role and limitations with regards to the provision of assistance with
medication. It is possible that an individual will only have the necessary skills and authorisation to provide
assistance, with specific types of medication administration. However, refer to the delegating health professional
if unsure of any duties or responsibilities.
Clarification may be obtained in a variety of ways. If meeting with the delegating health professional in person,
then ask them to repeat work instructions, or ask a series of questions in order to find out the necessary details
about the role.
It might be helpful for the delegating health professional to provide a written overview, including specific details
of drug administration duties.
A variety of open and closed questions may be posed when clarifying a role and any limitations. Open questions
will be helpful when information about how to act in certain scenarios needs to be expanded.
The types of questions to ask the delegating health professional include how to deal with a client who is putting
up physical resistance to medication.
Closed questions should be asked when simple and direct answers are required. For example, asking if the
administering of certain type of medication upon the client’s request is allowed.
Follow these steps for clarification during discussions with the delegating health professional:
 Admitting that you do not understand instructions that have been given
 Asking for repetition when necessary
 Encouraging the provision of specific examples
 Summarising and rephrasing statements to ensure understanding
Assistance with medication administration might include:
 Selecting appropriate forms of medication

 Ordering repeat prescriptions
 Collecting prescriptions
 Storing and providing medications when necessary
 Opening medication containers and preparing equipment
 Reading labels and ensuring that clients take their medications at the right time
 Informing clients of how the medications should be taken
 Providing food or drink in addition to the medication
 Administering medications when necessary


2.3 Check that all equipment, including dose administration aids, are complete, ready for use, up to date and
tamper free before proceeding
Checking equipment and dose administration aids
It is important to perform checks of medication equipment and ensure appropriate standards are met, for both
the worker’s own safety and that of the client. It might be possible to consult written instructions detailing the
types of checks that should be carried out.
If in doubt refer to the delegating health professional and ensure that how to perform inspections is made
absolutely clear.
It is likely that there will be a number of components to certain types of medication equipment and dose
administration aids; confirm that they are all intact and working as expected.
It will be necessary to ensure that medication and dose administration aids are properly prepared. It may be a
requirement to check the quantities of medication and ensure that medication environments are set up properly.
Be aware that medications which are past their use by date may pose a danger to clients, or be comparatively
ineffective. The medication expiry dates should be specified on labels and checked before administration. If the
expiry date cannot be found, consult the delegating health professional, or medication provider. It is essential to
ensure that there are no signs that the medication has been tampered with.
The types of medication equipment that may be checked include:
 Administration aid/medication pack

 Applicator for lotions/ointments
 Aprons
 Container for dirty spoons/dishes
 Cotton wool/gauze
 Drug/treatment sheet or case record
 Gloves
 Health/care/support plan
 Key to medication storage/cupboard/area
 Measuring cups
 Medicine dishes/cups
 Mortar and pestle
 Nebuliser/spacer
 Paper towels and tissues
 Spoons
 Tablet divider
 Tea towel
 Tumblers
 Water jug and cup
It may also be expected the worker will be required to check these dose administration aids:
 Blister packs - single dose packs and multi-dose packs

 Dosettes
 Sachets


2.4 Follow infection control procedures
Infection control
There will be a significant risk of infections in medical environments, if control procedures are not followed. Be
aware that the infections may be spread in a variety of ways, including transfer via airborne particles, bodily
contact, and blood transfer.
The bacteria which cause infections will increase if the medical environment is not kept clean, and people do not
take the necessary precautions.
Make certain that infection control procedures are followed at all times. Standard precautions should be
implemented, no matter the situation.
Standard precautions include:
 Washing hands before and after client contact

 Using PPE eg. gloves, masks and plastic aprons
 Safely using and disposing of sharps
 Routine cleaning eg. of equipment
 Sterilising tools and only using certain tools once
 Handling linen appropriately
If it is necessary to sneeze or cough, then do this away from the person and into a tissue which can be disposed of
(if none available, it is acceptable to sneeze or cough into the crease of the arm at the elbow).
There may be additional procedures, and extra precautions, needed in certain situations of high risk. These should
be discussed with the delegating health professional.
Hand washing procedure
These steps should be followed when washing the hands:
1. Applying disinfectant/liquid soap and rubbing into your palms, using a circular motion (to create a lather)
2. Rubbing the lather between fingers
3. Rubbing the lather onto the back of the hands
4. Placing fingers in a 'monkey grip' and rubbing together
5. Grasping the right thumb with the left hand and rotating around it. Repeat for the opposite hand
6. Rubbing the tops of your fingers back and forth in the palm of your hand
7. Rinsing your hands with water
8. Drying your hands using a paper towel
Other important things to remember are to keep fingernails short and clean, not to wear artificial nails or polish,
and to remove any rings, bracelets and watches, where possible.
PPE
Personal protective clothing and equipment (PPE) is important for the maintenance of safety when working in
hazardous environments and handling contaminated items. It stops the transmission of harmful microorganisms
from the host to the worker(s).

Protective clothing and equipment may include but is not limited to:
 Gowns and waterproof aprons that comply with Australian/New Zealand standards
 Examination gloves and surgical gloves that comply with current Australian/New Zealand standards
 Glasses, goggles, or face-shields
 Surgical face masks that comply with current Australian/New Zealand standards
 Footwear to protect the feet from dropped sharps and other contaminated items
 Guidelines for latex allergic clients and staff
Safe sharps disposal and handling
Sharps and syringes must only be handled by qualified staff who have been given training in the safe handling and
disposal of sharps. Following national recommendations and organisational procedures for the handling and
disposing of sharps, is the best way to protect everyone against injury.
Guidelines include:
 Avoiding the use of needles where safer alternatives are available

 Using retractable needles if available/permitted
 Using tools instead of fingers to grasp needles (and other sharps)
 Making announcements when using sharps eg. announcing that you are using, disposing of, or passing
someone a sharp
 Avoiding passing sharp instruments via hand-to-hand and using a basin, tray, or neutral area
 Using gloves to protect yourself from injury (though it is unclear how effective this technique is)
 Only disposing of sharps in a sharps box – not using ad-hoc or substitute containers
 Ensuring that sharps boxes are clearly labelled, secured in a high place (out of the reach of children), and
not overfilled
Routine cleaning
The first step in decontamination of tools and equipment is the cleaning process. This should be undertaken
before disinfection, or sterilisation, can occur. Disinfection and sterilisation will not work effectively if preliminary
cleaning has not occurred. However, it might be possible to use a washer disinfector for smaller tools, or send
them away for special cleaning.
Some general guidelines for cleaning:
 Use detergent and lukewarm water at a maximum of 35 degrees for general or preliminary cleaning (this
may be different for certain practices, so it is best to check your own guidelines on this).
 An appropriate disinfectant should be used (according to instructions) for the cleaning of bodily fluids for
example vomit or blood.
 A schedule of cleaning should be provided to instruct how often routine cleaning should be carried out.
 If you need to undertake manual cleaning (and some practices will only allow manual cleaning as a last
resort), use a designated sink and fully immerse the tools/implements to clean.
 Do not scrub tools when holding out of the water – if you must scrub the implements immerse these and
carry out scrubbing underwater so that spray carrying bacteria cannot escape.
 You may need to rinse tools/implements in a separate sink
 Personal protective equipment should be used at all times, including apron and gloves. These should be
disposed of after use.

Sterilising
Sterilisation is the only way to destroy both bacteria and their spores – high temperatures and pressures are too
much for them to handle. An autoclave is a device used to perform such sterilisation in a health-care
environment. Note that while chemical disinfectants can destroy bacteria, they cannot kill their spores.
Methods of sterilisation include:
 Low-temperature hydrogen peroxide plasma sterilisation

 Ethylene oxide
 Dry heat sterilisation
 Flash sterilisation
 Low-temperature paracetic acid
 Steam under pressure (moist heat)
Some organisations may not use sterilisation. Another option would be to use pre-packed, single-use sterilised
products. Be careful when opening products to ensure that they remain sterile, follow hand washing procedures,
wear gloves, and prepare surfaces.
Handling linen
Used linen should be handled with care to avoid contact with clothing, and the spreading of microorganisms that
could be harmful to the environment.
Guidelines include:
 PPE should be used eg. aprons, gloves and masks to remove linen
 Linen should be bagged appropriately and put into the appropriate receptacle
 Hands should be washed before and after handling linen
Cough etiquette
Cough etiquette is used to prevent transmitting respiratory infections:
 Cover the mouth with a tissue when you cough or sneeze (if you cannot get a tissue in time, cough or
sneeze away from others and into the crook of your arm
 Dispose of your tissue in the nearest waste bin
 Perform routine hand wash procedures for the prevention of infection (the procedure can be found at the
beginning of this section)


