 Assisting people with developmental disabilities with their medications is a great responsibility. You can do harm if you do not manage medications properly. This video contains information about medication practices you must know to promote the health and safety of the individuals that you as support staff assist. In addition, you need to know and practice the requirements for medication management contained in the Department of Social Services Community Care Licensing Regulations found in the California Code of Regulations, Title 22. In this video, we are going to follow Jacob through the process of being assisted with his medications. This process starts in the doctor's office. All medications for people living in a licensed community care facility require a doctor's prescription. This includes both prescription medications, which by law must be ordered by a physician, and medications usually bought over the counter, such as aspirin, cold remedies, vitamin, and herbal supplements. Well, Jacob, if I understand you correctly, you've had a cold for about 10 days now and it's not getting any better, and now you're getting a headache as well. I think in addition to perhaps a bronchitis, you probably have an acute sinus infection, and that's prolonging your illness. I think there are some medications we can give you that will make you feel better and help you get well more quickly. Are you currently taking any medications? Tegertal? Tegertal. And are you allergic to penicillin or any other medications? As far as we know right now, it doesn't have any allergies that we know of. Good. Well, then there are a couple of medicines I'd like you to take. The first one is an antibiotic, moxacillin, which should help fight the infection. I want you to take one pill three times a day for 10 days. I want you to keep taking it, even though you may feel better before then, for the full 10 days. And then the other is a cough medicine, and you can take a teaspoon every six hours as needed for your cough. Do you have any questions about that? As far as side effects or anything, anything that you think about there? Yeah, it's possible to have an allergic reaction to a moxacillin. The rovotestin wouldn't be much of a problem, but if he's never had an allergic reaction in the past, he probably won't have a significant one this time. However, if he should get shorter breath, should develop skin rash like hives, you need to stop the medicine and call us immediately. Now, when you pick up your medicine at the pharmacy, and I'll go ahead and call that in a few minutes here, and when you pick it up, pharmacists will give you a medication sheet. Now, that will contain detailed information about your medication, including the side effects at that point. Make sure if you have any questions, address them to the pharmacist, and he should answer them completely. If you still have any questions after that, feel free to give us a call. Okay, sounds good. Jacob, that's all I can really think of. Is there anything else that you can think of that I want to make sure we tell the doctor while we're here? No. Great. Let's review key points for discussion during any visit to a doctor. Symptoms. Current medications taken. Medication allergies. Diagnosis. Treatment. Purpose of medication. Possible side effects. And follow-up. After visiting the doctor, the support staff picks up the prescription at the pharmacy. Can I have a couple of prescriptions for Jacob Smith? Did you get those yet? Yep, they got them right here. Sure do. If you could spend a little extra time on going over the medication sheet with me as far as side effects and stuff, because these are new and I need to know what to watch for. Sure thing. I can highlight these for you. First thing he's getting is amoxicillin, which is to be taken three times a day. Space it out evenly through the day. We have the times on the bottles here for you. First thing he's getting is amoxicillin, which is to be taken three times a day. Then he takes these two completely. And there's a 10-day supply in here. Any special side effects I should look at? With or without food. Doesn't make any difference on this particular drug. The only things you need to be careful of, or there's a potential always with antibiotics to get a allergic reaction that would develop in a skin rash, tightness in the chest, difficulty in breathing. If that should come up, then you need to call less in the physician than I look for there. Robotessin should be given three times a day. Give it with a full glass of water. Water? Right. I've always heard that you're not supposed to have water, because it kind of ruins the effect of the medication. That's what everybody thinks. But Robotessin has an expectorin in it. And the expectorin action only works with water. And what it does is it helps break up the congestion by thinning out the mucus. And then when he does cough, which Robotessin limits the amount of coughing, however, when he does cough, it will be a more productive cough. And that, coupled with the antibiotics effect, which is going to limit the bacteria, it will help him cough that out of the chest and make things get along a little quicker. So actually the water helps? Water helps. Interesting. So if he can do those to completion, he should be better in 10 days. Okay. Good deal. And we're not getting to Tegretol now, but he's taking that also. These don't have any interactions with Tegretol in any way that's negative. No, it shouldn't be any problem. We screened his records against the Tegretol, and there's no drug interactions here. But again, anytime you see something out of the unusual, give us a call to the doctor or call. And if you read the package inserts or the detail sheets and you see anything there that you have a question about, feel free to call back and ask us. We're here to help you with those. Okay. Well, I need those extra labels like I always need some. Okay. Made those extra labels for your records. Don't be bashful. Get to know your pharmacist. It is best to go to one pharmacy to ensure that the pharmacist is familiar with each person's medication history. Key points for discussion during a visit to the pharmacist include what medication is being prescribed and why, possible side effects and or interactions, the medication information sheet, and special instructions. Individuals with developmental disabilities have the same common medical conditions as anyone. They often take the same medications. For example, medications