Unit of competency details

CHC08 Version 3 

CHC08 Version 4  

Comments 

CHCCS305B Assist clients with medication

CHCCS305C Assist clients with medication

ISC upgrade changes to remove references to old OHS legislation and replace with references to new WHS legislation. No change to competency outcome.

Descriptor 

This unit describes the knowledge and skills required by care or support workers to assist clients with medication

The unit addresses the provision of physical assistance with medication or supporting clients with self medication in response to an assessed need identified by the client or their substitute decision-maker for assistance with medication, in accordance with the health/support/ care plan and in line with jurisdictional requirements

It may involve distribution and administration of prescribed and over the counter medications within a residential care facility, or in a home or community setting

Application 

This function is undertaken in accordance with legislation, regulations, government policy and industry guidelines including:

• Relevant Commonwealth and State/territory legislation including the Drugs and Poisons Act, Disability Services Acts (Commonwealth and State) and/or Aged Care Act and associated regulations
• Organisation procedures and guidelines written in accordance with the relevant legislation and reflecting the scope of role and accountability for the level of worker in that jurisdiction
• Other relevant guidance such as the Australian Pharmaceutical Advisory Council (APAC):
• Guidelines for medication management in residential aged care facilities and
• Guiding principles for medication management in the community 2006

This function is undertaken in accordance with legislation, regulations, government policy and industry guidelines including:

• Relevant government policies and industry standards and guidelines
• Job role and job description which may include assistance with self medication and/or assistance with medication administration

Pre-requisite 

This unit must be assessed after achievement of the following related unit:

• HLTAP301B Recognise healthy body systems in a health care context

Employability Skills 

This unit contains Employability Skills

Elements define the essential outcomes of a unit of competency.

The Performance Criteria specify the level of performance required to demonstrate achievement of the Element. Terms in italics are elaborated in the Range Statement.

ELEMENT 

PERFORMANCE CRITERIA 

1. Prepare to assist with medication

1.1 Establish authority to provide assistance with administration of medication in line with organisation guidelines and protocols and jurisdictional legislative and regulatory requirements

1.2 Demonstrate an understanding of organisation policy and guidelines relating to assisting with medication within work role responsibilities

1.3 Identify lines of authority, accountability and actions to be taken to handle contingencies

1.4 Identify level and type of physical assistance required by the client to address their personal needs in taking medications

1.5 Identify level and type of supervision required by the client to self administer medications

1.6 Identify and report to a supervisor and/or health professional if there are any circumstances or changes in the client's condition or personal needs that may impact on assisting the client with their medication

1.7 Confirm that all forms of medication to be administered, including dose administration aids are complete, ready for distribution and up to date, confirm with supervisor and obtain authority to proceed

1.8 Confirm the procedure to be used for medication to be administered

1.9 Implement personal hygiene procedures according to organisation policy and procedure to minimise cross infection

1.10 Identify and implement duty of care procedures in relation to addressing individual client needs

2. Prepare the client for assistance with administration of medication

2.1 Implement all necessary checks to ensure the client and their medications are correctly identified according to organisation procedures and care plan

2.2 Clarify specific assistance required to address personal needs of each client in line with organisation procedures listed in the Range Statement and within work role responsibilities

2.3 Correctly identify and greet each client and prepare them for medication

2.4 Check client medications according to the procedures identified in the organisation guidelines defined in the Range Statement

2.5 Explain the administration procedure to the client in line with requirements and organisation procedures and ensure their needs are met

2.6 Prior to giving medication, observe the client to check for any physical or behavioural changes that may indicate a need to report to supervisor or health professional in accordance with organisation policies and procedures

2.7 Recognise circumstances when appropriate action is to report observed client health status rather than proceeding with administration of medication and seek advice of supervisor or health professional

3. Assist/support client with administration of medication

3.1 Remind and prompt client to take medication at correct time

3.2 Assist clients with administration of medications as required in accordance with legislation, organisation policies and the level of support needed as identified in their care / support plan

