Workbook
Describe pre-packaged medication and
the process for its use in a health or
disability context
US 23685
Level 2 Credits 2
Name
Contents
Before you start................................................................................................................ 4
What is medication? ......................................................................................................... 7
Pre-packaged medication ................................................................................................ 9
Types of pre-packaged medication ................................................................................ 10
Supporting a person to take pre-packaged medication .................................................. 17
Recording and reporting................................................................................................. 23
Important note about the scope of this unit standard:
When you are assessed as competent in this unit standard, you will be able to describe
pre-packaged medication and the process to be followed by a support worker when
supporting a person to use pre-packaged medication.
If you support any people who are self-medicating, you will also be able to check that
they are about to take the right medication – but only if this role is expected of you by
your organisation and by the individual’s service plan.
Careerforce would like to make it clear that when you complete this workbook or unit
standard, you are not adequately trained or competent to administer medication.
‘Administer’ means to open the packaging or give the medication to the person, or both.
If you are expected to administer pre-packaged medications, you will need to be trained
for those specific medications. Those training needs will be addressed in your
organisation’s policies and procedures.
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Before you start
Welcome to this workbook for:
Describe pre-packaged medication and the process for its use in a health and
disability context
Unit Standard 23685.
For this unit standard you will have:
• this workbook.
• a trainee assessment.
In this workbook you will learn more about:
• what medication is.
• types of pre-packaged medication.
• advantages and potential risks of pre-packaged medication.
• supporting a person to use pre-packaged medication.
• recording and reporting.
How to use this workbook
• This is your workbook to keep – make it
your own by writing in it.
• Use highlighters to identify important
ideas.
• Do the learning activities included
throughout this workbook. Write your
answers in the spaces provided.
• You might find it helpful to discuss your
answers with colleagues or your
supervisor.
• Finish this workbook before you start on
the assessment.
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When you see a
sticky note like
this, it gives a tip
or hint.
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Workbook activities
Stop – check what you know about this topic
You will see this stop symbol in places where you
are asked to stop and think about what you know
and:
• record your current knowledge
or impressions.
• check your knowledge.
This stop provides a reference point to return
to later. Stop activities have blue shading like this.
Learning activities
You will come across learning activities as you
work through this workbook.
These activities help you understand and apply
the information that you are learning about.
Learning activities have yellow shading like this.
Rewind
When you see this rewind symbol, go back to:
• think about what you know.
• check your knowledge.
This rewind gives you an opportunity to add to,
change or confirm some of your initial thoughts
and ideas. Rewind activities have green shading
like this.
The glossary and study hints book has study hints
for all trainees. It also explains key words and
phrases from the compulsory unit standards for
Foundation Skills and Core Competencies.
You can download it from www.careerforce.org.nz
or order it from http://shop.careerforce.org.nz
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Before you go any further in this
workbook, think about...
Medication
Why do people take medication?
What are three types of medication that you know about?
1
2
3
Where can people go to get medication?
What do you think is meant by the term ‘pre-packaged’ medication?
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What is medication?
Medication is a term that covers a range of medicines. Medicine is the term for a legal,
therapeutic drug that has an active, chemical ingredient. Some medicines are prescribed
by a doctor or other health professional such as a nurse, midwife, optometrist or dentist.
Prescribed medication is dispensed by a pharmacist (chemist). Some medicines can be
purchased ‘over-the-counter’ (OTC) in pharmacies, health shops and supermarkets.
Medicines are used to prevent, cure or control illness or to manage a chronic condition.
They can be used to manage pain and other symptoms in order to help people live
independent lives.
Medication can come in many different forms, such as:
• injections or infusions.
• liquids to be swallowed.
• tablets or capsules.
• transdermal (skin) patches.
• creams and ointments.
• suppositories.
• inhalers.
• eye or ear drops.
• nasal sprays.
• herbal remedies.
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Medicines must be taken the way they are prescribed or as directed by the instructions
on the packaging. A doctor, nurse or pharmacist will explain how to take the medicine
and any possible side effects.
Medicines can make people ill if they are not taken in the way they are prescribed. If a
person is self-medicating, it is their own responsibility to make sure they are taking the
medicine in the correct way. They will take responsibility for administering their own
insulin injections, for example, or taking a variety of prescribed tablets at the correct time
and dosage.
A ‘side effect’ is something (usually undesirable) that occurs in addition to the intended
effect of medication or therapy.
LEARNING ACTIVITY
Name a medicine that you, or a person you support, has taken.
What form is this medicine usually taken in?
Why would a person take this medicine?
What positive benefit could be expected from taking this medicine?
Are there any possible side effects from taking this medicine? What are they?
