Joint Learning Disabilities Service
APPENDIX 4
Medication
Competency
Assessment
Tool
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Joint Learning Disabilities Service
Competency Assessment Tool
Name of Trainee
Name of Assessor
Area
Date of Assessment
Competency Tool number: or 2
ENVIRONMENTAL FACTORS
1. Free from distractions
YES
NO
COMMENTS
YES
NO
COMMENTS
2. Well lit area
3. Clean and tidy
4. Telephone/ Alarm system in place
5 & 6. Appropriate lockable case(if
required)
PREPARATION PRIOR TO
ADMINISTRATION
1. Sort out medicine charts
• Safe environment
• Preparation of all equipment
• Knowledge of individual’s and
medication changes
2. Check communication book/diary/
care plan for drugs to be withheld
• Omit individual’s on leave and
mark Medicine charts with leave
3. Check all Medication
Administration Charts;
• Identity/Individuals name
• Consent to treatment (MCA)
• Signatures, legibility, written
correctly
• Dates/times
• Route of administration
• Names of drugs to be
administered
• Special precautions
4. Prepare medicine tots/spoons or
other equipment required
5. Offers glass of water or other
appropriate drink checking no
interactions
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YES
NO
COMMENTS
YES
NO
COMMENTS
PREPARATION PRIOR TO
ADMINISTRATION
6. Delegate someone to ask the
individuals to be available to take
their medication
7. Wash hands
ADMINISTERING
THE MEDICATION
1. Select designated area
• One individual at a time
2. Greet each Individual by name
check identity with other staff if
required
3. Select individual’s medicine charts
and nomad/boots system/Bottles
• Check that the
chart/cassette/bottles
corresponds with the individuals
name
4. Check week commencing dates
on the nomad/boots system
• Right day/right time
• Check each tablet matches the
description on the back of the
medication cassette if applicable
5. Once the seal is broken transfer
the medication into a medicine tot, If
bottles dispense into lid then into tot.
(Without touching the medication)
6. Before administering the
medication make one final check
that you have:
• the right person
• the right medication
• the right day/ time
• the right dose
• the right route
7. Offer the individual their
medication, checking consent,
offering them a drink of water or
alternative method as identified in
their care/support plan.
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8. Administering medication in
liquid form.
• Check expiry date on the bottle
• Always ensure that new bottles
are marked with the date of
opening (Record the new expiry
date as per local policy)
• Check the MAR chart as with
other medications and follow the
procedure
• Check the label on the bottle
corresponds with the Mar chart
before administering.
• Before pouring always shake the
bottle vigorously so that the
correct strength of liquid is
administered (Unless otherwise
stated)
• When pouring liquids always
pour away from the label
• Ensure you have dispensed the
correct amount in mg/mls
• Pour the liquid into the correct
medicine tot that is marked in
mls
• Clean the bottle before replacing
in the medicine cupboard
• To administer follow all previous
steps for administration of
medication.
9. Applying external/topical
applications
• Ask the individual where they
wish to have the application
applied (Bedroom/Bathroom)
• Ensure curtains are closed and
the room is warm
• The individuals may wish to apply
the application themselves and
should be supported in doing so
by the staff member.
• Check the MAR chart as with
other medications and follow the
procedure
• Check the label on the box and
tube corresponds with the Mar
chart before applying
• Check expiry date and always
date any new applications
opened record new expiry date
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• Check the instructions of how to
apply
• Wash hands before and after
application
• Gloves are to be worn
• After application clean any
spillage off the tube or bottle.
10. Sign the MAR chart for each
medication administered when you
believe that it has been swallowed.
Sign for any external applications
11. If any medication is not
administered what ever the reason,
complete the MAR chart as stated
on the bottom of the chart.
• Fully document the reasons for
this in the individual’s care plan
• Inform the staff member in
charge of the shift
• Inform all staff when handing
over to next shift
• Observe the individual for any ill
effects of refusal of treatment
and record in the individual’s
care plan
• Staff should contact the
pharmacist/GP or on call
manager for advice.
• Follow procedure for spoilt
medication.
12. Giving of PRN Medication:
• PRN medication may only be
given under the guidance of the
prescribing GP.
• The use of PRN medication must
be clearly outlined in the
individual’s care plan.
• Staff members must follow the
guidelines set up in the
individuals care/support plan
• Prior to administering PRN
medication all alternative
strategies must be implemented
If PRN medication is given :
• Fully document in the individual’s
care/support plan
• Sign the Mar chart and the
individuals PRN chart, counting
the stock level and record
appropriately
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HOUSE KEEPING
1. Tidy medicine cupboard and
ensure that all medicine bottles are
clean. Check medicine cupboard is
locked, stocked and secured.
2. Wash and dry any equipment
used glasses spoons etc..
3. Check all medication
administration charts are correct and
that you have signed appropriately.
YES
NO
COMMENTS
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Questions for the Administration of Medication
Assessment 1
Storage and Administration: (to include consent issues and covert use
of medications)
1)
How should medicines be stored?