3.3 Supervise and observe clients when taking medication and confirm with them their ingestion or completion

3.4 Complete documentation/record of medication administration according to organisation procedures

3.5 Observe client for any changes in their condition listed in the Range Statement and seek assistance from a health professional, supervisor, medical officer or emergency services as indicated in the organisation's policies

3.6 Discard waste products according to organisation procedures and/or manufacturer's instructions

4. Assist/support medication administration according to prescription/instructions

4.1 Prepare medications and administer to the client or support their self administration according to the specific requirements of the form of medication, in strict accordance with defined legislation and organisation procedures and written prescription instructions

4.2 Implement all necessary checks to ensure the right medication is given at the right time, to the right person, in the right amount, via the right route

4.3 Assist the client to take the medications as required, in accordance with their needs and documented procedures

4.4 Supervise and observe the client when taking the medication and confirm with the client their ingestion or completion

4.5 Implement documented procedures for medication not being administered or absorbed, such as through expelling/vomiting, refusal or damage to medication and report to supervisor and/or health professional

4.6 Record all required details of medication administration and other details in the appropriate documents according to the legislation and organisation's procedures

4.7 Observe the client for any possible medication effects listed in the Range Statement and report to a supervisor or health professional

4.8 Collect used equipment, discarded medications / applicators and rubbish and place in appropriate/ designated receptacle according to instructions

5. Comply with organisation's procedures for handling the range of issues/ contingencies which may arise

5.1 Report to supervisor and/or health professional all concerns with the administration of medication (such as: client refusal to take some or all medications, incomplete ingestion, missed or missing doses) according to organisation procedures and protocols

5.2 Identify, report, record and address individual's reactions to medication according to organisation guidelines and health professional's instructions

5.3 Clearly identify contaminated or out of date medication and implement organisation's procedures for ensuring safe and appropriate disposal

5.4 Identify, report and record changes in individual's condition, including within essential timeframes where relevant, according to organisation guidelines

5.5 Identify procedures to address / respond to changes in the client's condition or needs according to the organisation's guidelines

5.6 Promptly report to the supervisor or health professional any inconsistencies observed with the medication or client and take action in accordance with the organisation's procedures or health professional's instructions

5.7 Document all inconsistencies and address according to organisation guidelines and procedures

6. Complete the distribution and administration of medication

6.1 Clean and store unused and/or used medications, containers and administration aids in accordance with industry and the organisation's infection control guidelines

6.2 Follow the organisation's arrangements and procedures to replenish dose administration aids and supplies of medications

6.3 Securely store medication charts/care plans/ treatment sheets according to organisation procedures to ensure safety, security and confidentiality

6.4 Follow the organisation's procedures to ensure medication storage complies with legislation and manufacturers instructions, maximises security and prevents medication deterioration

REQUIRED SKILLS AND KNOWLEDGE 

This describes the essential skills and knowledge and their level required for this unit.

Essential knowledge:

The candidate must be able to demonstrate essential knowledge required to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

These include knowledge of:

• Administrative procedures for medications listed in the Range Statement
• Appropriate storage of medications
• Basic knowledge of body systems and how illness affects people in the context of their life stage and support needs (e.g. age, intellectual disability, sensory disability, etc)
• Basic knowledge of commonly used medicines/drugs, including prescribed and over the counter medications
• Basic knowledge of some of the terms and abbreviations used in relation to medication such as PRN
• Correct handling of medications
• How and when to use the equipment listed in the Range Statement
• Organisation procedures related to medication, including documentation of medication and the use of medication charts
• Relevant commonwealth and jurisdictional legislative, regulatory, policy and industry guidelines and requirements relating to the provision of assistance with medication administration
• Standard and additional infection control procedures
• The difference between prescribed medication and over the counter medication
• The expected effect of medications being administered, the consequences of incorrect use of medication and of main reasons for errors in medication administration
• Understanding of duty of care in assisting clients with medication administration within scope of own work role
• Understanding of potential hazards in the environment including use of appropriate cleaning and sanitising procedures in relation to medication residue in containers

Essential skills:

It is critical that the candidate demonstrate the ability to:

• Provide assistance with administration of medications for clients in accordance with the client's individual support needs, including providing physical assistance to take the medication or supporting a client to self administers medications
  This assistance is to be provided in accordance with the worker's defined job role and always in compliance with legal and organisation policies and procedures including principles of best practice relating to:

• all work to be in accordance with health professional's instructions
• applying standard and additional precautions in infection control
• correct documentation of medication administered
• following instructions for assisting with administration of medication as per the client's health/care/support plan
• following work health and safety (WHS) guidelines
• medication provision including managing and reporting contingencies which may arise
• observing, recording and reporting on the client's state of health and well being

In addition, the candidate must be able to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

These include the ability to:

• Demonstrate the following skills, including specific levels of literacy and numeracy and physical capabilities as required to:

• accurately use dose administration aids
• correctly read and follow all documentation relevant to the administration of medication, including: client's health/care/support plan, information sheets, treatment sheets, instructions from pharmacy and health professional for administration and storage requirements of medications
• discuss the self-medication process with the client and the support needed
• negotiate the level and type of physical assistance to be provided to address the client's needs
• observe, report and record discrepancies in the medication, instructions and administration procedures
• recognise possible changes in condition of the client through observation or as communicated by the client
• report and record any changes in client's condition as listed in the range statement before, during and after medication has been taken, to a supervisor and / or health professional so action can be taken
• undertake required communication and documentation tasks
• verbally report relevant details by telephone or face-to-face

• Distribute medications in a timely, appropriate and effective way to clients with differing needs and according to the form of medication
• Take into account opportunities to address waste minimisation, environmental responsibility and sustainable practice issues
• Use equipment listed in the Range Statement effectively and appropriately

EVIDENCE GUIDE 

The evidence guide provides advice on assessment and must be read in conjunction with the Performance Criteria, Required Skills and Knowledge, the Range Statement and the Assessment Guidelines for this Training Package.

Critical aspects for assessment and evidence required to demonstrate this unit of competency:

• The individual being assessed must provide evidence of specified essential knowledge as well as skills
• This unit must be assessed in the workplace under the normal range of work conditions
• Prior to application of skills in the workplace, assessments should be undertaken in a simulated environment as an appropriate risk management strategy
• Assessment must be conducted on more than one occasion to cover a variety of circumstances and medication types
• Assessment must be undertaken by a person with higher order medication management/administration qualifications and current knowledge of practices relevant to medications in the health and community services sectors
• Employers should endeavour to maintain currency of skills and knowledge in line with specific workplace and/or jurisdictional requirements, through annual workplace skills assessments

Access and equity considerations:

• All workers in community services should be aware of access, equity and human rights issues in relation to their own area of work
• All workers should develop their ability to work in a culturally diverse environment
• In recognition of particular issues facing Aboriginal and Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on Aboriginal and Torres Strait Islander people
• Assessors and trainers must take into account relevant access and equity issues, in particular relating to factors impacting on Aboriginal and/or Torres Strait Islander clients and communities

Context of and specific resources for assessment:

• This unit can be assessed independently, however holistic assessment practice with other community services units of competency is encouraged
• Competency in this unit should be assessed using all the relevant resources commonly provided in community and residential care service settings
  Specific tools may include:

• medication charts and documentation
• medications and equipment
• relevant policies and procedures manuals
• other documentation relevant to the work context such as:
  . organisation charts
  . floor plans
  . instructions for the use of equipment
  . specific instructions for staff, reporting procedures, organisation documents
  . client list
  . relevant guidelines and legislation
• relevant equipment and cleaning agents currently used in the workplace

Method of assessment:

Assessment will include:

• Observation of work performance
• Supporting statement of supervisor/s
• Authenticated evidence of relevant work experience and/or formal/informal learning
• Case studies and scenarios as a basis for discussion of issues and strategies to safely support the administration of medication in specific work environments and communities
• Written assessment of functional English language, literacy and numeracy skills appropriate to the level of responsibility of the care worker
• Annual reconfirmation of the essential knowledge (including written or oral assessment) and competency by the employer within a performance management framework is desirable

RANGE STATEMENT 

The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Add any essential operating conditions that may be present with training and assessment depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts.

Health professional includes:

Health professionals relevant to medication administration in specific area of work:

• Complementary medicine therapist (subject to government and organisation policies)
• Dentist
• Dietitian
• Medical practitioners (General Practitioners and medical specialists)
• Occupational therapist
• Pharmacist
• Physiotherapist
• Podiatrist
• Psychiatrist
• Psychologist
• Registered nurses

Commonwealth and State/ Territory legislation may include:

• Aged Care legislation
• Community care legislation and polices
• Disability Services legislation (Commonwealth and State)
• Drugs and Poison's Act and Regulations and other relevant State/territory legislation, regulations and policies
• Legislation, regulations and policies relevant to each State or Territory
• Nurses Registration legislation

Authority to proceed refers to:

• Ensuring all organisation guidelines are followed
• Ensuring that all documentation in relation to a client's medication has been checked
• Ensuring that the prescribing health professional has documented all medications and instructions
• Ensuring the client has been assessed by a health professional for the level of assistance required and they or their decision-maker understands and can make the request for assistance
• Ensuring the client has up to date / current documentation on the level of assistance and support required in relation to medication

Supervisor may include:

• Health professional
• Supervision may be provided on site or through an on call system
• Supervisor or team leader with experience and appropriate qualification/s in administration of medication and/or assistance with self medication at a higher level than the worker

Required medications may include:

• Medications prescribed for a client by a health professional and dispensed by a pharmacist in dose administration aids
• Medications purchased over the counter and identified in the client's health/care/support plan or drug/ treatment sheet
• PRN medications:

• as prescribed and instructed by the health professional
• in response to staff observation of need as identified in drug sheet and/or health/care/support plan and according to relevant legislation, organisation guidelines and clear written instructions from a health professional
• in response to specific information provided by client, where the medication is documented in the client's health/care/support plan

Industry standards include:

• Aged Care Accreditation Standards and policies
• Disability Service Standards and policies
• Home and Community Care National Service Standards and policies
• State or Territory government policies

Required equipment may include:

• Administration aid / medication pack
• Applicator for lotions / ointments
• Aprons
• Container for dirty spoons/dishes
• Cotton wool / gauze
• Drug/treatment sheet or case record
• Gloves
• Health/care/support plan
• Key to medication storage/cupboard/area
• Measuring cups
• Medicine dishes/cups
• Mortar and pestle
• Nebuliser / spacer
• Paper towels and tissues
• Spoons
• Tablet divider
• Tea towel
• Tumblers
• Water jug and cup

Organisation guidelines for client identification may include:

• Actions to be taken if a client who is self-administering fails to identify themselves correctly
• Confirmation from nursing/care staff or client's family or friends
• Referral to identification such as photographic identification of client in client cards
• Response by client
• Visual recognition

Organisation policy for checking medications with clients who are self-medicating may include:

• Confirming the following with the client:

• the amount of medication (e.g. number of tablets or amount of gel)
• the time for self-medication (e.g. once a day with food)
• the route of self-medication (e.g. by mouth)
• any alterations authorised by the pharmacist, registered nurse or health professional (e.g. crush tablets or mix with water or food)

• Checking the medication for expiry date and any obvious discrepancies such as colour changes, disintegration or deterioration

Dose administration aids may include:

• Blister packs - single dose packs and multi-dose packs
• Dosettes
• Sachets

Organisation guidelines for checking medication may include:

• Checking dose administration aids for evidence of tampering
• Checking medication is free from contamination or deterioration
• Checking that administration, instructions and the identity of the client correlate with documentation
• Checking that discrepancies in administration are documented appropriately
• Checking the procedure for infection control, storage and disposal

Prepare the client for assistance with administration of medication may include:

• Discussing the procedure
• Encouraging client's participation
• Adjusting posture and position
• Seeking assistance from other staff if available and required
• Providing privacy
• Appropriate exposure of treatment area (in the case of lotion application)

Circumstances when appropriate action is to report observed client health status rather than proceeding to administer medication may include but are not limited to:

• Changes in condition of the client that must be immediately reported
• Client refusal
• Client unconscious

Current needs may include:

• Assistance in securing client cooperation
• Posture or positioning of client including physically supporting the client
• Provision of approved PRN order according to relevant legislation, organisation guidelines and doctors orders

Prepare medications may include:

• Assistance provided in taking medication by grinding or dividing tablets where there are clearly written instructions
• Dissolving powder medication in water
• Measuring liquid medications into measuring cup / spoon
• Placing medication in nebuliser / spacer
• Placing tablets/capsules from dose administration aids into a medicine cup

Necessary checks include:

• Checking client details
• Checking for authorisation
• Checking medication against the requirements
• Checking the chart
• Checking the client's health/care/support plan
• Checking the treatment sheets

References may include:

• Drugs hotline/Drug Information Line
• MIMS annual or drug reference guide

Forms of medication may include:

• Capsules
• Ear-drops
• Eye-drops
• Inhalants
• Liquid
• Lotion and cream
• Nose-drops
• Ointments
• Patches
• Powder
• Tablets
• Wafers

Possible changes in condition of the client that must be immediately reported to a supervisor or health professional may include, but are not limited to:

• Anything that appears different from the client's usual state
• Blurred vision
• Changes in behaviour
• Changes to airway (e.g. choking), changes to breathing (including slowed, fast or absent breathing), changes in person's colour (e.g. pale or flushed appearance or bluish tinge), or changes to circulation (including unexpected drowsiness, loss of consciousness, and absence of pulse)
• Confusion
• Feelings of dizziness
• Headache
• Inflammation or redness
• Nausea and vomiting
• Others as advised by health professional
• Rash
• Skin tone
• Slurring of speech
• Swelling

Incomplete ingestion includes:

• Ejection of medication
• Inability or difficulties in swallowing tablets, capsules or liquids
• Refusal to take medications
• Vomiting

Document all inconsistencies may include:

• Adverse drug incident reports
• Client's record of medications according to organisation guidelines
• Incident reports
• Medical charts
• Progress notes

Medication storage procedures include:

• Acting in accordance with defined job role
• Locking and storing drugs according to organisation policy and procedure
• Referring to instructions from health professional/ manufacturer

Industry guidelines may include:

• Australian Pharmaceutical Advisory Council (APAC):

• Guidelines for medication management in residential aged care facilities and
• Guiding principles for medication management in the community 2006

• State and Territory legislation, policies and guidelines
• Organisation policies and procedures
• WHS industry guides

Physical assistance provided to administer medication or support self medication may include:

• Discussing the process and addressing any likely difficulties
• Confirming the time and type of medication
• Establishing the type and level of support required by the client to take / receive the medication
• Adjusting posture or position
• Opening bottles or dose administration aids
• Removing tablets or capsules from dose administration aids
• Measuring the amount of liquid required into a medicine cup or a cream onto the affected area
• Crushing or dividing tablets where indicated by pharmacist or health professional
• Placing medication into nebulisers or spacers
• Dissolving medication in water
• Ensuring that fluids are available to assist with swallowing
• Providing privacy

NB Medication dose must be prepared by a pharmacist