Welcome to the Pennsylvania Department of Public Welfare (DPW), Office of Developmental Programs (ODP) Medication Administration Course for life sharers. This course was developed by the ODP Office of the Medical Director in conjunction with the Lifesharing Coalition and with technical assistance from Community Health Connections, the Western Pennsylvania Healthcare Quality Unit. Please adjust your computer volume to a comfortable listening level. This is lesson 4 – How do you handle medication at home?

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Hello, I’m Jill Morrow and I am the Medical Director for the Office of Developmental Programs. I’ll be your presenter for this webcast.

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This slide includes the learning objectives for lesson 4. In this lesson, you will learn to identify the information on a prescription and a pharmacy label. We’ll discuss how to check the five rights and how to document a medication administration. We’ll also look at how to properly store medication.

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Remember the medication cycle. We are now looking at how to get and store medication. Getting and storing medication refers to the process by which a filled prescription is brought home from the pharmacy, recorded, and stored for use.

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Now that you have left the office of the healthcare practitioner with all the information the person will need, it is time to go to the pharmacy and have the prescription filled by the pharmacist. The best idea is to go to the same pharmacy every time a medication is needed. That way, there is a complete record of the person’s allergy and medication information including current and past medications as well as the person’s insurance information. By going to the same pharmacy, the pharmacist can better help to answer any questions that may arise. This establishes a good relationship with the pharmacists and promotes good service. The prescription, or script, is a written or electronic documentation of what the healthcare practitioner orders. The pharmacist fills that order. Pharmacies receive the prescriptions from healthcare practitioners in multiple ways. You may bring a handwritten, paper prescription and give it to the pharmacist. The prescription may also be sent to the pharmacy electronically or by fax from the healthcare practitioner’s office. In addition, the healthcare practitioner may phone the order in to the pharmacy.

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There are certain pieces of information on the prescription necessary for the pharmacist to fill the script and dispense the medication. First, there will be information about the person: name, birth date, address. Then there will be information about the healthcare practitioner including their name, signature, address, phone number, and license number. It may also include the healthcare practitioner’s Drug Enforcement Agency (DEA) number which is required for controlled substances like narcotic pain medication. The date the medication was ordered and information about the medication itself will be on the prescription. The information about the medication will include: • Name of the medication • Dose of the medication • Time the medication is to be given • Route or way the medication is to be given Remember that the four items listed above, plus the person, make up the five rights of medication administration. Any time a medication is given, each of the five rights must be present to safely administer it. There may be some special instructions on the prescription. For example, if an antibiotic is taken for a certain condition, then it may only need to be taken for a certain number of days. It will be specified on the prescription how many days the person will take the medication. Also present will be the number of times the medication can be refilled, and the total amount of medication dispensed in the container (number of pills).

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When you get the medication from the pharmacy, check the medication label and the medication itself to make sure that it is the right prescription. You should do this regardless of how you receive the medication, whether you pick it up in person or have it delivered from the pharmacy or through the mail to your home. First, check the label to make sure the person’s name is correct. Then continue to check the rest of the label to make sure that each of the five rights of medication administration is also correct: the medication, dose, route, and time. Check the rest of the label for refills, special instructions, etc. Also take a look at the medication itself. If this is a medication that the person has been on before, does it look the same? Same color, same shape? If there are any problems or questions, speak to the pharmacist. Each medication has package inserts or drug information sheets which give information about the medication. The pharmacist is also a good resource if there are any questions or need for clarification. The pharmacist can give instruction on how to store medication, how to administer medication, and any specific side effects to watch for. The pharmacist can reinforce all of the information you get from the healthcare practitioner. Now that the medication has been verified, it can be stored and administered.

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The next step is to record the information about this new medication, or the change in an existing medication. You will record this information on a document referred to as a medication log. A medication log can be a flow-sheet, checklist, or a more formal Medication Administration Record (MAR) like the one shown on the slide. The documentation on the medication log allows you to see all of the consumer’s medication(s) in the same place. It also gives you a place to document the administration of medication as required by regulation. This allows you to go back and see if the person has received the medication on a particular day at a particular time. For example, you might support a person with a seizure disorder. Suppose this person has a seizure and the blood level of medication is low. Reliably documenting that the medication is given helps the healthcare practitioner figure out how to change the medication to better treat the seizures.

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Flow-sheets and checklists used for documenting medication administration may look different, but they all should have the same basic information. There should be some identifying information like the person’s name. You need to have the date and year of the administration(s). It is probably easiest to use one document per month. You need to be sure to document the day and time of each administration as well as each medication given. Your document does not necessarily have to have all of the details about the medications written on it, but you must be able to go back and verify the five rights for each medication administration. So, at a minimum, the flow-sheet needs to have each medication with its dosage and the time(s) that it is to be given and the person’s name as well as a place to document each administration. There are some sample flow-sheets in the resources section where you launched this webcast.

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Storage of the medication is important to maintain its integrity and to keep the members of the household safe. All medications should be kept in their original containers which have the instructions for administration on the label. Medications should be stored in a dry, cool place unless they must be refrigerated. The bathroom is definitely not a good place. The best place is a spot close to where the medications will be taken. Depending on the person and other household members, medications may need to be kept locked or inaccessible. Controlled substances, drugs that have the potential for abuse, should be locked for safety. Controlled drugs should be counted periodically to assure that none are missing.

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When a medication is discontinued or changed and you have additional medication that will not be used, it should be disposed of properly. Medication should not be flushed down the toilet. Some pharmacies will accept medication in return either for disposal or management by the pharmacist. If the pharmacy will not take the medication, then check with your agency or community to see if they have a procedure for the disposal of medication. If you are going to dispose of medication yourself, then you should document what you destroyed with another person present as a witness. This may provide you with some protection from legal action related to improper use of medication especially regarding controlled substances. An information sheet about proper disposal of medication can be found in the resources section of this course. This concludes Lesson 4. Please return to the course and begin Lesson 5.

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