As a Service Provider for persons with developmental disabilities, one of the most critical tasks you must perform is medication management. It is extremely important that you consistently follow specific practices to ensure that errors do not occur.
Title 22 contains the minimum requirements for medication management. You can go to the California Department of Social Services web site or contact your licensing office for a copy of the "Self-Assessment Guide to Medications". This document contains more information about the regulations that apply to giving medications. These two sources should give you the basic expectations of service providers who assist consumers with medication management.
Beyond the Regulations
The following practices should greatly reduce the risk for errors and should increase the safety of consumers.
- Every medication that is taken by mouth should be packaged singly either on bubble pack cards or in prescription bottles. Do not store multiple medications in the same container. Ask your pharmacist to package the medication in single doses. Pharmacies can make errors in multi-medication packaging so this is something to avoid.
- It is very important that staff and consumers can consistently identify each medication. Be sure all staff know and practice the FIVE RIGHTS when assisting consumers with medication. They are:
- Right Person Example: Be sure the medication goes to the right person. An error occurs when medication is given to John Smith instead of John Smithson.
- Right Medication Example: Be sure the correct, prescribed medication is given. An error occurs when the person receives Sular instead of Sudafed (medications that are used for very different purposes).
- Right Dose Example: It is important to be sure that the medication is given in the exact, prescribed dosage. An error occurs when the person receives 400mg. in the morning when it is supposed to be split into two 200 mg. doses, one in the morning and one at night.
- Right Time Example: The time of day the medication is to be given must be as close as possible to the time listed on the prescription. An error occurs when the person was away camping and gets back three hours after the time for medication. It is given three hours late.
- Right Route Example: The right route means how the medication is given. By mouth is common and topical ointments are an example of another "route". An error would occur when eye drops are put in ears! (Remember that 'otic' in the label means ears and 'ophthalmic' means eyes).
- Obtain Drug Information Sheets from your pharmacy and have staff review them. Keep them in a place where staff can access them. Add other information that you have collected on drugs prescribed, side effects, behavior changes and effectiveness of the medication.
- Ask the physician to write the purpose of the medication on the prescription. You should not try to figure out why someone gets a particular drug.
Medication Administration Record
Use a Medication Administration Record (MAR) to track when consumers are assisted with taking medications.
- The MAR should contain all the information that is found on the prescription label such as name, medication, dose, and frequency.
- Use the MAR as a checklist when assisting consumers taking medication.
- When visiting physicians, share the MAR and other data to help them understand how well their treatment is working.