2.5 Confirm medication administration route and procedure
Confirming medication routes and procedures
There are a variety of administration routes and procedures specific to different types of medication. Medication
may either be absorbed or injected directly.
Pills and eye drops are examples of medications which are absorbed. They are ingested and then begin circulating
through the system and combatting different types of medical conditions.
Medications such as Adcetris (used in the treatment of Hodgson’s Lymphoma) are injected into specific parts of
the body.
Be aware of these medication administration routes:
 Insulin by subcutaneous injection using pre-loaded syringes or pens – Insulin is used in the treatment of
conditions causing low blood sugar levels, including diabetes. It is important to check the blood sugar
levels before administering these types of medications. If the levels are at a level requiring insulin, then the
dosage should be confirmed, and the label should be checked. It will then be necessary to mix the insulin
and prepare the injection. Wash your hands and inject the insulin into the appropriate area of the body.
 Intranasal – intranasal medications are inserted into the nose and may be used in the treatment of various
medical conditions including seizures and pain control. The medication may come in bottle form and have
to be attached to a syringe. It may then be pumped directly into each nostril.
 Ocular – these types of medications must be sterile and are designed for insertion into the eye. Eye drops
are the most common form. It is important to thoroughly clean the hands before administering such
medications. Ask the client to look up, hold a tissue on the cheekbone, and apply pressure to access the
conjunctival sack. Care should be taken to apply the eye drops from a distance of one to two centimetres.
It might be necessary to reapply the medication if the client blinks or closes their eyes during
administration.
 Oral – this is the most common type of medication and is taken through the mouth. The medication must
have an active ingredient which ensures protection against stomach acid. It is important to check the
dosage and ensure that the medication is prepared in accordance with individual requirements. It might
be necessary to crush pills and capsules for ingestion. The medications may be taken in combination with
drinks or food. Oral medications may be given in liquid form and might have to be measured.
 Rectal – these types of medications are ingested through the rectum in the form of suppositories. They are
considered quite effective due to the large number of blood vessels in this area. The client should be
turned onto their left-hand side, if this medication is going to be professionally administered. It will be
necessary to lubricate the area and ensure that the client is in a relaxed state. The suppository should then
be inserted and retained.
 Topical – creams and ointments are common forms of topical medication. They are applied to specific
areas of the body, usually for the treatment of external conditions. Refer to the label and follow
instructions for the application of topical medications. It is important to clean the area and check on the
effects of previous topical medications. Gloves should be worn during this process.
 Vaginal – these medications come in the form of suppositories for insertion through the vagina. They may
be administered with or without the use of an applicator. Standards of cleanliness should be maintained
throughout this process and the client should be assured of privacy.

The pros and cons of common medication routes are outlined in this table:
Route/method Pros Con
Oral Easy to use Can sometimes be difficult or not
(eg. capsules, liquids, powders, Non-invasive suitable for:
tablets, wafers) Drug can be made to protect o Uncooperative clients
from digestive enzymes and acid o Nil by mouth clients
Its slow release can mean that it o Clients who are vomiting
has a longer acting period o Slow absorption means client is
in pain for longer
o Difficult to predict how much is
absorbed (due to stomach acid
and enzymes)
Intramuscular Good absorption Absorption can be a bit unpredictable
(eg. liquids) Onset is quicker than oral and Injections are painful, can lead to
rectal routes bruising and some people are scared of
Can have very long acting period them eg. children
Intravenous Reliable effects o More difficult to administer
(eg. liquids) Immediate circulation of drug in o More expensive
its entirety (100% bioavailability) o It needs a cannula which is:
o Prone to infection
o Can cause a skin reaction
o Frightening and painful to some
clients
Inhaled Quick absorption Bioavailability (how much reaches
(eg. inhalants) Can target lungs for respiratory systematic circulation) depends on the
difficulties technique used for inhalation
Rectal/vaginal Good absorption o Invasive and uncomfortable
(eg. pessary, suppository) o Cannot be used after
rectal/vaginal surgery
o Some clients may feel
embarrassed
Topical Easy to administer o Most drugs are not suitable for
(eg. lotions and creams, Non-invasive this form
ointments, patches) o Slow absorption
The individual worker should account for other contextual information specific to the client. For example, a client
who cannot be given medication orally as they cannot swallow, and who has an enteral feeding tube in place,
might be able to receive that medication through the tube.
This saves the client from further invasive procedures and is preferable for the client’s comfort. Check this with
the delegated health professional. Some medications will not be suitable for this route. It may depend on the type
of internal tube eg. intestinal or stomach.
It is important to think about individual differences and needs. For example, some people with mental health
conditions, some elderly people and some children, may not be able to make their own decisions regarding care.
In these cases, ask permission from whoever is acting on their behalf as power of attorney, or guardian.

2.6 Confirm purpose and function of prescribed medications from care plans and delegating health professional
Confirming purpose and function of prescribed medications
Prescribed medications may only be provided by a pharmacist upon the authorisation of a doctor or medical
prescriber. The client should be provided with a printed statement detailing the name, form, strength and dose
that the pharmacist is able to give.
A label should be attached detailing how and when the medication should be taken. If any further information is
required about prescribed medications, then consult the client’s care plans and with the delegating health
professional.
Details of commonly used prescription and over the counter medications are outlined in this table:
Medication name Purpose Intended effects Side effects (examples) Contraindications
(examples)
Generic Zocor Cholesterol Decreasing bad Dizziness, fainting, and Atazanavir, boceprevir,
reduction cholesterol and increased heart rate and cobicistat
increasing good
cholesterol
Lisinopril Blood pressure Relaxing blood vessels Blurred, vision, Previous administration
management and increasing blood confusion, dizziness, of angiotensin
flow and sweating
Azithromycin Antibiotic Preventing the growth of Diarrhoea, fever, and Azithromycin,
bacteria swelling erythromycin, and
, macrolide
Generic Glucophage Management of Encouraging natural Stomach pain, History of renal disease
diabetes responses to insulin coughing, fever, and and administration of
fatigue metformin hydrochloride
Levothyroxine Hyperthyroid Encouraging production Chest pain, fatigue, overt thyrotoxicosis and
medication of the thyroid hormone and fainting acute myocardial
infarction
Aripiprazole Antipsychotic Restoring normal Drooling, difficulty History of
chemical balances in the balancing, and general hypersensitivity related
brain stiffness to administration of
aripiprazole
Rosuvastatin Cholesterol Decreasing bad Fever, cramps, and History of
reduction cholesterol and muscle pain hypersensitivity related
increasing good to Rosovastatin and
cholesterol active liver disease
Esomeprazole Proton pump Reducing the production Blistering/peeling skin, History of
inhibitor of stomach acid coughing, and fatigue hypersensitivity related
to substituted
benzimidazoles
Albuterol Asthma Relaxing the airways and Shaking/trembling, History of
medication increasing the flow of air coughing, and noisy hypersensitivity to
into the lungs breathing albuterol
Fluticasone Allergy Decreasing the effects of Nose bleeding, Hypersensitivity to
medication substances which cause coughing, and fever ingredients of
allergic reaction and Fluticasone
reducing swelling
Duloxetine Antidepressant Maintaining the natural Stomach pain, MAOIs for the treatment
balance of substances blindness, and fever of psychiatric disorders
such as serotonin and
norepinephrine in the
brain
Medication name Purpose Intended effects Side effects (examples) Contraindications
(examples)
Valsartan Relaxing blood vessels Confusion, altered Hypersensitivity to
Anti-
and increasing blood heartbeat, and nausea elements of Valsartan
hypersensitivity
flow
Lisdexamfetamine Attention deficit Increasing relaxation and Lack of social control, Hypersensitivity to
dimesylate disorder concentration chest pain, and amphetamine products
medication dizziness and elements of vyanase
Adalimumab Arthritis Suppressing immune General pain, No specific
medication responses which cause coughing, and light- contraindications
inflammation headedness known
Glatiramer acetate Multiple Reducing immune Back pain, flushing, Hypersensitivity to
sclerosis responses which cause and nausea glatiramer acetate and
medication relapses of MS mannitol
Pegfilgrastim Neutropenia me Increasing the Muscle pain, History of serious allergic
dication generation of white tenderness, and reactions to
blood cells which fight changes in blood Pegfilgrastim
cancer cells pressure and Filgrastim
Acetaminophen Fever Relieving pain and Fever, pain, and No specific
medication reducing fever unexpected bruising contraindications known
symptoms
Ibuprofen Anti- Blocking substances Abdominal pain, Hypersensitivity to
inflammatory which cause diarrhoea, and ingredients of Ibuprofen
medication inflammation indigestion and Aspirin
Aspirin Pain relief and Reducing fever Indigestion, stomach Hypersensitivity and
anti- symptoms, relieving aches, and unexpected allergic reactions to
inflammatory pain, and decreasing bruising ingredients of Aspirin,
medication swelling tartrazine, and NSAID’s
Dextromethorphan Cough Suppressing reactions Confusion, dizziness, Use of MAO inhibitors,
medication which cause coughing and nausea stimulants, and alcohol
Also, be aware that different types of medications are placed into groups (or categories) depending on their
functions and effects on the body.
Recognised medication groups and categories include:
 Beta blockers – these medications ensure that the activity of hormones including adrenaline are blocked to
place reduced strain upon the heart. They are used in the treatment of conditions such as angina, atrial
fibrillation, and high blood pressure.
 Antidepressants – these medications increase the production of neurotransmitters in the brain. They are
commonly used in the treatment of clinical depression. However, they are used in the treatment of
conditions such as obsessive-compulsive disorder and general anxiety disorder.
 Anti-anxiety medications – there are a variety of anti-anxiety medications which are designed to stimulate
the production of neurotransmitters and reduce the nervous response in the brain.
 Antipsychotics – these medications are taken for the purpose of rebalancing dopamine, serotonin,
noradrenaline, and acetylcholine chemicals in the brain. They are administered for the prevention of
hallucinations, extreme mood swings, and unusual thoughts.
 Antihypertensive drugs – these drugs are administered for the purpose of reducing hypertension and blood
pressure. They are used in the treatment of conditions such as heart disease and dementia.
 Anti-seizure medications – these medications have traditionally been administered in the treatment of
epilepsy. However, they are known to reduce the levels of pain caused by nerve damage. They are thought
to reduce the transmission of nerve signals which result in significant pain.

