Right medicine, right dose, right time

Administering medicines to residents can be a daunting task. You need to ensure that they are administered correctly by referring to several sources such as the residents care plan, MAR chart, medication label and the resident themselves.

As a care worker you must ensure the resident you care for have a regular medicines optimisation review. Care staff must ensure that a review has been conducted which:

• Identifies the dose of medicines which is most effective for the resident
• Identifies the formulation which is acceptable to the resident
• Ensures any changes that have been made is documented in the care plans
• Involves the appropriate healthcare professionals e.g. GP, pharmacist or community geriatrician ensures the involvement of residents in any medicines optimisation review

Ensure an advance care plan, which includes medication, is in place for the resident, with a regular review when their condition changes.

You must ensure that:

• Discussions between the resident, family members and multi-disciplinary team members are enabled
• Within these discussion, advance decision care plans and how these relate to residents medicines are considered
• Any decisions, wishes or preference not to take medication, is recorded in the care plan as part of advanced decisions
• You monitor progress and trigger discussion with the multi-disciplinary team when necessary

Work with other members of the multi- disciplinary team to ensure that the resident’s medication needs are met. As people, have increasingly advanced degenerative conditions they have increasingly complex and more difficult nursing needs. Members of the multi-disciplinary team have unique knowledge and skills which can be used to support the residents

Speech and language therapists: advise where the swallowing difficulty may arise i.e. mouth, throat or oesophagus provide advice on appropriateness of oral feeding

Dieticians: review nutritional status of the resident ensure residents weight is maintained

Dentists: review oral hygiene, appropriateness of dentures

Pharmacists: ensure formulations are appropriate identify the need for medicines to be crushed or altered

Occupational therapists: ensure that eating is a meaningful activity identify the need for adaptations to help with eating

Physiotherapists: identify the appropriate posture for the resident identify if the resident needs aids or help with their posture

Clinicians: ensure that the goals and aims of treatment are still appropriate identify when to involve the relatives ensure an advanced life directive is in place Communication is key, and staff must ensure that care records are shared within the multidisciplinary team and they know how to contact the agencies

Watch the video to get a better understanding of what to consider for these 3 ‘Rs’ of safe medication administration.

This information will come in useful for the final steps which tests your understanding. You can come back to, pause or replay the video as you need.