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Pre-packaged medication
Pre-packaged medication is prepared by pharmacists according to the prescription
instructions from medical practitioners such as doctors. Packs can be supplied for daily,
weekly, or monthly usage and are organised according to days and times.
Tablets and capsules are the only forms of medication that can be pre-packaged.
Medicines that are not suitable for pre-packaging include ointments and liquids, eye and
ear drops, suppositories and ‘PRN’ (taken as needed) medication. Each space in a
prepared package may contain varying numbers and types of tablets and/or capsules.
Medication details and instructions about how to take the medicine are also included on
the pack.
Pre-packaged medication may also be called:
• dose administration aids (robotic packaging).
• blister packs.
• monitored dosage systems.
• cassettes.
Advantages of pre-packaged medication
Some of the advantages of using pre-packaged medication are that:
• a person is more likely to complete a course of treatment.
• the system is easy to use and the potential for error is reduced.
• it is easy to see when a medicine should be taken and whether it has been taken.
• the medicine is available in the correct dose and the correct time.
• photo id can ensure that the right person is receiving the medication.
• the package is sealed and is less prone to moisture damage.
• limited amounts are dispensed at one time so there is less chance of using expired
medicines and less wastage if the medication is stopped.
• staff spend less time in administration procedures.
Potential risks of pre-packaged medication
Some of the potential risks of using pre-packaged medication are that:
• some medications are not suitable for pre-packaging.
• a person may miss all the medicine that should be taken at a specific time.
• there is less flexibility for changes and issues may arise if one of the medications is
modified or stopped.
• some people have difficulty in opening the packs.
• the packs may be bulky to store and forward planning is needed to keep a supply.
• some medicines deteriorate when stored together.
• there may be an extra cost in receiving medicines this way.
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Types of pre-packaged medication
Blister packs
This is an example of the front of a blister pack designed to hold a week’s medication.
Directions on
how to open
the pack.
The company who
distributes the
pack, when it was
packed and who
packed and
checked it
Photo identification.
This is the only
person who is to
take the medication
in this pack.
The date the pack
should be started.
The person for
whom the
medication is for
and their place of
residence.
The time of day the
medication should
be taken.
The day the
medication
needs to be
taken.
The medication,
packed so the
person can take the
right amount at the
right time of day.
Note that some time
slots are not used in
this pack.
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Here is the back of the same blister pack.
The person who is to take the medication, the
prescriber of the medication (the doctor’s name and
surgery address), and who prepared the blister pack.
The date the
pack should be
started.
Directions on
the quantity of
medication to be
taken and how it
should be taken.
The medicines
included in the
blister pack.
The day and time
the medication
should be taken
and who it is for.
A description of
what each
tablet looks
like.
The type and
the quantity of
the medication
contained in
the blister.
The day of the
week the
medication is to
be taken.
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LEARNING ACTIVITY
What are two advantages of using pre-packaged medication such as a blister pack?
1
2
What are two potential risks of using pre-packaged medication such as a blister pack?
1
2
Why is Mrs Johnson’s photograph on the front of her blister pack?
Why are there no medications in half of the blisters in Mrs Johnson’s pack?
How many Metformin tablets does Mrs Johnson take at breakfast time?
What does the Metformin tablet look like?
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Tamper proof cassettes
A cassette is a plastic package containing the medication prescribed to a person along
with instructions on how and when the medication is to be taken. A cassette can be
refilled by the pharmacist.
Tamper proof means that the
contents cannot be opened or
altered without seals being broken.
There is a plastic slider to pull out
for each day, but individual doses
for each time of day are also
individually sealed. Medications in
tamper proof cassettes should
never be used if they have been
opened before the right time.
The backing sheet will contain information on all the medication a person is taking,
including things that aren’t contained in the cassette such as ointments or suppositories.
The medication contained in the cassette is listed above the heavy black line in the
example below, with other prescribed medication below the line, with any instructions on
how it is to be taken.
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The information on the back of the cassette package should be easy to read and
understand for both the people who are taking the medication and support workers who
are involved with their care.
Here is another example of a backing sheet for a tamper proof cassette.
LEARNING ACTIVITY
Find the answers to these questions on the backing sheet for Nora Robinson’s
medication cassette (shown above).
What time of day do the Phenytoin tablets have to be taken each day?
How many Phenytoin tablets are to be taken each day?
What should not be taken at the same time as the Phenytoin tablets?
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Robotic packaging
Robotic packaging is designed for situations where there are multiple dosages to be
dispensed daily to a range of people. This could apply to:
• a residential rest home.
• a hospital.
• other patient care facilities.