 Anti-histamines – these medications are used in the treatment of common allergies and medical
conditions such as insomnia and motion sickness. They reduce the production of histamine which is
generated by the body in response to suspected attacks.
Oxymetazoline Nasal decongestion Narrowing nose blood Blurred vision, Hypersensitivity to

vessels, reducing increased blood Oxymetazoline
swelling and pressure, and ingredients and MAO
congestion trembling inhibitors
Alprazolam Sedation and anxiety Encouraging calming Depression, slurred Hypersensitivity to
management chemical responses in speech, and fatigue Alprazolam
the brain ingredients and
benzodiazepines
Eszopiclone Sleep management Calming the brain and Coughing, fever, and Hypersensitivity to
inducing sleep back/side pain eszopiclone
Morphine Pain relief Interacting with the Stomach pain, blurred Administration for
brain and relieving vision, and confusion people with medical
pain conditions which
would preclude the
administration of
intravenous opioids
The types of medications that have been mentioned have general effects on body systems and major disorders
including:
 Central nervous system

 Musculo-skeletal system
 Peripheral nervous system
 Endocrine system
 Cardiovascular system
 Respiratory system
 Gastrointestinal system
 Renal/urinary system
 Reproductive systems
 Immune system
 Integumentary system
 Eye, ear, and special senses
 Micro-organisms
 Neoplastic disease
Pharmacodynamics and Pharmacokinetics
Pharmacodynamics and Pharmacokinetics involve the study of effects of drugs upon people with different
characteristics. The medical professionals focus on the biochemical and physiological reactions. It is recognised
that drugs interact differently and have variable levels of benefit for clients. Age is recognised as one of the
factors that have an effect upon the action of drugs.
Children and aged individuals have trouble processing some drugs as their liver and kidneys are not as effective. It
is common for older people to take various drugs and have a higher risk of interaction and contraindication.
Pharmacotherapeutics
It is vital to have an understanding of the concept of pharmacotherapeutics. This relates to the effects of drugs
upon people of different characteristics.
However, the focus is upon the individual, rather than the medication, or condition. It emphasises the importance
of considering factors such as client weight, age, genetics and the environment, when administering medications.
Major factors that may affect the action of drugs include:
 Disease – the absorption and action of drugs may be limited by the debilitating effects of medical conditions
and diseases. Individuals with liver disease have exaggerated responses to some medications
 Processes – the processes of absorption, distribution, metabolism and excretion will vary depending upon
the characteristics of the individual and the nature of their medical condition
 Nutrition – the consumption of different types of food is known to have an impact on the absorption and
processing of medications. The effectiveness of some drugs will be decreased if individuals have nutritional
deficiencies
 Hydration – a reasonable level of hydration is required for the effective action of many drugs. Certain forms
of medication are designed to be dissolved or swallowed with water in order to enhance absorption into the
system.

2.7 Accurately calculate medication dosages according to authorised documented request
Calculating medication dosages
It will be essential to calculate the correct medicine dosages in order to minimise the risk of adverse reactions. It
is necessary to have access to calculators in order to reduce the chance of errors. It might be necessary to
calculate the specific amount of tablets, mixtures, solutions and other medications required by clients.
It is helpful to have knowledge of some basic conversions and calculations to provide appropriate assistance.
List of conversions
Larger units to smaller units:
 Kilograms (kg) to grams (g) = kg x 1,000

 Grams to milligrams (mg) = g x 1,000
 Milligrams to micrograms (mcg) = mg x 1,000
 Micrograms to nanograms (ng) = mcg x 1,000
 Litres (L) to millilitres (ml) = L x 1,000
To convert smaller units to larger the smaller is divided:
 Grams to kilograms = g/1,000

 Milligrams to grams = mg/1,000
 Micrograms to milligrams = mcg/1,000
 Nanograms to micrograms = ng/1,000
 Millilitres to litres = ml/1000
A common calculation is the required drug volume from stock strength. Be aware that a lot of prescribed doses
are smaller than the existing preparation.
Amount required / Stock strength

x Stock volume
=
If working in Paediatrics, dosage is often calculated using weight. The prescription may be in millilitres per
kilogram (ml/kg), or milligrams per kilogram (mg/kg).
Prescribed volume x Body weight =

(Or: Prescribed dose x Body weight) =
It may be expected to calculate the flow rate in drops per minute, for certain types of medication; referring to the
prescription and identifying the total volume in millilitres.
Total volume in ml Drop factor

------------------------ x --------------- = drops per minute
Time in minutes 1

Another common calculation is the flow rate in millilitres per hour. This is commonly applied when using infusion
pumps and is calculated as follows.
Solution in ml
------------------ = ml per hour
Time in hours
Remember, untrained/unlicensed staff can provide help when the client provides informed consent. This consent
must be documented, and a written and signed consent form obtained before assisting the client with their
medication for the first time.

2.8 – Prepare medications according to delegated role and in line with legal and environmental guidelines
Preparing medications
It is essential to have a signed and dated form authorised by a registered medical practitioner, registered nurse
practitioner, or registered dental practitioner, for the administration of medication. This form should specify the
client’s name, the name and strength of the medication, the appropriate dosage and regularity of administration,
the commencement date, and the period of medication, where known.
The individual worker should have access to a medication storage room, with carts and drawers containing the
specific medication and equipment needed for administration to each client. The drawers should be clearly
labelled with the client’s identification.
In each drawer, there will be a medication slip or medication administration record (MAR) detailing the client’s
name, dosage, room and bed number. Confirm that the information corresponds to the physician’s written order
and medication label.
It will be necessary to read the label at least three times prior to the administration of medication. The
appropriate times are when the medication is taken from the drawer, before the medication container is opened,
and when the empty container is returned to the drawer, or discarded.
Take particular care when measuring the medication and refer to the supervisor or delegating health professional
if help or guidance is required.
The preparation of medications may include:
 Assistance provided in taking medication by grinding or dividing tablets where there are clearly written
instructions
 Dissolving powder medication in water
 Measuring liquid medications into measuring cup/spoon
 Placing medication in nebuliser/spacer
 Placing tablets/capsules from dose administration aids into a medicine cup


Identify and prepare the client for administration of medication
3.1 Greet and identify client according to organisation procedures and prepare for medication administration
Greeting clients
The ‘greeting’ is another important aspect of medication administration. The client should be identified by their
full name and then referred to using their preferred moniker (name or nickname) – this can be their first name, or
their surname, preceded a by their title eg. Mrs or Mr.
The greeting should be formal, yet friendly; use small talk, such as asking how they are feeling and what activities
they have engaged in. This will help put them at ease and allow them to relax. If they are inclined to reject
medication, or be difficult in any way, then this approach may make them more receptive.
Do the following when greeting clients:
 Wear an identification badge and introduce yourself by name (never assume they know you)
 Tell the client the reason you are there and what the procedure will be
 Mention the name of a family member or another resident, to show familiarity
This can all be done while preparing them for medication.
Examples of greetings are shown below:
‘Good afternoon, Mr O'Rourke. My name is Sophie. How are you today? I'm here to help you take your
medication.’
‘Hello Ms Myers. I'm Tom and I'll be taking care of you this morning. How are your eyes today? Let me just sort out
your medication first.’
Preparing medication
It is important to explain the dose administration procedure to the client. They are much more likely to trust a
person, if they know what is going on and why.
Preparing the client for assistance with administration of medication may include:
 Discussing the procedure

 Encouraging client's participation
 Adjusting posture and position
 Seeking assistance from other staff if available and required
 Providing privacy
 Appropriate exposure of treatment area (in the case of lotion application)


3.2 Check client medication according to organisation guidelines and the delegation from the health
professional
Checking client medication
The worker will be expected to check medication prior to administration, ensuring it is within the expiry date and
has not been contaminated or tampered with in any way. The organisational guidelines may specify the need to
attach dated labels to any medication bottles and any refrigerated medication that is being administered.
The worker will be expected to follow organisational procedures for discarding medication that has been
contaminated, or is past its use by date.
An organisation’s guidelines for checking medication may include:
 Checking dose administration aids for evidence of tampering

