Medication Unit

The Health and Safety at Work etc Act 1974, was introduced to place responsibility for health and safety on the employer but also on the employee’s. To ensure Health and Safety was maintained in the workplace. In relation to the administration of medication, your employer has a responsibility to ensure policies and procedures are up to date and accessible at all times. Also to provide adequate training to prepare you for administering medication and to provide you with personal protective equipment and clothing to enable you to safely administer medications. As the employee, you have a responsibility to follow policies and procedures in the safe administration of medications.

To also attend any training offered by the employer and put what you have learnt into practice in the workplace. As the employee it is also your responsibility to wear any personal protective equipment and clothing provided for you to safely administer any medications and to also make an effort to maintain good health and safety awareness in the workplace. The Control of Substances Hazardous to Health (COSHH) Regulations2002, forms part of the health and safety legislation and establishes a legal framework for protecting people from harmful substances in the workplace.

These regulations apply to all hazardous substances including medications. Under these regulations your manager must take reasonable steps to ensure hazardous substances are used safely and also stored correctly in the workplace. If you are responsible for handling medication known to be harmful, a risk assessment must be undertaken and should identify the steps which must be taken to minimise the risk of harm to yourself and others. Royal Pharmaceutical Society Guidelines.

The royal pharmaceutical society is the professional body for pharmacists in England, Scotland and Wales. The Royal Pharmaceutical Society recognise that where care workers are responsible for managing medications, they should follow a set of general principles to ensure that it is done safely. The Misuse of Drugs Act 1971.

The Misuse of Drugs Act (MDA) 1971 and its associated regulations, provide the statutory framework for the control and regulation of controlled drugs. The primary purpose of the Misuse of Drugs Act is to prevent the misuse of controlled drugs. These are drugs which tend to be addictive and can cause harm if used incorrectly or illegally. The Medicines Act 1968.

The Medicines Act was the first piece of comprehensive legislation relating to medicines within the United Kingdom. It is this piece of legislation which provides a legal framework for the import, production, licensing, prescribing, sale and supply of medicines. This Act gives pharmacists the responsibility to supply medicines on receipt of a valid prescription. The Act also categorises medicines according to whether they can be supplied as prescription only medicines, pharmacy medicines or general sales list medicines. The Health and Social Care Act 2008 (Regulated Activities) Regulations2010. These regulations came into force on the 1st October 2010. It is under this piece of legislation that the Care Quality Commission introduced the Essential Standards of Quality and Safety.

These essential standards of quality and safety are intended to help providers of care to comply with the regulations. They contain guidance on which care should be based. Each regulation is accompanied by an outcome which details the experiences people who use the service should expect to receive. The outcomes also state what service providers must do in order to ensure they meet the requirements of the regulations. Regulation 13 of the Health and Social Care Act 2008 and Outcome 9 of the Essential standards of quality and safety relate to the management of medicines. The Care Quality Commission continually monitors services to ensure compliance with these essential standards. Q.2.

A common type of medication is Aspirin. Commonly used for its pain relieving properties, helping with headaches, toothache, period pains, back pains and all other muscular aches and pains. It is also used to thin the blood and prevent clotting, after heart attacks or in patients with unstable angina. Like all medicines, Aspirin tablets can cause side effects, although not everybody gets them. Possible side effects are :-

Allergic reactions- runny nose, itchy, red, blotchy, blistered skin, swelling of the face, lips, throat or tongue, difficulty breathing, worsening of asthma. Gastrointestinal system- stomach ulcers or bleeding, severe stomach pain, inflammation of the liver. Blood- Anaemia.

Kidney- changes in the amount or need to urinate.
Ears- a ringing or buzzing in the ear.
Salicylism- if you take large doses for a long time you may develop symptoms of salicylism, they include dizziness, ringing in the ears, deafness, sweating, feeling or being sick, headache and confusion. Another common type of medication is Statins. Which are lipid (fat) regulating medicines, used to lower lipids known as cholesterol and triglycerides in the blood when a low fat diet and lifestyle changes have failed. Used mainly to reduce the risk of heart disease. Some common side effects include:-

Inflammation of the nasal passages, pain in the throat and nose bleeds. Allergic reactions.
Increases in blood sugar levels ( diabetics ).
Headaches, nausea, constipation, wind, indigestion and diarrhoea. Joint pain, muscle pain and back pain, and blood test results that show your liver function can become abnormal. Some uncommon side effects include:-

Anorexia (loss of appetite), having nightmares, insomnia.
Dizziness, blurred vision, ringing in the ears, vomiting, neck pain and fatigue, weakness and chest pain. Q.3.
I’ve identified two types of medication which demand the measurement of specific physiological measurements, they both belong to the group of medicines known as Anticoagulants. They are Heparin and Warfarin. These are used to reduce the ability of the blood to clot, blood clots are essential to aid healing but can also be very dangerous. If an individual develops an internal blood clot and it breaks free, it could travel in the circulatory system and possibly block a major blood vessel or block blood from flowing to vital organs such as the brain, lungs or heart.

