Medication Administration

1
Medication Administration

• The Five Rights

Adapted from a presentation by Division for
Perinatal, Early Childhood, and Special Health
Needs Massachusetts Department of Public
Health 2009
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606 CMR 7.11(1 3) EEC Standards Regarding
Medication

• Please review the regulations before completing
  this training
• The regulations can be downloaded at
• http//www.eec.state.ma.us/kr_regulations_main.asp
  x

3
Rationale for Training

• Benefits of Medicines
• Cure infection
• Prevent chronic disease
• Ease pain and suffering
• Risks from Medicines
• Injury
• Illness
• More than 700,000 emergency department visits
  annually

4
Young Children At Risk

• Children lt5 years old 98,000 emergency visits
  per year
• Children find and eat or drink medicines
• Correct dosing is critical

5
Get Ready

• Prepare the environment
• Take your time
• Be cautious
• Eliminate distractions
• THINK FIRST

6
Wash Your Hands!

• Wash your hands before and after administering
  medication to an individual child.

7
EEC Regulations

• Medication administration requires
• Plan/policy for administration
• Written physicians instructions
• Written parental consent
• Documentation
• Proper/safe storage and disposal

8
EEC Regulations

• Medication must be administered in accordance
  with physicians orders.

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Medication Plan Initial Steps
Before giving any medication

• Obtain written order (Rx) from health care
  practitioner
• Obtain written consent from parent
• Verify that child has taken this medication before

Note Written order from health care
practitioner is not required for non-prescription
(over-the-counter) medications in family child
care homes.
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10
New Training Regulations

• Every person who administers medication must be
  trained, and must demonstrate competence.

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Training Requirements

• 5 Rights of medication administration

• Recognizing side effects/adverse reactions

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The 5 Rights of Medication Administration

• Right Medication
• Right Child
• Right Time
• Right Dose
• Right Route

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Right Child ?

• Compare the label to the parent permission form
  
• Check ID with another educator

• Verify with a picture
• Ask the child (if appropriate)

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Right Medication?

• labeled original bottle
• Check the label three times
• When removing
• When pouring
• When returning

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Right Dose?
Give the exact amount ordered.

• Do not guess!

• Use a standardized measuring device.

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Right Time?

• Check with parent

• Check the medication log

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Right Route?

• Check the pharmacy label

• chewed or swallowed (mouth)
• inhaled (nose or mouth)
• dropped (ears or eyes)
• applied/topical (skin)

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Documentation

• Permission form
• Medication log
• For each child
• For each medication
• Signature or initials of
• person administering
• each dose
• Spills or refusals
• reactions or side effects

19
Documentation
Omissions
Errors
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Common Adverse Reactions

• Difficulty Breathing
• Rash
• Drowsiness and/or confusion
• Nausea and/or vomiting
• Headache
• Muscle Weakness
• Severe stomach cramps
• and diarrhea

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Medication Storage

• Maintain a secure area inaccessible to children.
• Store medication separately from food and toxic
  materials.
• Controlled substances must be locked.
• Rescue Meds must be immediately available!

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Refrigerated Storage

• Read label for instructions.
• Refrigerate when necessary.
• Keep a separate refrigerator, or a separate
  (inaccessible) container within refrigerator.

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Disposal of Unused Medication

• Return directly to parent
• Discard as recommended by the DPH Drug Control
  Program (617-753-8100 )

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Thank you for your attention to this training.
To check your understanding of the information
presented, please answer the questions that
follow.
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1. According to EEC regulations, who must be
trained to give medication to children?

• Parents
• Program Administrator
• All educators
• Any educator who will give medication.

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2. What are the Five Rights of medication
administration?

• Right hand, right child, right staff, right
  medication, right route
• Right child, right staff, right medication, right
  color, right time
• Right staff, right medication, right route, right
  time, right dose
• Right child, right medication, right dose, right
  time, right route

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When should you check the label on the medication?

• When you take the medication out of the cabinet
• When you pour the medication out of the bottle
• When you put the medication back in the cabinet
• All of the above

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Who needs to know about possible side effects
/adverse reactions of medication?

• Parents
• Educators who give medications
• The Licensee
• The children
• All educators in a child care program

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5. Which of the following are signs of adverse
reaction to medication?

• Difficulty Breathing
• Rash
• Drowsiness
• Nausea or vomiting
• Headache
• All of the above

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6. When must medication administration be
documented?

• Immediately after each dose is given
• Once a day
• When the medication is finished
• All of the above

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7. Which of the following circumstances must be
documented?

• Whenever a medication is given
• Whenever a medication is forgotten
• Whenever the wrong dose is given
• Whenever a medication is spilled
• Whenever a child refuses to take his/her
  medication
• All of the above

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8. What should you do with unused medication?

• Flush it down the toilet
• Return it to the parent
• Throw it in the trash
• Save it for another child who might need it

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9. How do you know you are giving the right
amount of medication?

• Check the label and use a standard measuring
  device
• Check the label and use a kitchen spoon to
  measure
• Determine the childs height and weight and
  estimate
• Mix it up in applesauce and hope the child eats
  it all

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10. What should you do if you make a medication
error?

• Document the error in the childs medication log.
• Monitor and observe the child. Do not leave the
  child alone.
• Complete an incident report.
• Notify the parent.
• Notify EEC, if hospitalization results or the
  wrong medication is given.
• All of the above.