 Checking medication is free from contamination or deterioration
 Checking that administration, instructions and the identity of the client correlate with documentation
 Checking that discrepancies in administration are documented appropriately
 Checking the procedure for infection control, storage and disposal
An organisation’s policy for checking medications with clients who are self-medicating may include:
 Confirming the following with the client:

o the amount of medication (eg. number of tablets or amount of gel)
o the time for self-medication (eg. once a day with food)
o the route of self-medication (eg. by mouth)
o any alterations authorised by the pharmacist, registered nurse or health professional (eg. crush
tablets or mix with water or food)
 Checking the medication for expiry date and any obvious discrepancies such as colour changes,
disintegration, or deterioration
These medications should be double checked prior to administration:
 Anti-coagulants
 Insulin
 Schedule 4 (D) and 8 drugs
 All intravenous solutions
 Steroids
 Vaccinations
 Dinoprostone (Prostin/Cervidil)
 Rhesus D immunoglobulin
 Misoprostol
 Gemeprost (Cervagem)
 All medications for administration to infants
It may be expected that an MDS (monitored dosage systems) is used, for the management of solid oral dose
medications. There are various types of MDS, and the individual must be confident of using the system chosen by
the organisation. The use of the MDS should minimise the risk of dosage and timing mistakes.
The MDS may prompt the clients to self-medicate appropriately. Ensure that the MDS are topped up in
accordance with organisational expectations and client requirements.


3.3 Accurately explain the administration procedure to the client
3.4 Prior to the administration of medication, check the client for any physical or behavioural changes that may
indicate the need to report to delegating health professional
Explaining the administration procedure
Provide clients with clear and easily understandable explanations about the administration procedure. The first
step should be to inform the clients of why the medication is being administered and what function it will
perform.
The clients should be aware of the importance of correctly administering the medication. Also, provide details of
common side effects and tell the client to contact the medical practitioner if they have any adverse reactions.
The client should be given an overview of all the essential details prior to administration. Demonstrate respect
and speak in a calm and controlled manner, as it is likely that the clients will be concerned about the
administration of some medications.
They might worry about the levels of pain and possible adverse reactions. However, by providing reassurance and
maintaining a sense of professionalism throughout the process, answering any questions and setting the client’s
mind at rest will result in a more relaxed client.
It is encouraged that the worker should question the client and ensure that they have processed all of the
information that has been provided.
It will be necessary to listen carefully and ensure that the client has fully understood the administration
procedure. There may be occasions when there is a need to clarify details; or it may be necessary to provide
family members and carers with information about the medication process.
Follow these rules when explaining the administration procedure:
 Encourage the client to raise any fears and concerns

 Demonstrate empathy, kindness and respect
 Avoid the use of medical jargon and technical terms
Checking for physical or behavioural changes
It will be necessary to monitor the client’s health status on an ongoing basis, taking note of any visible signs that
their condition has changed. Look out for sweating, scratching, altered skin tone, and signs of confusion.
Communicate with the client and ensure that they are as responsive and mentally alert as can be expected. If any
changes are noticed, report directly to the delegating health professional.
It will not always be possible to speak with the client. However, ideally the individual should be able to establish
how they are feeling and responding to treatment. If the client can communicate verbally, then listen carefully
and record any key details. Questions should be asked to demonstrate interest, and encourage the client to keep
on speaking. Ask the self-medicating clients whether they have taken their medications and ask to see the
opened containers or packets.
If there are specific concerns, then seek advice before acting. It is possible that the medication may have a
negative impact.


Administer medications within legal parameters
4.1 Administer medications as delegated within role responsibility
Administering medications
The worker may be expected to follow a variety of procedures depending upon the medication that is being
administered. It is important to recognise that clients require different levels of support, in accordance with their
health status and capabilities.
If the clients are self-medicating, there will be occasions when they need to be supervised, as this confirms that
the correct procedures are being followed. It is important to act in accordance with medication instructions and
organisational expectations. Medications will need to be taken at the right times and through the correct routes.
The worker may have to prepare the area of administration, to minimise the risk of adverse reactions.
The administration of medications may involve:
 Selecting the correct medications and scheduling administration appropriately

 Ensuring that medications are taken through the correct route
 Applying professional skills and knowledge to minimise risk during the administration procedure
Medications such as rectal suppositories, insulin and endoscopic gastronomy, should only be administered by fully
trained healthcare practitioners.
If there is any doubt about professional responsibilities, then it would be advisable to inform the delegating
health care professional.


4.2 Administer medications according to ‘rights of medication’, specific requirements from the form prescribed
and in accordance with defined legislation, organisation procedures, professional standards and prescriber’s
written instructions where available
Administering medications according to the ‘rights of medication’
Administration procedures must be undertaken in accordance with the widely recognised ‘rights of medication’.
There is some debate regarding the specific number of ‘rights’ and the worker is advised to apply those that are
recognised within their specific organisation. It will be necessary to check the medication against the MAR
(medication administration record) at least three times before administration.
The ‘rights of medication’ include:
 Right client – follow organisational procedures for the correct identification of clients
 Right medication – perform checks to ensure that the correct medication is administered
 Right dosage – the order should be checked, and calculations should be performed to ensure that the
correct dosage is administered
 Right route – re-check the medication order and clarify the appropriate medication route
 Right time – check the expected regularity and ensure that medications are administered at the correct
times
 Right documentation – complete any necessary documentation upon the administration of medication
 Right reason – confirm the reason for administering the medication and account for any changes in the
client’s condition
 Right response – monitor the client’s reaction to the medication and complete documentation as
necessary
Considering specific requirements of the form
The main routes of administration have already been mentioned; ensure that these routes are chosen in
accordance with the nature of medication. The medication should be provided with instructions that the worker
will be expected to follow. If there is any doubt, refer to the delegating health professional.
Forms of medication include:
 Capsules – these medications are included in a plastic outer coating and should be taken orally, with or
without food/drink
 Tablets – these types of medication usually include two active ingredients and may be taken directly or
dissolved in water and then swallowed
 Injections – considerable care should be taken over the preparation of injections. Different methods of
administration are used for subcutaneous and intravenous injections
 Drops – these medications come in liquid form and are designed to be inserted into areas of the body such
as the eyes and ears
 Liquids – the primary medication may be combined with liquid in order to make it easier to digest. use
measuring equipment and ensure that the correct quantities are administered
 Lotions and creams – these medications should be applied to areas of the body which have been affected
by specific conditions. They may then be absorbed into the system and have a general effect on the
development of the condition
 Ointments – these medications generally come in cream form and are meant to be applied to areas of the
body affected by specific medical conditions
 Patches – Transdermal patches are designed to be applied to the skin for the transmission of medication
into the system. The medication flows through the skin and enters the bloodstream for treatment of
different medical conditions
 Powders – there are various types of medicinal powders which are meant to be combined with food and
drink for oral absorption into the system
 Wafers – these medications are made from dried flour paste and are designed to be wrapped around
medications for administration without the bad taste
 Pessaries – these medications take the form of small bullets and are designed for easy insertion and
absorption through the vagina
 Inhalers – these devices are designed to pump medications through the mouth for rapid ingestion. Spacers
may be used to make the administration process easier
 Suppositories – these medications are combined with other substances and come in bullet form for
insertion into the rectum or vagina
Follow the prescriber’s instructions when administering the different types of medications. Widely recognised
professional standards should be adhered to at all times.
There will be occasions when the worker may be expected to administer medications in accordance with the
following items of legislation and professional standards:
 Aged Care Accreditation Standards and policies

 Disability Service Standards and policies
 Home and Community Care National Service Standards and policies
 State or Territory government policies

4.3 Assist the client taking the medication as required and according to documented procedures and
professional standards
Assisting the client
The organisation should provide training and documented procedures relating to the assistance that will be
provided in the administration of medication. It is essential to have an understanding of the duties and the
limitations of the particular role.
There should be procedures for refusing assistance, when the required level of understanding or competence is
not evident.
The worker will be required to speak with the client prior to the administration of medication. It is advised to use
small talk and discuss general ‘life’ topics in order to increase the sense of calm and relaxation. It will be necessary
to assure the client of privacy during the administration process.
Always inform the client that the administration process has been scheduled and confirm that they are happy to
proceed. Wash the hands thoroughly each time the administration process is undertaken. However, it might be
necessary to use gloves when handling the client’s medication. It will be necessary to follow the ‘rights of
medication administration’.
The worker may be expected to provide the following forms of assistance when administering medication or
supporting self-medication:
 Discussing the process and addressing any likely difficulties

 Confirming the time and type of medication
 Establishing the type and level of support required by the client to take/receive the medication
 Adjusting posture or position
 Opening bottles or dose administration aids
 Removing tablets or capsules from dose administration aids
 Measuring the amount of liquid required into a medicine cup or a cream onto the affected area
 Crushing or dividing tablets where indicated by a pharmacist or health professional
 Placing medication into nebulisers or spacers
 Dissolving medication in water
 Ensuring that fluids are available to assist with swallowing
 Providing privacy


4.4 Oversee and observe the client when taking medication and confirm ingestion or completion of
administration
Overseeing and observing clients
It might be necessary to supervise the client taking their medication to ensure that it is properly ingested.
The supervision should involve being present before, during, and immediately after they have self-administered
their medication.
The reason for this is that some clients refuse or are reluctant to take their medication. However, rejection of the
medication may have serious impacts on health and wellbeing. It may lead to the very change in psychological
state of mind that causes the client to refuse their medication.
Confirmation of the ingestion/completion of self-administration can be done through observation and verbal
confirmation. If there are any doubts about the client ingesting their medication, then performing an examination
(as assigned by the job role and legislation) is acceptable.
Always report any concerns to a supervisor or health professional.