2)
What checks should be made before administering medicines?
3)
What action would you take if the service user refused the prescribed medicine?
4)
Why is it important not to touch medicines when administering them?
5)
What are the key points to observe when administering liquid preparations?
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6)
What are the key points when applying creams / ointments?
7)
What would need to have happened before covert administration of medicines would
be permissible?
8)
What do you understand by the term PRN medication and what information would you
need before administering this?
9)
What would you do if a service user dropped a tablet on the floor?
10) Why must we record that medicines have been given?
Action points/Additional Comments
…………………………………………………………………………………………..
………………………………………………………………………………………….
…………………………………………………………………………………………..
Signed Assessor
Signed Trainee
Thank-you for completing this audit of your practice.
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Joint Learning Disabilities Service
Questions for the Administration of Medication
Assessment 2
Safety Issues and Procedures:
1)
What would you do if you lost the key to the medicine cupboard?
2)
What would you do if a service user left home to go to day services before he had
been given his medication for the morning?
3)
What would you do if a service user told you she had bought a bottle of Night Nurse to
help them sleep?
4)
What would you do if you noticed that the tablets in a service user’s cassette were a
different colour than usual?
5)
What is the procedure to follow if a medication error is made? Who needs to be
informed?
6)
What would you do if the fire alarm went off while you were administering medicines?
7)
What is the procedure to follow if you notice that a service user’s supply of medication
is running low?
8)
What would you do if a service user vomited half an hour after having his or her
medication?
9)
What would you do if a service user who was not prescribed Paracetamol asked for
some for toothache?
10) What would you do if a service user’s mother said she gave her son some of her
sleeping tablets if he couldn’t sleep when he went home for the weekend?
Action points/Additional Comments
…………………………………………………………………………………………..
………………………………………………………………………………………….
…………………………………………………………………………………………..
………………………………………………………………………………………….
Signed Staff member
Signed Assessor
Thank-you for completing this audit of your practice.
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Questions for the Administration of Medication
Assessment 3
Uses and Effects of Medication:
1)
Why must no more than eight Paracetamol be given in 24 hours?
2)
How would you find out what a medicine is for and its side effects?
3)
Why are some medicines given before meals and some with or after meals?
4)
What is an anticonvulsant ?
5)
What action would you take if someone appeared to be suffering side effects of a
newly prescribed medicine?
6)
If a person who is prescribed an anticonvulsant does not have his / her medicine what
is likely to be the effect?
7)
Why is it important to ensure that someone who has been prescribed antibiotics
completes the course?
8)
Why would a person be prescribed Lactulose?
9)
Why should we ensure that service users’ medicines go with them if they are admitted
to hospital?
10) Why would the following medicines be prescribed and what are the common side
effects? The following is only an example, please substitute these medicines with
actual medicines used in your area.
Sodium Valproate
Frusemide
Fybogel
Chlorpromazine
Action points/Additional Comments
…………………………………………………………………………………………..
………………………………………………………………………………………….
…………………………………………………………………………………………..
………………………………………………………………………………………….
Signed Assessor
Signed Trainee
Thank-you for completing this audit of your practice.
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Competence Assessment Tool
Name of Trainee
Name of Assessor
Area
Date of Assessment
The assessor must complete the following;
Questions
Yes
No
Comments
1. Has this person
completed all the
practical sections of
the competency tool
successfully?
2 Has this person
sufficient knowledge
to ensure safe
administration of
medicines
3. Did they use safe
practices through out
the administration
procedure
4.Did this person
complete all the 3
assessment question
sets correctly
5 Was this person
able to read all
medication labels
correctly and read
then back verbally?
6. Was this person
able to understand all
directions given by
the labels and MAR
charts
7. Was this person
able to calculate mgs
into mls for liquid
medication
Signed Assessor
Signed trainee
If you have answered YES to all of the above questions please complete section
A below
If you have answered NO to any of the above questions please complete section
B below
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SECTION A:
I have supervised: ………………………………………………. They have successfully
administered medication to the individuals (Minimum of 1 individual) covering all of the
criteria in the competency tool on this occasion. ( This tool must be done on 2 separate
occasions and recorded on the tracker form)
Therefore I feel that they are competent to administer medication.
SIGNED ASSESSOR:
FULL NAME AND DESIGNATION
DATE;
SIGNED TRAINEE:
FULL NAME AND DESIGNATION:
DATE:
SECTION B:
I have supervised: ………………………………………………. They have NOT successfully
administered medication to the individuals (Minimum of 1 individual) covering all of the
criteria in the competency tool on this occasion. Therefore I feel that they are NOT
competent to administer medication.
SIGNED ASSESSOR:
FULL NAME AND DESIGNATION
DATE;
SIGNED TRAINEE:
FULL NAME AND DESIGNATION:
DATE:
NOW COMPLETE Administration of Medication Action Plan
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Joint Learning Disabilities Service
Joint Learning Disabilities Service
October 2011
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