^

 
 

Unit of competency details

CHCCS424A - Administer and monitor medications (Release 1)

Summary

Usage recommendation:
Superseded
Mapping:
MappingNotesDate
Is superseded by and equivalent to CHCCS424B - Administer and monitor medicationsISC upgrade changes to remove references to old OHS legislation and replace with references to new WHS legislation. 06/May/2012

Releases:
ReleaseRelease date
1 1 (this release) 25/Mar/2011

Classifications

SchemeCodeClassification value
ASCED Module/Unit of Competency Field of Education Identifier 060307 Community Nursing  

Classification history

SchemeCodeClassification valueStart dateEnd date
ASCED Module/Unit of Competency Field of Education Identifier 060307 Community Nursing  02/Feb/2009 
The content being displayed has been produced by a third party, while all attempts have been made to make this content as accessible as possible it cannot be guaranteed. If you are encountering issues following the content on this page please consider downloading the content in its original form

Modification History

Not Applicable

Unit Descriptor

Descriptor 

This unit describes the knowledge and skills required to responsibly administer and monitor prescribed medications to a person with stable health conditions in a range of settings under delegation from a health professional in accordance with legislation and the organisation's medication and delegation policies and practice

This unit is available only  as part of a qualification at Certificate IV level and above or as part of the High support and complex care skill set  which is available to those holding a Certificate IV qualification

Application of the Unit

Application 

This unit of competency requires the application of skills and knowledge to administer medication to clients in a manner that is safe

Competency requires an awareness of and practice consistent with health legislative requirements and codes of practice and enterprise safe workplace practices

The unit must be applied strictly in accordance with relevant state/territory legislation and industry guidelines which include, but are not limited to:

  • Aged Care Act and Regulations
  • The Drugs and Poison's Act and other relevant legislation in the state/territory
  • Disability Services Act

continued  ...

Application  (contd )

Legislation and industry guidelines (contd):

  • The organisation's 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
  • Australian Nursing Council (2005) Guidelines on Delegation and Supervision of Registered Nurses 
  • NSW Nurses and Midwives Board (May 2005) Delegating the Administration of Medication in Aged Care Facilities 
  • Royal College of Nursing Australia and Australian Nursing Federation (2004) Joint Position Statement : Assistants in nursing and other unlicensed workers  (however titled )

When the requirements of this standard are achieved, medications will be administered strictly in compliance with advice, instruction and relevant legislation. Where necessary, health professional  support is sought to administer medication as appropriate for that environment or context

Annual reconfirmation of the essential knowledge and competency by the employer within performance management framework is mandatory

Licensing/Regulatory Information

Not Applicable

Pre-Requisites

Pre-requisites 

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

  • HLTAP301B Recognise healthy body systems in a health care setting
  • CHCCS305A Assist clients with medication

Employability Skills Information

Employability Skills 

This unit contains Employability Skills

Elements and Performance Criteria Pre-Content

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.

Elements and Performance Criteria

ELEMENT 

PERFORMANCE CRITERIA 

1. Identify situations that pose a potential risk  to the safe administration of medications

1.1 Based on care plan and/or delegation, access information to enable identification of substance incompatibilities

1.2 Identify environmental and/or practice issues that may impact on or contraindicate administration of medication in specific situations

1.3 Report potential risks related to medication administration to supervisor or health professional

1.4 Confirm client identity and if any allergies exist

1.5 Identify drugs and poisons schedules and classifications as determined by law

1.6 Identify any limitations on own capability in relation to undertaking delegated medication administration function and report to delegating health professional

2. Prepare for medication administration  within a variety of settings 

2.1 Establish authority to assist with medication administration in line with organisation policies, guidelines and protocols and jurisdictional legislative and regulatory requirements

2.2 Clarify role in providing assistance with medication administration in line with delegation 

2.3 Confirm that all dose administration aids  are complete, ready for use and up to date

2.4 Implement personal hygiene procedures according to organisation policy and procedure to ensure cross infection is minimised

2.5 Ensure practice is at all times consistent with policies, procedures and delegations in order to fulfil duty of care requirements

2.6 Gather equipment required  for medication administration

2.7 Confirm medication administration route  and associated terminology and procedures for medication administration

2.8 Identify from the care plan the purpose and function of prescribed medications for administration

2.9 Report environmental and/or practice issues that may impact on or contraindicate administration of medication in specific situations and seek direction from supervisor or health professional