4.5 Dispose of all used and unused medication, containers, according to organisation procedures
Disposing of medication
An individual must act in accordance with organisational expectations and the prescriber’s instructions when
disposing of used and unused medication. It might be tempting to keep any medication that has not been
administered. However, be aware that the risk of contamination and adverse reactions will be greater when
taking medication that has passed the use by date, or stored incorrectly.
It is unlikely that it will act as effectively as medicine that is within the use by date and stored correctly. It is
advised that any out-of-date medication be returned to the prescribing pharmacist.
Ensure that any waste medication is placed in the appropriate disposal unit or receptacle. The waste bins should
be clearly labelled for easy identification.
As an example, syringes should be placed in the sharp’s disposal unit. It is necessary to wear gloves when handling
any waste products, for the assurance of personal hygiene and safety.
Section 6.11.3 of NSW Health Waste Management Guidelines for Health Care Facilities – August 1998 specifies
that ‘Pharmaceutical waste awaiting disposal should be stored in the same manner as pharmaceuticals in use.
Pharmaceutical waste should be placed in non-reactive containers and should not be discharged to the sewer or
any process where they may find their way into the environment.’


4.6 Identify signs from client ‘when necessary’ medications might be required, then inform delegating health
practitioner and act in accordance with organisation’s policies, procedures, delegation and role responsibility
Identifying signs from client
There are some medications that should only be administered to clients ‘when necessary’. These medications are
sometimes referred to as PRN and are suitable for short-term conditions which may only become obvious
intermittently.
Relevant information about the administration of these medications should be included on the MAR and specified
by the delegating health practitioner. The worker may be expected to identify the signs of deterioration which
signal the need for administration.
Signs from the client may include:
 Specific requests for medication

 Signs of pain
 Noticeable deterioration in the client’s condition
Common types of ‘when necessary’ medication include:
 Analgesics
 Anti-inflammatory drugs
 Hypnotics or sedatives
 Medications used for breathing problems
 Medications used for digestive problems
If any of these signs are identified, immediately inform the delegating health practitioner and act in accordance
with their instructions. It might be necessary to make a referral if the administration of ‘when necessary’
medications fall outside the scope of responsibilities.
The procedures for the administration of ‘when necessary’ medications should specify how much should be taken
and at what times they should be taken. Also, be aware of the period of time that may be allowed between doses
and the purpose of the medications.
It is important to record the administration of ‘when necessary’ medications. The records should specify the name
of the drug and quantities that have been administered. Also, record the time of administration and any other
information deemed necessary.
It will be necessary to monitor reactions to these medications and ensure that they are having the desired effect.


4.7 Record administration of medications according to organisation policy
Recording administration of medications
An organisation’s policy will usually specify the need to record the administration of medications on an MAR or
drug chart. The formatting and layout of this chart will vary. However, there are a number of essential details
which should be included.
The client’s name and date of birth should be specified. It will be necessary to detail the name of medication, size
of dosage, specific times, and dates upon which medication has been administered. The chart should be signed by
the prescribing doctor and the healthcare practitioner who administers the medication.
There may be a reference to a key which specifies the terms which may be included on the medication sheet.
The organisation should provide training and guidance in the completion of medication records. It will be
necessary to fill in relevant sections of the medication chart each time medication is administered. The worker is
expected to include details of the client’s response to medication.
If the medication was rejected, or deemed unnecessary, then state the reasons. The exact dosage should be
recorded, and specify all of the staff members involved in the administration process.


4.8 Provide accurate information to clients and carers on medication administration, including possible side
effects as per instructions of the delegating health professional
Providing accurate information to clients and carers
It is essential to provide clients and carers with information about the administration of medication. They should
be aware of the types of medication that has been scheduled. Also, providing information about the side effects
associated with the medication is deemed essential.
Clients should be encouraged to raise any concerns and ask questions. It will be necessary to explain the
administration process to the carers so that they can assist and give reminders when required. The information
should be given in person in the first instance. It is recommended that written documents, which the clients and
carers can review at their convenience, are provided.
The types of information that may be shared include:
 Purpose and function of medication

 How the medication is to be administered
 Food and drink which should not be consumed after medication
Instructions may include:
 Verbal
 Practice Protocols
 Written
 By phone
 Via electronic means
Certify that information about medication is clear and easily understandable. It may be necessary to provide
information about any technical terms that have to be included.
Question the client and carer to ensure that they fully understand all of the information that has been provided.
They may be encouraged to clarify and rephrase any details that have been given.
Confirming customer understanding may include:
 Explaining information contained on cautionary and advisory labels in plain English suited to the customer
communication requirements
 Questioning to confirm that the correct customer understands the information provided
 Inviting further questions from the customer
 Arranging for the customer to make contact with a pharmacist where more detailed support or advice is
required


Monitor client response to administered medication
5.1 Identify possible acute and delayed adverse reactions to medications, respond within role responsibility
and report to supervisor or health professional
5.2 Implement emergency response for identified acute and delayed adverse reactions within role
responsibility
5.3 Record and report response to emergency strategies
Identify and report individual's reactions
It is important to keep ‘checks’ on individual reactions to certain medications. This will help address any
immediate safety concerns and aid in the management of medication. As the person helping them with the
administration of their medication, the worker is often the go-between for them and their medical professional
eg. their GP.
It is necessary to identify, report, record and address, client reactions in line with organisational guidelines and
instructions of the health professional responsible for overseeing the client's care. Acute reactions to medication
will be immediately obvious and will vary in severity. However, there will be a need to observe and communicate
with the clients after the administering of medication, in case they have delayed adverse reactions.
Usually, the reaction to the medication will be positive and the client will respond as intended.
However, be aware of adverse reactions, including:
 Anything that appears different from the client's usual state

 Blurred vision
 Changes in behaviour
 Changes to airway (eg. choking), changes to breathing (including slowed, fast or absent breathing),
changes in person's colour (eg. pale or flushed appearance or bluish tinge), or changes to circulation
(including unexpected drowsiness, loss of consciousness, and absence of pulse)
 Confusion
 Feelings of dizziness
 Headache
 Inflammation or redness
 Nausea and vomiting
 Others as advised by a health professional
 Rash
 Skin tone
 Slurring of speech
 Swelling
Toxicology
Be aware that the process of identifying adverse reactions to medications and other chemicals is known as
toxicology. Toxicologists perform testing to establish the levels of risk associated with exposure to certain kinds of
chemicals.
It is recognised that the prospect of serious reactions increases in accordance with the dose that is administered.
This is because there is increased exposure to toxicity.


Anaphylaxis
Anaphylaxis is widely recognised as one of the most serious adverse reactions to medication. This reaction may be
acute or delayed and is categorised as an allergy. The response may occur as a direct result of administering a
drug.
However, it may be the effect of combining the medication with food and other drugs. The reaction occurs
because the body’s immune system incorrectly identifies the medication as a threat. There is a sudden rush of
chemical substances from blood and tissue cells to the area of the body that is thought to be under ‘attack’.
It is common to provide adrenaline auto-injectors to individuals who are considered at significant risk of
Anaphylaxis (including those with asthma). However, be aware of the procedures which must be followed in the
event of emergencies.
Symptoms of Anaphylaxis include:
 Redness of the face

 Nettle rash (hives)
 Feeling that something terrible is happening
 Swelling throat and mouth
 Trouble swallowing and talking
 Asthma
 Fluctuating heart rate
 Significant decrease in blood pressure.
 Fainting and general weakness
Reporting individual reactions
Once the reaction of the client has been identified, report it to the appropriate person. This will usually be the
person in charge of their care (typically a Registered Nurse).
If they have an adverse reaction, the people to report to include:
 Complementary medicine therapist (subject to government and organisation policies)

 Dentist
 Dietitian
 Medical practitioners (General Practitioners and medical specialists)
 Occupational therapist
 Pharmacist
 Physiotherapist
 Podiatrist
 Psychiatrist
 Psychologist
 Registered nurses
Recording individual reactions
It is necessary to record individual reactions on the medication form. If administering or supervising the
administration of the medication - note the reaction.
This provides a historical reference for health professionals to review the medication of the client.

