Unit of competency details

Unit Descriptor 

This unit describes the competencies required to work with medicines in line with legislative, regulatory and organisation requirements in a multi-disciplinary team with Aboriginal and/or Torres Strait Islander clients

Application 

This unit includes supporting the client's option to use traditional Aboriginal medicines, taking a medicines history, interpreting medicine orders and supporting clients in the use of medicines

The unit also addresses the skills and knowledge required to calculate correct doses, administer and store medicines

It is acknowledged that some Aboriginal and/or Torres Strait Islander Health Workers at this level may need to undertake these functions, whilst others may need to apply the knowledge and skill to their role in supporting and/or advising clients

This competency unit is available only within the context of qualifications at Certificate IV level or higher in Aboriginal and/or Torres Strait Islander Primary Health Care

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. Determine client medication  requirements

1.1 Consult client/significant others for medication history  and allergies

1.2 Review relevant documentation 

1.3 Identify options and contraindications of commonly used medications and discuss with client, prescriber and significant others 

1.4 Maintain appropriate records of client medication in line with organisation requirements

2. Interpret orders and instructions for medication

2.1 Receive written and verbal orders and instructions for medications, document them and, if required, correctly interpret them

2.2 Consult medical practitioners and other senior health staff if required to clarify medication instructions

2.3 Check written and verbal medication instructions against published medicines information resources

3. Refer queries appropriately

3.1 Identify potential drug interactions and refer to an appropriate person (eg. prescriber)

3.2 Recognise special precautions and contraindications to use of particular medicines and refer to an appropriate person

4. Support clients in their use of traditional and western medicines 

4.1 Identify traditional/bush medicines commonly used in the local community

4.2 Support and promote the role of traditional healers and traditional/bush medicines as an adjunct to western medical treatment

4.3 Identify generic and brand names of medicines used commonly in Aboriginal/Torres Strait Islander primary health practice, using reference sources as required

4.4 Provide information to clients on mechanisms of action, dosing and common side effects

4.5 Provide Consumer Medicines Information (CMI) and explain to clients as required

4.6 Instruct clients in self-administration of medicines

4.7 Support clients to question proposed medical treatments to clarify the purpose, action and any issues relating to medication

4.8 Obtain feedback from client to determine their understanding of information provided

4.9 Support clients, where appropriate, to obtain prescription medicines under the Pharmaceutical Benefits Scheme (PBS)

5. Administer medications safely

5.1 Administer medications by appropriate methods, observing universal precautions and in line with organisation, legal and regulatory requirements

5.2 Correctly identify medicine dosage in standard treatment manual or calculate mathematically

5.3 Measure out specified doses of medicine accurately as required in tablet, capsule, mixture and solution form

5.4 Give injections correctly and safely

5.5 Identify adverse events (eg. allergic reactions) related to medication and take appropriate action in line with standard protocols

5.6 Accurately fill, check and label medicine administration aids in line with statutory requirements

5.7 Fully document administration of medicines and maintain records in line with organisation, legal and regulatory requirements 

6. Transport, store and dispose of medicines

6.1 Store medicines securely in an approved medicines store in line with manufacturer's organisation, legislative and regulatory requirements

6.2 Dispose of medicines in a safe and timely manner in line with organisation, legislative and regulatory requirements

6.3 Correctly apply cold chain transport for medication requiring refrigeration

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

This includes knowledge of:

• Application of universal precautions in the administration of medicines
• Basic understanding of medication commonly used in daily role, and effects on the body
• Correct techniques for medicine administration for adults and children, including:

• dividing scored tablets
• swallowing tablets and capsules
• reconstituting and administering correct volumes of mixtures
• administering intramuscular and sub-cutaneous injections
• use of metered dose aerosols and spacer devices
• use of nebulisers, installation of ear/eye drops and eye ointment
• use of dosette box

• Federal and State legislation relating to the control, storage and dispensing of drugs and medication
• Legislative and regulatory requirements for labelling, storage and safe disposal of medicines
• Methods of medicine administration for adults and children, including:

• oral
• intramuscular and sub-cutaneous injection
• intravenous injections and infusion
• topical application (creams, ointments, eye and ear drops)

• Occupational health and safety issues
• Organisational policies and procedures relating to drugs and medications
• Requirements of the Pharmaceutical Benefits Scheme (PBS)
• Signs of anaphylaxis and methods of management
• Special considerations in use of medicines, including:

• pregnancy and lactation
• renal failure
• anti-coagulant therapy
• potential drug interactions

• Types of locally available/used traditional bush medicines and their benefits

Essential skills :

It is critical that the candidate demonstrate the ability to:

• Support clients in the choice, use and obtaining access to medicines in line with own role
• Use underpinning knowledge of medicines and associated skills as a basis for decision-making in relation to health assessment, education, planning and monitoring clients' health status
• Work independently and consistently in delivering primary health care services to Aboriginal and/or Torres Strait Islander clients
• Work with medicines specifically in line with organisation procedures and within the relevant jurisdictional legislative framework

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

This includes the ability to:

• Administer medications safely, by appropriate methods observing universal precautions and in line with organisation, legal and regulatory requirements
• Calculate correct quantities of medications in line with specified dosages to address client needs
• Consult and communicate with clients
• Maintain records in appropriate manner
• Provide clear and accurate information and instruction to clients on the use of medicines
• Take into account opportunities to address waste minimisation, environmental responsibility and sustainable practice issues
• Understand, interpret and ensure accurate application of:

• prescriptions for medicines
• dispensing instructions
• manufacturer's storage instructions
• medicine disposal requirements
• client health records

• Use MIMS and other medication references and resources, such as standing orders, guidelines and Consumer Medicines Information
• Use published medication references and resources to:

• check written orders for medicines
• identify medicines by their generic and/or brand names
• identify potential drug interactions
• identify special precautions and contraindications
• check terms and abbreviations commonly used in prescribing and administering medications

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 of assessment :

• The individual being assessed must provide evidence of specified essential knowledge as well as skills
• Consistency of performance should be demonstrated over the required range of situations relevant to the workplace
• Where, for reasons of safety, space, or access to equipment and resources, assessment takes place away from the workplace, the assessment environment should represent workplace conditions as closely as possible

Conditions of assessment :

This unit includes skills and knowledge specific to Aboriginal and/or Torres Strait Islander culture

Assessment must therefore be undertaken by a workplace assessor who has expertise in the unit of competency or who has the current qualification being assessed and who is:

• Aboriginal or Torres Strait Islander him/herself

or:

• accompanied and advised by an Aboriginal or Torres Strait Islander person who is a recognised member of the community with experience in primary health care

Context of assessment :

Competence should be demonstrated working individually, under supervision or as part of a primary health care team working with Aboriginal and/or Torres Strait Islander clients

Assessment should replicate workplace conditions as far as possible

Related units :

This unit may be assessed independently or in conjunction with other units with associated workplace application

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.

Cultural respect 

This competency standard supports the recognition, protection and continued advancement of the inherent rights, cultures and traditions of Aboriginal and Torres Strait Islander peoples

It recognises that the improvement of the health status of Aboriginal and Torres Strait Islander people must include attention to physical, spiritual, cultural, emotional and social well-being, community capacity and governance

Its application must be culturally sensitive and supportive of traditional healing and health, knowledge and practices

Community control 

Community participation and control in decision-making is essential to all aspects of health work, and the role of the health worker is to support the community in this process

Supervision 

Supervision must be conducted in accordance with prevailing state/territory and organisation legislative and regulatory requirements

References to supervision may include either direct or indirect supervision of work by more experienced workers, supervisors, managers or other health professionals

A person at this level should only  be required to make decisions about clients within the organisation's standard treatment protocols and associated guidelines

Legislative requirements 

Federal, state or territory legislation may impact on workers' practices and responsibilities. Implementation of the competency standards should reflect the legislative framework in which a health worker operates. It is recognised that this may sometimes reduce the application of the Range of Variables in practice. However, assessment in the workplace or through simulation should address all essential skills and knowledge across the Range of Variables

Aboriginal and/or Torres Strait Islander Health Workers may be required to operate in situations that do not constitute "usual practice" due to lack of resources, remote locations and community needs. As a result, they may need to possess more competencies than described by "usual practice circumstances"

Under all circumstances, the employer must enable the worker to function within the prevailing legislative framework

Workplace procedures in the administration of medicines must include :

• Observance of universal precautions
• Doses of medicine to be checked with other appropriate health staff prior to administration
• Use of approved product information sources, such as MIMS, CARPA, Australian Medicines Handbook and/or other reference sources for medicines information to be consulted
• Reference to National Medicines Policy and Quality Use of Medicines
• Powdered medicine to be reconstituted as a mixture according to manufacturer's instructions
• Scored tablets to be split as required to make up a specified dose
• Medicines for injection to be drawn up to the specified dose using sterile procedures and according to manufacturer's instructions
• Medicine for nebulised inhalation to be correctly measured out and administered using an electronic nebuliser
• Following accepted best practice, such as using spacers and/or nebulisers rather than inhalers

Instruction in self -administration of medicines may include :

• How to swallow tablets and capsules
• How to correctly use a metered dose aerosol inhaler and spacer device
• How to instil eye drops

Medication refers to :

• Treatments using drugs or remedies

Medicine refers to :

• Any substance used in treating or alleviating the symptoms of a disease or injury

Commonly used medication may include :

• Medications as outlined in protocol manuals and in accordance with workplace policies and legislative requirements
• Traditional bush medicines

The effects of medications may include :

• Intended outcomes eg. relieves pain, removes infection
• Adverse reactions that must be recognised and appropriate action taken (refer if required), including:

• cease administration of medication
• management of anaphylactic shock reaction as per organisation protocols
• referral to appropriate authority
• documentation of event
• highlight allergy in client file

Medication history may include :

• Past medication history
• Recent medication history
• Drug allergies or adverse reactions
• Client records, including dental records
• Family history
• Compliance history
• Concurrent medications

Significant others may include :

• Members of family
• Carers
• Any person with the right to speak for the client
• Senior Aboriginal and/or Torres Strait Islander Health Workers
• Nurses
• Medical officers and dental personnel
• Key members of the community
• Government and non-government organisations

Relevant documentation may include :

• Client notes
• Files
• Specialist reports
• Referrals
• Reports from other professionals
• Pathology reports

Records of medications may be maintained :

• Verbally to supervisor
• In writing
• On audio (or video) tape

Legislative requirements may include :

• Commonwealth, State and Territory laws, regulations and directions, as determined by workplace requirements
• Schedules 1 - 8 of the Drugs and Poisons Act.
• Drug storage and disposal requirements

Relevant information to be provided and explained to clients includes :

• When and how to take /use
• Medication side effects
• Length of treatment
• Drug interactions
• Consequences of non-compliance

Informed consent may be given :

• Verbally or written
• By client or appropriate carer

Workplace policies and procedures may include :

• Clinical protocol manuals
• Imprest lists
• Occupational health and safety guidelines
• Organisational/workplace procedure manuals
• Infection control guidelines
• Legislation

Methods of medication administration may include :

• Topical
• Oral
• Intramuscular injections (IMI)
• Subcutaneous injections (SCI)
• Inhalations
• Dosettes
• Z track
• Intradermal injection
• Eye drops

Appropriate dispensing and administration must include :

• The 6 'Rights' of administration:

• right route
• right person
• right dose
• right medication
• right time
• right documentation

• Application of universal precautions

Medication side effects and contraindications may include :

• Anaphylaxis
• Contraindications
• Special precautions
• Drug interactions

Universal precautions include :

• Standard procedures for infection control
• Confidentiality as it applies to community/organisation
• Workplace policy and procedures for clinical practice
• Correct usage of clinical equipment
• Correct disposal techniques for wastes/sharps as per workplace policies and procedures