And this could lead to life threatening conditions such as a heart attack, stroke, deep vein thrombosis or pulmonary embolism (blood clot in the lungs). Individuals taking this medication are at an increased risk of haemorrhage (uncontrollable bleeding), and must be monitored very closely by taking their blood pressure regularly. Also to make sure their blood levels are within an ideal range. Bisoprolol, losartan and Eplerenone are taken to treat a condition of the heart called Cardiomyopathy. And a regular check of the pulse (heartbeat) is required for this condition. Aswell as regularly taking the individuals blood pressure. Q.4.

An adverse drug reaction (ADR) is a response to a medicinal product which is noxious and unintended. Response in this context means that a causal relationship between a medicinal product and an adverse event is at least a reasonable possibility. Adverse drug reactions may arise from use of a product within or outside the terms of the marketing authorisation or from occupational exposure. Conditions of use outside the marketing authorisation include off label use, overdose, misuse, abuse and medication errors. The reaction may be a known side effect of the drug or it may be new and previously unrecognised. A common adverse reaction to medication is an allergic reaction called Anaphylaxis, usually linked with Penicillin.

The individual having the reaction is likely to have a swollen face, lips and mouth. And unless they receive urgent medical assistance, could result in death. Usually the individual knows they are allergic to a certain medication and they carry with them an Eppy Pen. In the form of a plastic device containing a shot of adrenalin, usually this can be administered by the individual or somebody trained to do so. Most common adverse reactions are recognised by a visual, some of these being:- skin rash, easy bruising, bleeding, severe nausea and vomiting, diorrhea, constipation, confusion and breathing difficulties.

If an individual has an adverse reaction whilst you are with them, you are to stop the medication immediately and continually monitor the individual, record the event in the daily log, inform a manager and make a note on the MAR sheet. If the individual’s condition worsens a phonecall to a G.P. and a Pharmacist for advice is a must, and maybe ring an ambulance, so the individual can be rushed to hospital. All adverse reactions will be listed on the information leaflet contained in the medications original packaging, this should be read by all before administering any medications, and before starting a course of drug treatment. Q.5.

The different routes of medicine administration are:-
The oral route:- by mouth. The buccal route:- between the top gum and cheek. The sublingual route:- under the tongue. The intra-nasal route:- into the nose. The intra-ocular route:- into the eyes. The intra-aural route:- into the ears. The inhaled route:- directly into the lungs. The vaginal route:- into the vagina. The rectal route:- into the rectum. The topical route:- the outer surface of the skin.

The transdermal route:- usually in the form of a patch on the outer surface of the skin. The percutaneous endoscopic gastrostomy (PEG) route:- through the abdominal wall into the stomach.The subcutaneous route:- injecting medication into the fatty layer of tissue just below the surface of the skin. The intramuscular route:- involves injecting medication into a large muscle, buttock, thigh for example. The intravenous route:- involves injecting medication directly into a vein. Q.6.

Hands must be washed thoroughly and gloves worn at all times when administering medication. Syringes are required to administer medication via the peg route, sterile water will also be needed for flushes. Plastic spoons and medi-cups are required for administering liquid and tablet form medications via the oral route. Hypodermic needles are required to administer medications via the Intravenous route. People who suffer with asthma will use an inhaler or a nebuliser, which enables them to breathe the medication directly into the lungs. Q.7.

When a pharmacist dispenses a valid prescription the container in which the medication is supplied must be clearly labelled and should have the following information on it:- The service user’s full name.

The date of dispensing.
The name of the medicine.
The dose and frequency of doses (how much to take and how often it should be taken). The route by which the medicine should be taken.
Any special instructions to consider when taking the medication (take with food or on an empty stomach for example). Any warnings or cautions(for example:- may cause drowsiness). Any extra instructions (for example:- shake the bottle, store in a cool dry place, for external use only). The name and address of the pharmacy.

The use by date.
The total quantity of medicines in the container.
Directions for use, how to store.
The wording `keep out of reach of children’ (This is a legal requirement). The individual should have a MAR sheet, containing the following information:- Date medication started.
Their name and date of birth.
Any allergies.
List of medications, dosage, how frequently to take the medication, what form the medication is in, by what route it should be taken and should be initialled by the person who administers the medication, or putting in a code if the medication is refused for example. Q.8.

The timing of medication is very important, the prescriber puts these times on medications for them to be most effective for the individual taking them. Before administering medication, i check the MAR sheet to see when medication was given or is due to be given, so as not to overdose the individual. Q.9.

If i had a problem with the administration of medication, for example the individual refused their medication i would ask them in a calm professional manner why they hadn’t taken it, this could possibly be not being able to swallow a tablet, so liquid form may be better for them. I would put this information on the MAR sheet and ( inform a manager/contact the individuals G.P.) Q.10.

It may be necessary to confirm an individual has taken their medication because it was prescribed for them, for a specific purpose. If not taken they may become seriously ill. If an individual passed their medication to someone else they could overdose and become very ill, even resulting in death. Q.11.

Disposing of out of date and part used medications should be done in accordance with the law and your organisations policy, and in accordance with the Hazardous Waste Regulations 2005. But for the most part medications can be returned to the pharmacy or collected by the pharmacy when delivering medications to you. And relevant paperwork being completed. Completed by Andrew Cartmell, this is all my own work done for a second time.