for fever, anti-inflammatory agents for arthritis, or anti-convulsant medications for seizure disorders. You must be familiar with each medication being taken by the people you assist. This includes the possible side effects. Talking to the doctor and the pharmacist is important. Taking the time to review additional medication reference materials is equally important. Side effects may be caused by interaction with other medications or interaction with foods or alcohol. Side effects may be either physical, for example nausea, vomiting or diarrhea, and or behavioral, for example, agitation or inactivity. Some side effects may be harmless, such as a urine discoloration, while others are potentially fatal, such as a severe reaction to an antibiotic. Symptoms of a severe allergic reaction include severe swelling, shortness of breath, and difficulty in breathing. In the event of a life-threatening reaction, first call 911. Labeling of medications may only be done by a licensed pharmacist, according to federal and state guidelines. The label may not be altered in any way. Do not scratch out or write on a medication label. There are also warning labels which may appear on prescription or over-the-counter medications. The individual's medication log should contain information about all medication prescriptions, including the name of the individual, name of the medication, the time the medication should be taken, the dose, and the route to be used. The extra medication labels provided by the pharmacist have all of this information. Attach the extra labels to the individual's medication log and note times each medication is to be taken. On an ongoing basis, support staff should use the log to record when each medication has been taken. Let's observe how to assist an individual with self-administration of medication. When assisting with self-administration of medication, you must follow the five rights. These five rights are the right person, right medication, right dose, right time, and the right route. The best way to ensure a person's safety is to check the five rights. The first check is when you remove the medication from the locked storage area or storage container. The second check is when you remove the medication from its original labeled container. The third check is just before you assist the person with self-administration. The following scenes demonstrate the correct use of the five rights when assisting a person with self-administration. I'm going to go call Jack. I'll be right back. Do you want it again? You want to keep playing? Yeah. Okay, let's play sports. It's almost two o'clock, though. We better get your beds first, okay? I'll do that, and then we'll get back in place. Let's go wash our hands. I'm going to use my paper towel to open up the drawer so we can throw these away. Can you use your paper towel to turn off the water? Great. Okay, good. Let's throw them away in here. I'm going to put my watch back on, but could you maybe get a glass of water, and I'm going to go get your meds? Thanks, Jacob. All medications must be stored in a locked area. When you remove the medication storage container from the locked storage area, check to make sure that you have the medication for the right person. Make sure you have the supplies you will need, the person's medication log, a pen, a glass of water, small paper cups in which to put tablets or capsules, tissues, and, for liquid medications, a calibrated measuring cup or spoon. Now you are ready to begin. It's going to take a lot longer today because we got those two new medications from your doctor yesterday, but we'll still get our cards in. Okay, Tegretol 400 milligram tablets at 2 p.m. Tegretol 400 milligram tablets at 2 p.m. And that's an oral medication of a Moxacillin 250 milligram tablets. And that's also at 2 p.m. Moxacillin 250 milligram tablets at 2 p.m. And that's an oral medication. The last one is Robotussin at 2 p.m. 5cc Robotussin. And that's at 2 p.m. And that's a liquid medication. So that's oral also. Okay, let's start with our Tegretol. You remember what you're taking that Tegretol for? That's the one you're taking for your seizures. Remember how you used to have seizures and now you haven't been having them anymore? Tegretol 400 milligram tablets at 1 p.m. Tegretol 400 milligram tablets 1 tablet at 2 p.m. Okay, and that one's ready. And that's an oral medication. And we've got our Moxacillin 250 milligram tablets. A Moxacillin 250 milligram tablets. 1 tablet at 2. 1 tablet at 2. Got one extra one in there. So we're going to do it again. Moxacillin 250 milligrams at 2 o'clock. That's the oral medication. And lastly, we're going to do the Robotussin. Robotussin 5cc's. Robotussin 5cc's 2 p.m. Okay, remember why you're getting this Robotussin? Yeah. And this is the one that we're taking for that cough. You've got to get rid of that thing. There we go. 5cc's. That one's all ready. Okay, and actually we didn't talk about the Amoxacillin. You know what that one's for? Yeah. The Amoxacillin you're taking for that bronchi is also for that cough. It actually comes from an infection that's in your lungs, I think. That's the way the doctor described it anyway. So that's why you're taking that one. So let's do these. We'll double check them one last time, though, before you take them. So if you can have your water glass ready there. And Tegretol 400 milligram tablet. 1 tablet at 2 p.m. Okay. That's the oral medication. Go ahead and take that and drink lots of water. Good job, dig up. Okay, we're finished with that one. Next we're going to go Amoxacillin, 250 milligram tablet, 2 p.m. Amoxacillin, 250 milligram tablet. Take one tablet at 2 o'clock. Okay. That's the Amoxacillin. Okay, and that's the oral medication. Take that one. A bunch of water. Good job, dig up. One more. Robotucin, 5cc's, 2 o'clock. Robotucin, 5cc's at 2 o'clock. Now we're going to do the 5cc's of Robotucin. 