It allows a check if the client has had similar reactions previously (if they are adverse) and see what was done in
those instances, then repeat any successful decisions and actions.
Addressing individual reactions
If the client has an adverse reaction to medication, then it may be required to address their safety and wellbeing
immediately. For example, if the client starts choking, check their airway and perform interventions such as the
Heimlich manoeuvre.
If the symptoms are not recognised and responded to appropriately, then there will be a risk of serious health
consequences and possible death.
It will be necessary to consult the records of any client who has an adverse reaction to medication. It may be
advisable to arrange a physical examination and testing of the client’s blood and vomit. Administration of the
medication should be stopped until the cause of any negative effects has been established.
The worker may be instructed to take a specific action by a health professional. Follow their instructions to
secure the immediate safety of the client. The types of actions that may be taken include the injection of
adrenaline and stomach pumping.
It might be necessary to have the client to see a health professional, who can properly assess their condition once
their immediate safety has been secured.
Recording and reporting responses
It will be necessary to record and report the response to emergency strategies in accordance with organisational
guidelines and expectations. The organisation may require the recording of such details in documentation and use
specific formatting methods. The writing should be clear and easily understandable. Detail the client’s response to
medication and any emergency strategies that were deemed necessary.
The types of emergency strategies that are implemented will depend upon the nature of the adverse reaction,
having checked the clients for signs of Anaphylaxis and other negative responses to medication. It will be
necessary to document the time at which the adverse reaction was identified and any initial response.
How the client was reassured, confirming the immediate call for emergency assistance. Specify who was
contacted and how long they took to arrive and assist the client.
Specify the details of any medication and other treatment that was administered when addressing the adverse
reaction. Detail the time of treatment and the effect that it had on the client. Information about the emergency
response should be stored appropriately.
It may be expected to provide relevant details in the individual care record. Other medical practitioners may need
to refer to these records and ensure that mistakes are not repeated. It might be deemed necessary to make
changes to the medication for reduced risk to the client.


5.4 Identify signs of a client experiencing pain and report to health professional
Identifying signs of pain
There are numerous signs of pain that may be identified when working in the medical environment. The worker
must be able to identify these signs and take rapid action in order to minimise the level of risk to the client.
It will be easier to assess the levels of pain when clients are able to communicate and express themselves.
However, there are a number of non-verbal signs that should be considered. It is expected that a report will be
given, regarding any signs of pain, to the appropriate health professional.
Signs of pain include:
 Grimacing
 Moaning
 Inability to stay still
 Grinding teeth
 Protecting the area where pain is felt
 Verbalised pain
 Expressions of anger
 Loss of appetite
 Requesting assistance
 Withdrawal
The health professional may be:
 Registered nurse
 Medical practitioner
 Pharmacist
 Complementary medicine therapist (for delegation within legislative requirements, specific to their area
of expertise where included in the care plan)
 Dentist


5.5 Observe and record client response to pain relieving medication and report to health professional
Observing and recording response to pain relieving medication
Observation of the client upon the administration of pain-relieving medication, and recording their response in
accordance with organisational expectations, is expected.
Monitor and communicate with the clients in order to identify instances of pain at the earliest opportunity. It is
best to treat pain before it becomes severe and causes significant distress.
If the pain is not particularly severe, then the client may be given over-the-counter medications such as
acetaminophen and paracetamol. However, more serious instances of pain may be treated with opiate pain
relievers such as codeine and methadone.
Unfortunately, these medications are associated with side effects such as constipation, drowsiness and nausea. If
these side effects are experienced, then further medical assistance may be required.
Other forms of pain-relieving medication include:
 Aspirin – a non-opiate medication commonly used for the treatment of mild pain. Side effects may include
vomiting, stomach pain, and heartburn
 Oxycodone – an opioid used for the treatment of severe pain. Side effects may include fever, chest pain,
and blood in urine
 Ibuprofen – an over-the-counter anti-inflammatory medication. Side effects may include stomach pain,
indigestion, and nausea
 Local anaesthetic – there are a variety of local anaesthetics which may be given for the treatment of mild-
moderate pain. Side effects may include dizziness, headaches, and muscle twitches
It will be necessary to monitor clients for the appropriate amount of time and identify any adverse reactions to
the pain-relieving medication. The individual response may be recorded on the MAR and within the client’s
records. Always specify which medication was administered and in what quantity.
Also, include all of the key details about the individual’s response. Other healthcare practitioners may consult the
records to aid decisions about the treatment of pain in the future.


6.1 Report medication refusal or incomplete ingestion to supervising health professional according to
organisation’s procedures and protocols
Reporting medication refusal or incomplete ingestion
It is expected that the worker will act in accordance with organisational procedures and protocols whenever
medication is refused, or unsuccessfully administered. It is possible that the client will spit out the medication
because they take exception to the taste, or do not understand why it has been administered.
The medication may be refused because of doubts over the benefits and concerns about the possible side effects.
The client may be sick after taking the medication due to gastroenteritis, or an unexpected adverse reaction.
Discuss the reasons for refusal or incomplete ingestion.
It might be possible to address their concerns and make changes for successful administration in the future.
It will be necessary to report to the supervising health professional as soon as possible after the refusal, or
incomplete ingestion of medication. Detail the type of medication, the dosage, and the time at which
administration was attempted. It is expected that the nature of the client’s response will be given in detail.
Incomplete ingestion may include:
 Ejection of medication
 Inability or difficulties in swallowing tablets, capsules or liquids
 Refusal to take medications
 Vomiting
The failed administration, or rejection, of medication may be down to professional errors. The appropriate actions
need to be taken to ensure that clients receive their medication in the future. The consequences of failure could
be serious and detrimental to the health of the client. Contingency plans should be implemented as necessary.


6.2 Clearly identify contaminated or out of date medication and implement organisation’s procedures for safe
and appropriate disposal
Contamination of medication
It is vital for all medication to be in-date and uncontaminated. An organisation should have a policy specifying
procedures that should be followed for the safe management of medication. The worker may be expected to
place dated labels on containers that are left in the fridge, and creams and lotions which have been opened.
If any medication is identified as out-of-date or contaminated, then immediately remove it from storage and
place in the appropriate disposal receptacle.
Contaminated medication may have:
 Come into contact with foreign substances

 A broken seal
 Been left out unattended
 Reached its expiry date
Implementing procedures for safe and appropriate disposal
The disposal procedures are the same for used medication and all necessary WHS precautions must be taken.
Identify the correct receptacle and make sure there is no direct handling of the contaminated medication. It is
important to ensure that others do not come into contact with it either.


6.3 Observe and record changes in the client’s condition according to the organisation’s guidelines and report
to supervisor and health professional
Observing and reporting changes in condition
It will be necessary to monitor the client upon the administration of medication and record any changes in their
condition. Note whether the medication has had the desired effect, and whether the client has suffered any
adverse reactions. Immediate action may need to be taken if the client experiences any severe side effects.
Possible changes in condition of the client, that must be immediately reported to a supervisor or health
professional may include, but are not limited to:
 Anything that appears different from the client's usual state

 Blurred vision
 Changes in behaviour
 Changes to airway (eg. choking), changes to breathing (including slowed, fast or absent breathing),
changes in person's colour (eg. pale or flushed appearance or bluish tinge), or changes to circulation
(including unexpected drowsiness, loss of consciousness, and absence of pulse)
 Confusion
 Feelings of dizziness
 Headache
 Inflammation or redness
 Nausea and vomiting
 Others as advised by health professional
 Rash
 Skin tone
 Slurring of speech
 Swelling


6.4 Record and report any inconsistencies according to delegation and organisation guidelines and procedures
Recording and reporting inconsistencies
Inconsistencies which are identified in any aspect of medication should be reported promptly to the supervisor or
the relevant health professional.
Inconsistencies may be associated with:
 Adverse drug incident reports

 Client's record of medications according to organisation guidelines
 Incident reports
 Medical charts
 Progress notes
Such inconsistencies need to be documented and addressed according to organisation guidelines and procedures.
This process will usually involve clarifying the areas of inconsistency with the relevant supervisor or health
professional. It is of utmost importance to have the correct information and consistency across all areas of
medication administration. This will minimise the chance of mistakes.
Some of the inconsistencies may simply be down to human error. The main concern is rectifying the situation,
rather than apportioning blame to the person responsible (though this may become an issue if the same errors
reoccur).
Clients' medication should be reviewed on a regular basis, to identify these inconsistencies and minimise the
chance of errors occurring. It will be necessary to reduce the liability of those involved with medication
administration.