Computer software at a pharmacy instructs a ‘robot’ machine to select and package
medications into a single dose supply. Each dose is then sealed in an envelope as part
of a continuous strip or roll. The strip can contain enough medication for a month.
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Each envelope of the robotic strip is printed with information.
The name and address of the person the
medication is for.
The date and day on which the medication
is to be taken.
The time the medication needs to be taken
(24 hour clock).
The name and quantity of the medication
included in the package.
The name and address of the pharmacy
which has distributed the medication.
th
This is the 18 dose.
LEARNING ACTIVITY
Find the answers to these questions on the example of robotic packaging above.
Who should be taking the medication contained in this strip?
What day of the week should the 17th dose be taken?
What time of day should the 18th dose be taken?
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Supporting a person to take
pre-packaged medication
Supporting people with their medication should always be carried out by an appropriately
trained person. Your organisation will have policies about who is approved to support
people to self-medicate. If this is one of your responsibilities, you must follow the
procedures set by your organisation at all times.
Self-medicating means that the person who has been prescribed the medicine, opens
the medication package and takes the medicine. Supporting someone to self-medicate
means doing checks before the person opens and takes that medicine and providing
assistance (if needed) to make sure the medicine is taken safely.
If your organisation allows you and trains you to support people to self-medicate you will
need to:
• check each person’s support plan to see whether or not to support the person in
that way. If it’s not mentioned in the plan, you don’t have to remind or support them.
Many people will be independently taking their medication without needing support.
• ask the person what instructions were given by the pharmacist or the person who
prescribed the medication.
• be able to read a label or backing sheet accurately.
• record the taking of any medication if your organisation requires this.
• report any concerns.
• ask your supervisor if you have any doubts.
You do not have to
know what a
medication is for in
order to be able to
support a person to
self-medicate.
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The 5Rs
The ‘5Rs’ are the ‘golden rules’ for supporting a person to self-medicate. Your
organisation’s policies and procedures will tell you how to check the 5Rs. If there is
anything you are not sure about, discuss this with your supervisor.
Right person
The person’s name on the medication is the same name as the person taking the
medicine. Check the person’s identity with their identification bracelet (id) or name tag or
badge if they are wearing one, or look at their photograph on medication packs or
medication order sheets or in their support plan. You must NEVER give medication to a
person who is not named on the pack.
Right medicine
The name of the medicine matches the blister pack or cassette label and the medication
sheet.
Right dose
The dose of the medicine matches the medication label or sheet.
Right route
The way the medicine enters the body (for example, taken by mouth or absorbed through
the skin) matches the medication label or sheet.
Right time
The time (and date) the medication is taken matches the label or sheet (for example,
breakfast time on Tuesday 8th March).
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Taking medicine safely
All medication should be taken according to the instructions. Even medicines bought
over-the-counter from the pharmacy, supermarket or natural health store should be taken
according to the instructions written on the packet or bottle. Never support a person with
any medication from blisters or cassettes that have broken seals.
When the people you are supporting take tablets or capsules, you need to have a whole
glass of water ready, to help them swallow their medicine.
Some medicines can cause damage to the lining of the throat and/or stomach if they are
not washed down properly.
You need to make sure that the person:
• has clean hands.
• is sitting upright.
• is fully alert.
• has a sip of water before starting to take tablets. A moist mouth helps stop tablets
sticking.
• has a sip of water between taking the tablets if there are more than one to take.
• has a full glass of water after taking the last tablet to fully wash the tablets out of the
mouth and throat and into the stomach.
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Cautionary notes
Cautionary notes may be written on the label or may be little yellow stickers that are
applied by the pharmacist when dispensing medication. These notes are applied as a
warning to the people taking the medication and the people who may be supporting them
to do so. They cover a range of topics, from advice on the correct way to take the
medication to warnings on possible side effects.
LEARNING ACTIVITY
When is the best time to take medication if it has to be taken on an empty stomach?
Name a route by which medication can be taken into the body.
Why is water important when a person is taking tablets?
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Supporting a person to use a blister pack
All blister packs must be opened from the back. The packs should not be twisted or the
tablets popped out as this may damage the medication. Only open blister packs if you
are authorised to do so and have been trained by your organisation. Do not open blisters
until after you have checked the label.
The company supplying blister packs may also
supply a special opener like this one. If there is no opener
supplied, the end of a teaspoon handle may be used.
Instructions for opening blister packs include:
Separate the blister you need from the pack.
Run your fingers over the back of the blister until a ring appears.
Using the special blister pick or the end of a teaspoon handle,
puncture a hole in the foil.
Run the spoon end or pick around the inside of the ring.
Peel back the foil and check the contents.