2.10 Accurately measure and /or calculate dosages  for administration of medication

2.11 Prepare medications  according to delegated role and in line with legal and environmental guidelines

2.12 Demonstrate medication administration techniques  and precautions specific to each client as per delegation

3. Identify and prepare the client for administration of medication

3.1 Identify the client, including clients who self administer, according to organisation procedures and delegation

3.2 Greet correctly identified client and prepare for medication administration 

3.3 Check client medication  according to organisation guidelines and delegation

3.4 Inform the client of the administration procedure

3.5 Prior to administration, check the client for any physical or behavioural changes  that may indicate the need to report to delegating health professional , according to organisation policies and procedures

4. Administer required medications  within legal parameters

4.1 Administer medications as delegated within role responsibility according to the law and environment policy

4.2 Prepare and administer medications according to specific requirements of the form of medication , in strict accordance with defined legislation and organisation procedures, according to delegation and in line with prescriber's written instructions where available

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

4.4 Assist the client taking the medication as required and according to documented procedures

4.5 Supervise and observe the client when taking medication and confirm ingestion or completion

4.6 Dispose of all used and unused medication, containers, needles and syringes in line with organisation procedures

4.7 Identify signs that PRN medications may be required, review care plan and written instructions and act in accordance with organisation's policies, procedures and role responsibility, in line with delegation

5. Monitor client response to administered medication

5.1 Record administration of medications according to organisation policy

5.2 Contribute to information provided to clients and carers on medication administration, including possible side effects

5.3 Identify apparent acute and delayed adverse reactions to medications, respond within role responsibility and report to supervisor or health professional

5.4 Implement emergency response for identified acute and delayed adverse reactions within role responsibility

5.5 Record and report response to emergency strategies

5.6 Identify signs of a client experiencing pain and report to supervisor or health professional

5.7 Observe and record client response to pain relieving medication and report to supervisor or health professional

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

6.1 Report to supervisor and health professional client refusal to take medication or incomplete ingestion  according to organisation's procedures and protocols

6.2 Identify contaminated or out of date medication

6.3 Implement organisation procedures for disposal of contaminated or out of date medication

6.4 Observe and record changes in the client's condition according to the organisation's guidelines and report to supervisor and health professional

6.5 Record and report any inconsistency (e.g. with the medication, the time or the client) according to the delegation

6.6 Document inconsistencies  and address according to the organisation's guidelines and procedures

7. Complete medication distribution and administration

7.1 Manage the trolley, or other medication container and used medication containers according to industry and the organisation's infection control guidelines

7.2 Complete arrangements and procedures to replenish dose administration aids and supplies

7.3 Store medication charts according to the organisation's procedures to ensure safety, security and confidentiality

7.4 Complete medication storage procedures  to maximise security, prevent medication deterioration and in compliance with legislation

Required Skills and Knowledge

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:

  • Clear understanding of principles, practices and regulatory framework underpinning delegation and supervision, accountability and responsibility
  • Basic understanding of medication groups and categories and their effect on body systems and major disorders, including:
  • central nervous system
  • musculo-skeletal system
  • peripheral nervous system
  • endocrine system
  • cardiovascular system
  • respiratory system
  • gastrointestinal system
  • urinary system
  • reproductive systems
  • immune system
  • integumentary system
  • eye, ear and special senses
  • micro-organisms
  • neoplastic disease
  • Principles of safe medication administration and consequences of incorrect use of medication, main reasons for errors in medication administration
  • Cross infection and prevention strategies including correct hand washing techniques, glove usage and awareness of how infection is spread
  • Basic understanding of major factors that affect the action of drugs, including age, disease processes, nutrition, and hydration
  • Measurement and calculation requirements for medication administration
  • Relevant medical/medication terminology
  • Commonly accepted medication abbreviations
  • Basic knowledge of commonly used medications
  • Basic pharmacology of medications, including:
  • pharmacodynamics
  • pharmacokinetics
  • pharmacotherapeutics
  • toxicology
  • Forms of medication, modes and routes for medication delivery
  • Legal requirements of each route of administration

continued  ...