7.1 Manage medication equipment and used containers according to infection control guidelines
Managing medication equipment and used containers
The individual worker will be expected to act in accordance with the manufacturer’s instructions and infection
control guidelines, specific to the management of medication equipment and used containers. It will be necessary
to carry out inspections and ensure that the equipment has not been damaged and that it is as clean as possible.
Also, ensure that any single-use equipment is discarded when necessary, even if it has only been opened and not
used in the treatment of clients. Any used equipment and containers should be placed in the correct receptacle,
in accordance with organisational expectations.
Those items which are meant for repeat use should be cleaned immediately after the administration of
medication and placed in the correct storage area.
According to the Dept of NSW Health Infection Control Policy ‘Used client care equipment soiled with blood and
body substances must be handled in a manner that prevents aged care or health support worker skin and mucous
membrane exposure, contamination of clothing and transfer of micro-organisms to other clients and
environments. Reusable equipment must not be used for the care of another client until it has been appropriately
cleaned and/or reprocessed. Single use items must be discarded after use.’
The Australian guidelines for the prevention and control of infection in healthcare (2010) specify the following
requirements:
 Before using any sharp medical device such as needles or scalpels, always plan for their safe handling and
immediate disposal at the point-of-use
 Make sure every used sharp medical device such as needles, scalpels etc. are disposed of properly in
puncture-resistant sharps containers located at the point-of-use
 Ensure that all reusable instruments and equipment are cleaned thoroughly and then either disinfected or
sterilised before being used on the next client
 Ensure that any instrument that enters a part of the body (eg. in surgery) is sterilised and completely free
of all potentially harmful organisms
 Ensure that any instrument that goes inside the nose, mouth or other orifice, or touches broken skin, is
either sterilised or disinfected to a high level
 Ensure that any equipment that touches the client or is touched by the client, is cleaned thoroughly and if
necessary disinfected
https://www.nhmrc.gov.au/book/html-australian-guidelines-prevention-and-control-infection-healthcare-2010

7.2 Complete arrangements and procedures to replenish dose administration aids and supplies
Replenishing dose administration aids and supplies
Dose administration aids are typically provided to clients who need help with the administration of medication.
Medical organisations provide these aids to ensure compliance with Australian healthcare regulations.
They are designed to aid in the organisation of medication and to ensure that clients self-medicate at the correct
times. If no care is taken over the replenishment of these aids, then clients may end up missing their medications,
causing a deterioration in their condition.
Dose administration aids include:
 Compartmentalised dosettes
 Blister packs
 Sachets
 Packettes
 Automated devices
Have systems in place to ensure that the dose administration aids and supplies are replenished when required. It
is essential that the aids and supplies are kept ‘topped up’ and that clients are able to have appropriate access to
their medications.
It will be necessary to monitor the medications and ensure that requests for new supplies are issued to the
pharmacist. The required dosages should be rapidly transported to the appropriate medical facility.
It is expected that the worker will manage and ensure access to essential medical supplies (including gloves and
medication cups). The replenishment of such supplies will be necessary for maintained standards of organisation,
cleanliness, and safety. Staff members should be aware of how to request and make new orders when supplies
are running low.

7.3 Store medication charts, care plans and treatment sheets according to the organisation’s procedures
Storage of documents
Medication charts, care plans, and treatment sheets must all be stored in a secure location, in line with
organisation procedures, to maintain the safety, security and confidentiality of the information.
Safety and security
All documents should be stored in a secure and locked location that only authorised personnel can access. It is
good practice to have a separate fireproof room dedicated to storage of files, to make sure the information is not
lost in the event of a disaster.
Another good practice is to back up the documents on hand. This has been a commonly used practice since the
start of the digital revolution. It saves space, can be accessed anywhere, can be transferred easily, and has
multiple storage options – hard drives, cloud storage, external storage drives, internet storage and so on.
The information can either be typed into a computer program, or scanned. While it may be time-consuming
initially, it is actually time-efficient latterly.
The other option is to manually back up the data and create photocopies of all the relevant documents, storing
them at another secure external location.
Confidentiality
Confidentiality is required by law in certain respects. The privacy of client and client records is the most important
aspect of confidentiality in the care industry. Failure to maintain the privacy of customer records is punishable by
law and organisation can be sued by the client.
Confidentiality covers:
 Physical privacy of clients in facilities, such as surgeries, hospitals and residential care homes
 Controlling/not sharing records
 Monitoring access to records
 Disclosure to third parties:
o employers
o other clients and family members
o insurance companies
 Use of audit trails to monitor who has accessed medical records and when
 Encrypting electronic records
 Protection of Personally Controlled Electronic Health Records (PCEHR)
 Not selling or communicating data to pharmaceutical companies
Confidentiality laws apply to discussing clients’ conditions and treatment with other people. Be aware of the legislation
around this and apply it to all discussions.
Clients must give their permission to contact others about their medical details. The worker can only discuss their
conditions with identified close family members, including spouses.
Some information must be stored appropriately in line with confidentiality laws and organisational procedures, such as:
 Financial information
 Healthcare/medical records
 Personal details

7.4 Complete medication storage procedures in compliance with legislation and own role responsibility
Medication storage
Medication must be stored properly, according to legislative requirements, and manufacturer instructions.
The main purposes of this are to:
 Avoid contamination or deterioration

 Avoid disfiguration of labels
 Maintain integrity of packaging and so guarantee quality and potency of drugs during shelf life
 Prevent or reduce pilferage, theft, or losses
 Prevent infestation of pests and vermin
Source: http://apps.who.int/medicinedocs/en/d/Js7919e/7.10.html
These requirements will vary between medicines and their specific contents. However, most medicines either
require cold storage (2-8 degrees Celsius) or storage below 25 degrees Celsius.
Therefore, it is important to have an appropriately-sized refrigeration unit on site. This unit should be monitored
daily using a maximum/minimum thermometer (reading and resetting it daily). It should be maintained with
regular defrosting and cleaning.
These processes, like everything else, need to be documented. Also, note that this refrigerator should be
dedicated solely to medication storage.
A cool room will be adequate for medications that require below 25 degrees Celsius storage. This should, as with
the medicine refrigeration unit, be kept locked and in a place that only authorised personnel can access. It is a
logical idea to store the refrigerator in the cool room.
Room temperature storage is usually sufficient for medications that require storage below 25 degrees. However,
temperature monitoring will need to be implemented. Air conditioners can usually solve the problem if the
temperature rises above 25 degrees Celsius.
Always read the manufacturer's label to identify the precise temperature requirements for storage. If unsure of
anything then contact the pharmacist/supplier for clarification.
General medication storage requirements are:
 Adequate temperature
 Sufficient lighting
 Clean conditions
 Humidity control
 Cold storage facilities
 Adequate shelving to ensure the integrity of the stored drugs
Source: http://apps.who.int/medicinedocs/en/d/Js7919e/7.10.html

Consider the storage and disposal requirements of medications outlined in this table:
Medication name Storage requirements Disposal requirements
Generic Zocor Should be kept in temperatures under Should be discarded once past the use-by date
25°C for a maximum of 24 months and when not required
Lisinopril Should be kept in sealed containers at Should be discarded once past the use-by date
room temperature and when not required
Azithromycin Should be kept in sealed containers at Should be discarded when opened and not
room temperature administered for ten days or more and when
past the use by date/not needed
Generic Should be kept in sealed containers at Should be discarded once past the use-by date
Glucophage room temperature and when not required
Levothyroxine Should be kept in sealed containers at Should be discarded once past the use-by date
Aripiprazole Tablets, solution, and orally Packages should be discarded immediately
disintegrating tablets should be kept in after taking the medication. Solution should be
sealed containers at room temperature. discarded after six months of being opened or
Orally disintegrating tablets should be when past the use by date
kept in the sealed package
Rosuvastatin Should be kept in sealed containers at Should be returned to the pharmacist when no
room temperature longer required or past the use by date
Esomeprazole Should be kept in sealed containers at Should be discarded once past the use-by date
Albuterol Unused nebulizer solution vials should Should be discarded once past the use-by date
be kept in the foil pouch until and when not required
administration. They should be kept in
the refrigerator or at room
temperature. Inhalers should be kept at
room temperature
Fluticasone Fluticasone furoate spray should be Should be discarded once past the use-by date
kept at temperatures of between 59 and when not required
and 86 degrees. It should be kept
upright and the cap should be sealed
tight
Duloxetine Should be kept in sealed containers at Should be discarded once past the use-by date
Valsartan Should be kept in sealed containers at Should be discarded once past the use-by date
temperatures of between 15°C and and when not required
25°C
Lisdexamfetamine Should be kept in sealed containers at Should be discarded once past the use-by date
dimesylate temperatures of between 15°C and and when not required
25°C
Adalimumab Should be stored in a refrigerator at Should not be kept past the expiration date on
temperatures of between two and the dose tray label or prefilled syringe
eight degrees C. Should be kept in the
original storage container until ready
for administration
Glatiramer acetate Should be stored in a refrigerator at Should be discarded once past the use-by date
temperatures of between two- and and when not required
eight-degrees C. If it has to be removed
from the refrigerator then it may be
kept at temperatures of 15 and 30
degrees C for up to a month