5cc's Robotucin, oral medication, 2 p.m. Go ahead and drink all of that for me. And I want to just finish all your water there. Look at it rinsed out. Good job. Okay. Mark these down. Put these back away. And then we're going to place some cards. Okay, so you can throw those empty cups away for me, and then deal the card, and I'll be right back and we'll play, okay? Okay. Thanks, Jacob. You did a great job with your minutes today. When you have completed assisting a person with self-administration, immediately return the medication to the locked storage area. Never leave it unattended. The support staff should always prepare medication in a clean, well-lit, quiet area. Allow plenty of time. Avoid rushing. And stay focused. Only one support staff should be assisting a person with medications at any given time. That support staff should complete the entire process of assisting a person with self-administration from beginning to end. Never hand a medication to one person to pass on to another. Good afternoon, ma'am. Good afternoon. Okay. Who's starting? Jacob's starting. Okay. Yeah. Aces? Yeah. Go fish. No. Turn that up. Have any six. Arts. Go fish again. Now, let's review the five rights. These five rights are the right person, right medication, right dose, right time, and the right route. The right person. When assisting with any medication, it is essential to know that you are assisting the right person. If you know the person, greet them and put them at ease. If you are unsure, you may ask, what is your name? Do not say, are you Jacob Smith? Some people may say yes to any question when asked. If you are uncertain that you're assisting the right person, check with another staff member to make sure. Also, check to make sure that the person's name matches the name on both the medication log and the medication labels. The right medication. Make sure you're giving the right medication to the right person. Read the medication label and the medication log to make sure that the name of the medication matches. The right dose. Read the medication label and compare to the medication log for the correct dose. Be alert to any changes in the dose. The right time. Check the medication label and compare to the medication log for the directions on how often the medication should be taken. In order to be sure a person is taking the medication at the right time, you need to know how often the person is supposed to take the medication. Is it the right time of day? How long has it been since the person last took the medication? Should the medication be taken with food or liquids? The right route. The route is how a person takes the medication. The medication label should provide directions on how to take the medication. Capsules and tablets are always taken orally, which means by mouth. As a support staff, you cannot give injections, enemas or suppositories. These can only be administered by a licensed healthcare professional. Check the medication label and compare to the medication log for the right route. When preparing tablets or capsules, pour the correct dose into the lid of the container and then into a paper cup. For bubble packs, push tablets or capsules directly into a paper cup. When preparing liquids, use a calibrated medication cup. First find the correct mark for the correct dose. Then pour the medication away from the label into the plastic cup and view at eye level. If possible, double check the measurement on a flat surface. If too much liquid is poured, do not return it to the bottle. Discard it. Or, when using a medication spoon, locate the marking for the dose. Hold the spoon at eye level and fill to the correct marking. To review, always store medication in a locked storage area. When assisting with any medication, any one support staff should complete the entire process from beginning to end. Never leave medication unattended. Remember, always check the five rights when you remove the medication from the locked storage area or the storage container, remove the medication from its original labeled container and just before you assist the person with self-administration. Talk with the person you are assisting about what you are doing and why they are taking each medication. When you are finished preparing the medication, place the medication within the person's reach, offer a glass of water and make sure that person takes the medication. If the person has difficulty swallowing, you may ask the doctor or pharmacist if the medication is available in liquid or chewable form. You may ask the doctor or pharmacist if the medication may be crushed. Do not crush medication without checking. Ask the person to take a small sip of water before taking the medication. Assist the person with tilting his or her head forward slightly to assist in swallowing. Tilting the head back may cause the person to choke. And finally, on the medication log, record that the person took their medication by writing your initials in the correct box. Once you have initialed the medication log, return the medication to the locked storage area. Anytime the right medications are not administered to the right person in the right amount at the right time and by the right route, a medication error has been made. When you discover an error, always observe the individual and make sure he or she is okay. We missed your last dosage of Tegretol, so I need to call the doctor to see what we should do next. Okay. Medication errors should be reported to the doctor's office and the facility supervisor or administrator immediately. The purpose of reporting errors is to help prevent harm to the individual and make changes that will prevent future errors, not to find fault or blame. Documenting a medication error is very important. Each facility will have their own procedure. Follow the procedure at your facility. In this example, the support staff circles the entry on the medication log. On the back of the log, the support staff records what occurred and the action taken. Whomever discovers the error, whether or not they actually made the error, is responsible for reporting and recording it. In addition, a special incident form or SIR must be completed and sent to the licensing agency and the regional center. When assisting an individual with self-administration of medication, you must know the person, their medical conditions, and their usual behaviors. Understand what medications are being used and why. Know about possible side effects and interactions with other medications and foods. Follow the five rights. Continuously observe the person's condition and evaluate their response. Identify and report any physical symptoms or changes in behavior accurately and completely. Record all medications taken on the medication log. Report all medication errors and follow your facility's policies and procedures. Assisting with medications is an area of great responsibility. Medications can do harm if not managed properly. Your work is important. Individuals in your care rely on you to follow the guidelines and the five rights to ensure the safe self-administration of medications.