Essential knowledge  (contd ):

  • Procedures for medication administration routes listed in the Range Statement
  • How and when to use the equipment listed in the Range Statement
  • Roles within the health care team in the administration of medications
  • Role in medical emergency
  • Basic understanding and knowledge of substance incompatibilities and contra-indications, such as:
  • warfarin and aspirin
  • medication and diet
  • medication and sunlight
  • Basic understanding of:
  • anaphylactic reactions
  • side effects
  • precautions
  • Basic understanding of complementary therapies
  • Legal requirements for practice parameters including Poisons Act, Poison Schedules S4Ds and S8s
  • Relevant workplace health and safety policies to ensure safe practice, including:
  • management of sharps
  • potential hazards in a health environment
  • chemical use in cleaning and sanitising in relation to medication residue in containers
  • Appropriate storage of medications
  • Methods of storage, handling and usage of medications
  • Organisation procedures for the documentation of medication and the use of medication charts

Essential skills :

It is critical that the candidate demonstrate the ability to:

  • Read and accurately interpret delegated medication responsibilities from the care plan or other written instructions
  • Ensure all work is in accordance with supervisor and health professional's instructions
  • Accurately observe, report and record discrepancies in medications, instructions and/or client
  • Observe and record changes in the client's condition as listed in the Range Statement, during and after medication administration and report to supervisor and health professional
  • Provide administration of medications according to the specific delegation and in compliance with legal and organisation policies and procedures, including principles of best practice relating to:
  • following medication label and/or instructions
  • occupational health and safety (OHS)
  • infection control including correct hand washing
  • managing and reporting contingencies as they arise
  • applying standard and additional precautions in infection control
  • correct documentation of medication administered
  • Demonstrate the following skills correctly, including specific levels of literacy and numeracy and physical capabilities required:
  • read and correctly interpret care plan or other written instruction from supervisor or health professional for administration requirements for medications
  • use dose administration aids
  • observe, report and record discrepancies in medications, instructions and/or client
  • report any obvious changes in client's condition as listed in the Range Statement before, during and after self-medication to a supervisor and / or health professional so remedial action can be taken
  • Negotiate the physical assistance that can be provided
  • Use equipment listed in the Range Statement effectively and appropriately
  • Distribute medications in a timely, appropriate and effective way to clients with differing needs and according to form of medication
  • Apply language, literacy and numeracy required for drug calculation, administration and documentation of medications
  • Demonstrate correct preparation, administration and recording of medications via delegated routes within the range identified in the Range Statement
  • Correctly administer and support self-administration of insulin by sub-cutaneous injection using pre-loaded syringes or pens
  • Skills and knowledge to conduct BSL monitoring including knowledge of the acceptable and safe range of results for an individual client and operating in accordance with organisation's policy and practice and seeking advice and assessment of the health professional when results are outside the acceptable and safe range before administering insulin by sub-cutaneous injection

continued  ...

Essential skills  (contd ):

It is critical that the candidate demonstrate the ability to:

  • Undertake basic calculations for oral administration of tablets
  • Safely measure liquids according to directions

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:

  • Respond within job role in an emergency situation where a client is experiencing an adverse medication reaction
  • Oral communication skills required to fulfill job role, including:
  • interviewing skills
  • questioning
  • active listening
  • seeking clarification

Evidence Guide

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
  • Assessment must be conducted on more than one occasion to cover a variety of circumstances
  • Assessment must reflect actual delegation from a health professional
  • Development of assessment tools and methods may include the input of a health professional

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 the residential care service setting
  • 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 medication administration instructions
    . client care plan
    . 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 or health professional
  • 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 achieve required infection control outcomes 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 and competency by the employer within a performance management framework is mandatory

Range Statement

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.

Potential risk may include but is not limited to :

  • Client identification
  • Allergic reactions
  • Immunisation status
  • Medication incompatibilities

Delegation refers to :

  • Conferring of authority to perform specific medication administration activities to a worker not usually authorised but who has been determined as appropriate for the task by the delegating health professional
  • Delegation is within the context of a care plan or other written instruction
  • Where delegation is provided verbally it must be confirmed as soon as practicable according to organisation procedures in writing and incorporated in the care plan
  • The authority is specific to an individual client within a specific care context and is not transferable
  • Delegation instructions must include:
  • medication and its purpose
  • medication form and instructions e.g. enteric coated - do not crush
  • dosage and related instructions
  • route
  • contra-indications
  • any other relevant instructions or information, especially information specific to the client

Supervision refers to :

  • Instructing, advising, and monitoring another person in order to ensure safe and effective performance in carrying out the duties of their position
  • Supervision may be conducted by various means including:
  • in person
  • through use of electronic communications media such as telephone or video conferencing, where necessary
  • Supervision level, form and frequency must be established by the delegating health professional for all work delegated to another worker
  • Frequency and form of supervision will be determined by factors such as:
  • the task maturity of the person being supervised
  • the need to review and assess client conditions and progress in order to establish or alter treatment plans
  • The need to correct and develop non-clinical aspects such as time management, organisation requirements, communication skills, and other factors supporting the provision of clinical care and working within a team

Health professional includes :

  • Registered nurses
  • Medical practitioners
  • Pharmacist
  • Complementary medicine therapist (for delegation within legislative requirements, specific to their area of expertise where included in the care plan)
  • Dentist

Settings may include :

  • Aged care residential
  • Client's home
  • Group home
  • Respite service

Dose administration aids may include :

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

Equipment required may include :

  • Aprons
  • Container for dirty spoons/dishes
  • Medication charts/sheets
  • Gloves
  • Key to medication trolley/medication cupboard
  • Lubricant
  • Measuring cups
  • Measuring spoon
  • Mortar and pestle
  • Nebuliser/spacer
  • Oxygen cylinder
  • Oxygen mask/nasal prongs
  • Pre-loaded dose administration aids for insulin
  • Paper towels/tissues
  • Tablet divider
  • Tea towel
  • Tumblers
  • Water pitcher

Medication administration routes include :

  • Aural
  • Insulin by sub-cutaneous injection using pre-loaded syringes or pens
  • Intranasal
  • Ocular
  • Oral
  • Rectal
  • Topical (including transdermal)
  • Vaginal administration

Measure and /or calculate dosages includes :

  • 100% accurate measurement and/or calculation of medication required as per written delegation and/or prescription, including:
  • measurement of liquid medications into measuring cup or spoon
  • calculation of medication mixtures and solutions
  • use of standard formulae to calculate the number or fraction of tablets to be administered to equate to required dose
  • calculation of the number or fraction of tablets to equate to identified weight

Prepare medications may include :

  • Dispensing tablets from dose administration aids into medicine cup
  • Measuring liquid medications into measuring cup/spoon
  • Dissolving powder in water
  • Placing medication in nebuliser/spacer
  • Use of lubricant

Medication administration techniques may include , for example :

  • Techniques to assist clients with difficulties swallowing
  • Techniques to assist clients with specific disabilities
  • Techniques for managing behaviours of concern

Prepare for medication administration may include :

  • Discussing procedures with client
  • Encouraging client participation
  • Adjusting posture and positioning client
  • Seeking assistance from other staff
  • Providing privacy
  • Exposure to treatment area

Check client medication may include :

  • Checking medication is free from contamination
  • Checking that medication, time and resident/client correlate with documentation
  • Checking dose administration aids for evidence of tampering

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

  • Changes to airway (e.g. choking), breathing (including slowed, fast or absent breathing, colour changes) or circulation (including unexpected drowsiness, colour change and absence of pulse)
  • Rash
  • Inflammation or redness
  • Swelling
  • Headache
  • Skin tone
  • Feelings of dizziness
  • Slurring of speech
  • Nausea and vomiting
  • Blurred vision
  • Confusion
  • Changes in behaviour
  • Anything that appears abnormal about the resident/client
  • Others as advised by a doctor or health professional

The form of medication may include :

  • Capsules
  • Ear drops
  • Eye drops
  • Inhalants
  • Liquid
  • Lotion and cream
  • Nose drops
  • Patches
  • Pessaries
  • Powder
  • Pre-loaded syringes or pens
  • Suppositories
  • Tablets
  • Wafers

All checks include :

  • Checking medication against the requirements
  • Checking client details
  • Checking the chart
  • Checking for authorisation
  • Checking specific delegation

Incomplete ingestion includes :

  • Inability or difficulties in swallowing whole or divided tablets
  • Ejection of medication
  • Vomiting
  • Refusal to take medications

Document inconsistencies may include :

  • Incident reports
  • Medical charts
  • Progress notes

Drug storage procedures include :

  • Acting in accordance with defined job role
  • Locking and storing medications according to organisation policy and procedure

Required medications may include :

  • Medications prescribed for client by doctor or health professional and dispensed by pharmacist in dose administration aids
  • PRN medications as prescribed (and identified in medication chart/sheet and/or care plan) according to relevant legislation, organisation guidelines and delegations

Client identification may include :

  • Referral to forms of identification such as photographs, wristbands
  • Recognition by response
  • Confirmation from nursing/care staff

References may include :

  • MIMS annual or drug reference guide
  • Drugs hotline/drug information line

Industry guidelines may include :

  • Australian Pharmaceutical Advisory Council Integrated best practice model for medication management in residential aged care facilities 
  • State and territory health department legislation, policies and guidelines
  • Organisation policies and procedures
  • Internal facility medication audits

Unit Sector(s)

Not Applicable