Once opened, the blister provides a ‘cup’ containing
the medication which is now ready for the person to
take.
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Things to avoid doing when opening a blister pack
Don’t open packs from the front.
Don’t twist the packs or
individual blisters.
Don’t try to ‘pop’ out the tablets.
Storage
Blister packs and cassettes and all other medication should be
stored in a suitable locked trolley, drawer or cupboard. They
should only be removed during times when medication is to be
administered.
In a residential care facility, a ring-binder folder may be used to
manage multiple medication packs.
Your organisation will have policies and procedures covering the
correct storage of medicines.
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Recording and reporting
Keeping records
Your organisation will have policies and procedures about when and how to record the
taking of medication. If it is your responsibility to support a person with self-medication
you will probably have to sign or initial the appropriate place on the medication sheet in a
person’s support plan.
If medication is not taken, this will need to be recorded. Here is an example of a code
that may be used to describe why the medication was not taken. The abbreviation would
be written into the place that would otherwise be signed or initialled on the medication
sheet to record that the medication was taken.
R = Refused
N = Nausea or vomiting
H = in Hospital
A = Away on holiday
D = Destroyed
D/C = Discontinued
If you are required to support a person to self-medicate and you notice anything of
concern, then it is your responsibility to report it to your supervisor.
Things that might be of concern include:
• a person has forgotten or refused to take their medication.
• the medication has been taken at the wrong time.
• too much medication has been taken.
• a person has spat out their medication or vomited a short time after taking it.
• a person tells you about side effects the medication is having.
• the person you are supporting is worried about the medication they are taking.
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Making reports
Whenever you report any information verbally or record it in writing, it is important to
report facts, not opinions.
A fact is a piece of information about something
that actually exists or has happened.
An opinion is what someone thinks may have
happened or will happen.
You can find out the facts about a situation or event
if you can answer these questions:
• Who is it about?
• What has happened?
• When did it happen?
• Where did it happen?
• Why or how did it happen?
Ask your supervisor to
show you where and how
to record issues that may
arise when you are
supporting a person to
self-medicate.
There may be a form, or
a part of a form, to fill in.
If a person has taken too
much medication, for
example, it could be
considered to be an
incident (something that
may cause harm to a
person or property).
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LEARNING ACTIVITY
Read this short scenario about Mrs Johnson.
Fill in the example form to record what happened.
Scenario
One of the tablets that Mrs Johnson takes every day is quite large. Usually, she has no
trouble taking it because her support worker, Dot, encourages her to take it first, with lots
of water to help wash it down.
This morning, Dot was running a bit late because she got held up in bad traffic. Mrs
Johnson decided she was quite capable of taking her tablets by herself for once. She
started with the smaller pills because they were easier to swallow. By the time she got to
the largest tablet, there wasn’t much water left in the glass.
When Mrs Johnston tried to swallow the large tablet, it got stuck in her throat. She felt
like she couldn’t breathe and became very frightened that she was choking. Dot arrived
to find her very distressed, trying to cough but unable to take a big enough breath. Dot
knew to get Mrs Johnson to bend forward as she slapped her on her back. Mrs Johnson
was able to cough up the tablet but she was still very upset.
With Dot’s reassurance, Mrs Johnston finally calmed down but she was too frightened to
try taking the ‘big pill’ again. Dot rang her supervisor to report what had happened and an
urgent appointment was made to discuss the problem with Mrs Johnson’s doctor. Dot
was asked to fill in an incident report to go in Mrs Johnson’s support plan to take to the
doctor’s appointment.
WHAT HAPPENED?
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Rewind to pages 8, 9 and 18...
What is meant by the term ‘side effect’?
Name two types of pre-packaging for medication.
1
2
What is a type of medication that would not be suitable for pre-packaging?
What are the 5Rs or ‘golden rules’ that your organisation has for supporting a person to
self-medicate?
1
2
3
4
5
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Completion and assessment
Congratulations!
You have come to the end of the workbook. Please check over all the activities in this
workbook to make sure you have completed them.
Your assessment is next
You need to complete the trainee assessment successfully to be credited with this unit
standard.
Acknowledgements
Careerforce thanks the people who have contributed to this workbook by:
•
•
•
•
•
researching and validating content.
providing advice and expertise.
testing the activities.
sharing personal experiences.
appearing in photographs.
The images contained in these workbooks are visual illustrations only and are not representative of
actual events or personal circumstances.
Creative Commons
This work is licenced under a Creative Commons Attribution-NonCommercial Licence. You are free to
copy, distribute and transmit the work and to adapt the work. You must attribute Careerforce as the
author. You may not use this work for commercial purposes. For more information contact Careerforce
www.careerforce.org.nz
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