Medication name Storage requirements Disposal requirements

Pegfilgrastim Should be stored in a refrigerator at Pegfilgrastim kept at room temperature for
temperatures of between two- and any more than 48 hours should be discarded.
eight-degrees C Should be discarded once past the use-by date
and when not required
Acetaminophen Should be kept in sealed containers at Should be discarded once past the use-by date
25°C
Ibuprofen Should be kept in sealed containers at Should be discarded once past the use-by date
25°C. Temperatures above 40°C should
be avoided
Aspirin Should be kept in sealed containers at Should be discarded once past the use-by date
25°C
Dextromethorphan Dextromethorphan liquid should be Should be discarded once past the use-by date
kept at temperatures of between 20°C and when not required
and 25°C
Oxymetazoline Should be kept in sealed containers at Should be discarded once past the use-by date
25°C
Alprazolam Should be kept in sealed containers at Should be discarded once past the use-by date
25°C
Eszopiclone Should be kept in sealed containers at Should be discarded once past the use-by date
30°C
Morphine Should be kept in the original container Morphine extended-release tablets, extended-
at temperatures of between 15°C and release capsules, and liquids that have passed
25°C the use-by date or are no longer needed
should be flushed down toilet to prevent
others from taking them


References
Drug interactions between aspirin and Coumadin:

https://www.drugs.com/drug-interactions/aspirin-with-coumadin-243-0-2311-1529.html
Medication interactions: food, supplements and other drugs:

http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Medication-Interactions-Food-
Supplements-and-Other-Drugs_UCM_437377_Article.jsp
Avoiding drug interactions:

http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm096386.htm
Sun-sensitizing drugs:
http://www.webmd.com/skin-problems-and-treatments/sun-sensitizing-drugs#1
Alcohol and medication interactions:

http://www.webmd.com/mental-health/addiction/alcohol-interactions-with-medications
Medication administration risks

http://www.omnisure.com/newsletters/Medication_Newsletter.pdf
Client identification:
http://www.safetyandquality.gov.au/our-work/client-identification/
Drug allergy:
http://www.mayoclinic.org/diseases-conditions/drug-allergy/basics/definition/con-20033346
Intravenous medication administration:

http://www.healthline.com/health/intravenous-medication-administration#Process2
Intravenous therapy:
http://www.ruh.nhs.uk/Training/Prospectus/Clinical_Skills/documents/IV_workbook.pdf
Six rights:
http://www.atitesting.com/ati_next_gen/skillsmodules/content/medication-administration-
3/equipment/safety.html
http://www.safetyandquality.gov.au/our-work/client-identification/
http://www.who.int/clientsafety/solutions/clientsafety/PS-Solution2.pdf
Drug allergy:
https://www.allergyuk.org/drug-allergy/drug-allergy
Tests and diagnosis:

http://www.mayoclinic.org/diseases-conditions/drug-allergy/basics/tests-diagnosis/con-20033346
Drug laws in Australia:

https://drugs-forum.com/forum/showwiki.php?title=Drug_Laws_in_Australia

Scheduling basics:
https://www.tga.gov.au/scheduling-basics
Scheduling of medicines & poisons:

https://www.tga.gov.au/scheduling-medicines-poisons
Clarifying and clarification:

http://www.skillsyouneed.com/ips/clarification.html
Ways infectious diseases spread:

http://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/health+topics/health+con
ditions+prevention+and+treatment/infectious+diseases/ways+infectious+diseases+spread
Routes of administration of medicines:

https://inspiredpharma.com/2012/08/29/routes-of-administration-of-medicines/
Insulin: from prescription to administration:
http://www.gosh.nhs.uk/health-professionals/clinical-guidelines/insulin-prescription-administration
Intranasal medication delivery - brief overview of the concept:

http://intranasal.net/overview/default.htm
Ocular medication administration:

http://www.nursingcenter.com/upload/static/592775/take5_ocular.pdf
Administration of oral medication:

https://www.nursingtimes.net/clinical-archive/medicine-management/administration-of-oral-
medication/203563.article
Rectal drug administration in adults: how, when, why:

https://www.nursingtimes.net/clinical-archive/neurology/rectal-drug-administration-in-adults-how-when-
why/7002595.article
Topical medications:
http://www.atitesting.com/ati_next_gen/skillsmodules/content/Medication-Administration-
2/equipment/topical.html
Vaginal medications:
http://www.atitesting.com/ati_next_gen/skillsmodules/content/Medication-Administration-
2/equipment/vaginal.html
Prescription medicines:
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/prescription-medicines
Factors influencing drug effects:

http://www.health.gov.au/internet/publications/publishing.nsf/Content/drugtreat-pubs-front6-fa-toc~drugtreat-
pubs-front6-fa-secb~drugtreat-pubs-front6-fa-secb-6~drugtreat-pubs-front6-fa-secb-6-1
Overview of Pharmacodynamics:
https://www.merckmanuals.com/professional/clinical-pharmacology/pharmacodynamics/overview-of-
pharmacodynamics

Overview of Pharmacokinetics:
http://www.merckmanuals.com/professional/clinical-pharmacology/pharmacokinetics/overview-of-
pharmacokinetics
Pharmacotherapeutics:
http://www.pharmamirror.com/knowledge-base/pharmaceutical-dictionary/pharmacotherapeutics/
How to calculate drug dosage accurately: advice for nurses:

https://www.nursingtimes.net/clinical-archive/medicine-management/how-to-calculate-drug-dosage-accurately-
advice-for-nurses/199884.article
Basic drug calculations:

http://nursing.flinders.edu.au/students/studyaids/drugcalculations/page.php?id=6
Medication – administration:
https://www.seslhd.health.nsw.gov.au/rhw/manuals/documents/Medications/Medication%20-
%20Administration.pdf
Educating clients about safe medication use:

http://www.drugguide.com/ddo/view/Davis-Drug-
Guide/110092/all/Educating_Clients_About_Safe_Medication_Use
8 rights of medication administration:

http://www.nursingcenter.com/ncblog/may-2011/8-rights-of-medication-administration
The importance of taking your medications correctly:

http://www.pfizer.com/health/senior_health/taking_medicines
Managing your medication:

http://www.caremark.co.uk/our-care-services/medication-assistance
Prompting, assisting and administration of medication in a care setting: guidance for professionals:
http://www.careinspectorate.com/images/documents/2786/prompting-assisting-and-administration-of-
medication-in-a-care-setting-guidance-for-professionals.pdf
Storing and disposing of medicines safely:

http://www.locallyhealthy.co.uk/story/features/storing-and-disposing-medicines-safely
Calculating IV rates: drops per minute:

http://nursing.flinders.edu.au/students/studyaids/drugcalculations/flash/PDF%20files/iv_dropspermin.pdf
Calculating Flow Rates for Infusion Pumps in mL/hr:

http://www.public.coe.edu/departments/Nursing/psychomotorskills/calculatingflowrateformula.htm
PRN – as required medications:

http://www.webstercare.com.au/files//SOP/PRN-As_Needed_Medications-SOP.pdf
Medicine administration record (MAR) charts:

http://www.pharmacy-xpress.co.uk/manuals/training-handbook/9-medicine-administration-record-mar-charts
Completion of medication administration records (MAR’s):

http://www.momentumpeople.co.uk/124.htm

Good practice in prescribing and managing medicines and devices:

http://www.gmc-uk.org/Prescribing_guidance.pdf_59055247.pdf
What is toxicology?
http://www.news-medical.net/health/What-is-Toxicology.aspx
What is anaphylaxis?
http://www.anaphylaxis.org.uk/what-is-anaphylaxis/client-signs-and-symptoms/
Adverse drug reactions:

http://www.emergencycareforyou.org/Emergency-101/Emergencies-A-Z/Adverse-Drug-Reactions/
Reporting and documenting client care:

http://caresfl.org/site/wp-content/uploads/2013/10/Reporting_Documenting_Client_Care.pdf
Australian guidelines for the prevention and control of infection in healthcare (2010):
https://www.nhmrc.gov.au/book/html-australian-guidelines-prevention-and-control-infection-healthcare-2010

Version Dates Version 2 approved 15.02.19
Review Date Version 2 will be reviewed as training materials are amended
Approved by CEO: Susan Ellis Hill

General Manager: Kate Lovett
Relevant to Trainers and Assessors; Students

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H&H accredited training australasia inc

98 south street granville | 02 9682 0100 | www.hnh.org.au | rto 90784

Unit Start Date:

Unit Code: HLTHPS007 Administer and monitor medications

Qualification Code and Title

 CHC43015 - Certificate IV in Ageing Support

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 Be attentive and alert

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Information for students

Student Workbook Overview

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Enabling identification of substance incompatibilities

Delegation refers to:

Delegation instructions must include:

 medication and its purpose

Substance incompatibilities come under the following categories:

Examples of substance incompatibilities include:

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Other environmental factors may include:

Health environments may include

 Residential aged care facility

Time management issues

It is essential to administer these medications on time:

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Reporting potential risks

Other risks may include:

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The identified risks may be reported to the following health professionals:

 Complementary medicine therapist (subject to government and organisation policies)

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1.4 Confirm client identity and if any allergies exist

Confirming client identity

It should be possible to consult client records before administering medication.

Organisation guidelines for client identification may include:

 Actions to be taken if a client who is self-administering fails to identify themselves correctly

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Identifying schedules and classifications

Be aware of the following drugs and poison schedules:

The poisons standard

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The following duties may fall under the scope of responsibilities:

 Checking and preparing medication for administration

They may include:

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Prepare for medication administration

Confirming authority to proceed

Authority to proceed refers to: