Nobility Reigns Academy

Excellence is not achieved in a single day—it is built through a commitment to learning. Each training you complete strengthens your knowledge, enhances the quality of care you provide, and helps ensure every resident lives with dignity, respect, and safety. Thank you for investing in yourself and in the lives of those we proudly serve.

Training Module 1.

Medication Administration

Nobility Reigns Training Session - Course 5.

Welcome to the Basic Medication Administration course at Nobility Reigns. This training program is designed to equip our dedicated employees with the essential knowledge and skills required to safely and effectively guide, administer, transcribe, and document medications within our facilities.

At Nobility Reigns, we pride ourselves on providing the highest standard of care to our residents, ensuring their well-being and health are always our top priority. Accurate medication administration is a critical component of this commitment. This course will cover fundamental principles and best practices that will enable you to perform your duties with confidence and competence.

Throughout this course, you will learn:

Guidelines and Regulations: Understanding the legal and ethical considerations in medication administration.
Types of Medications: An overview of different classes of medications and their uses.
Administration Techniques: Step-by-step procedures for administering medications via various routes such as oral, topical, injection.
Transcription and Documentation: Guidelines for precise transcription of medication orders and recording their administration.
Safety Protocols: Recognizing and reducing possible risks and mistakes in medication administration.
Resident Communication: Strategies for clear communication with clients regarding their medications and resolving any issues.

Most individuals you assist take one or more daily medications. At some point, everyone you support will require medication due to changes in their medical condition. Administering medication is a high-risk task. In this course, you'll acquire essential skills aimed at enhancing safety and minimizing errors, thereby maximizing protection for both the individuals you support and yourself.

No one wants to be responsible for causing injury or harm to someone else. The health of many individuals in licensed settings depends on the skills of our staff assisting them with taking medications. As you will see administering medications is a very important responsibility and there are many risks. This is why it is so important to follow the Physicians orders exactly. Safety is key to preventing medication errors.

Your duties extend past just providing the medication. You must comprehend each medication: its purpose, potential side effects, signs of effectiveness, foods or drinks to avoid, other medications to avoid, and if it limits certain activities.

Your knowledge and understanding of medications will help you keep the individuals you support informed about their medications and to answer any questions they may have. Now let's discuss the effects of medications.

Medications are substances used for prevention, treatment, symptom relief, or cure. Staff can only help with medications prescribed by a licensed professional, like a Doctor, Dentist, or Nurse Practitioner, as per the Department of Licensing and Regulation. This applies to both prescription and over-the-counter drugs.

The signed and dated order or prescription provided by the doctor includes detailed instructions regarding the preparation and administration of the medication. This document serves as a guide for healthcare caregivers to ensure that the medication is prepared and administered correctly, according to the specific directions outlined by the doctor.

Prescription medications require a doctor's authorization. Over-the-counter or O T C drugs, like vitamin supplements, herbal remedies, Tylenol, and Benadryl, can usually be purchased without a prescription. However, in licensed residential facilities, even O T C medications need a signed, dated order or prescription from a doctor.

PRN medications are used "as needed" for specific symptoms and can be either prescription or over-the-counter. A doctor's order is necessary for PRN medications, specifying the minimum and maximum doses, duration of use, the conditions for which it is prescribed, and any individual-specific instructions.

The reason for each dose of PRN medication must be documented. Each dose of medication must be recorded on the individual’s medication sheet, and the DSP should assure that a.m. or p.m. is noted too.

To prevent errors always check for the last time a PRN medication was given before dispensing and follow all individual medical protocols for that medication.

When a PRN medication is administered you must complete a follow up check in 30-45 minutes. This check involves talking to, and observing the individual for the intended effect, and documenting that effectiveness.

Medications are potent agents that can greatly influence a person's health, behavior, and capacity to prevent, fight, or manage diseases. Their effects vary from person to person. Typically, medications are used for a primary purpose: managing seizures, reducing blood pressure, or alleviating pain.

Medications are potent and can greatly influence a person's health, behavior, and disease management. They affect individuals uniquely. Typically, a medication is used for its main purpose: managing seizures, reducing blood pressure, or easing pain.

Many drugs have other known actions besides the primary or intended one.

These actions are called secondary actions or side effects. Many of these effects are predictable; however, some are not. Side effects may be desirable or undesirable, harmless or dangerous.

Sometimes they can even be deadly. Both prescription and OTC drugs have side effects. An example of a side effect is when the medication makes the individual feel nauseated, confused, dizzy, or anxious, or when it causes a rash or a change in a bodily function such as a change in appetite, sleep pattern, or elimination.

It is not uncommon for two or more medications to interact with one another, causing unwanted side effects. An example of this would be when iron or Penicillin is given with an antacid. The antacid prevents the iron or Penicillin from being absorbed in the stomach.

Let’s discuss common medication categories. Drugs are classified into categories or classes with other medications that affect the body in similar ways. Thousands of medications are on the market. Many drugs, because of their multiple uses, can be found in more than one category. For example, Benadryl is an antihistamine, which relieves allergy symptoms. It’s also a sedative to promote sleep.

Common medication categories for those with developmental disabilities or mental illness include: 1. Anti-convulsants. 2. Antibiotics. 3. Pain relievers. 4. Topical ointments or creams. 5. Psychotropic drugs, such as antidepressants and antipsychotics.

Anticonvulsants, or anti-seizure medications, are crucial for treating epileptic seizures and other conditions. These drugs are a varied group of pharmacological agents. Seizures can be managed with medications, commonly called anticonvulsants, prescribed to control seizure activity in epilepsy patients. The specific type of seizures a person experiences influences the physician's choice of anticonvulsant. It is of utmost importance to provide the physician with precise and detailed information regarding the person's seizure symptoms. This is essential for the physician to prescribe the most appropriate medication. Among the commonly used anticonvulsants are Depakene, Tegretol, Neurontin, Lamictal, Topamax, and Keppra. Each of these medications serves a specific purpose and may be more suitable depending on the individual's symptoms.

Anti-convulsants can interact with other drugs, affecting their effectiveness. Some may reduce vitamin levels, requiring a multivitamin and additional folic acid. Consult the physician or pharmacist, as they might not consider this nutritional aspect unless you mention it.

A number of prescription and OTC medications, such as anti-psychotics, Ibuprofen, as well as alcohol and illicit drugs such as cocaine and amphetamines, may lower the “seizure threshold,” or increase the likelihood of a seizure.

Many anti-convulsants impact the central nervous system, particularly Phenobarbital, affecting cognitive functions. These effects can include dizziness, sedation, mood alterations, nervousness, or fatigue.

Typical side effects of anti-convulsants include: 1. Drowsiness, lethargy, cognitive issues, altered walking, seizure recurrence, and memory problems, often linked to dosage. 2. Stomach issues, notably with Tegretol and Depakote, diarrhea, gum swelling with Dilantin, weight changes, and hair loss or growth. 3. Liver or kidney issues, hyperactivity, aplastic anemia, and allergic reactions.

Consult the prescribing doctor and the pharmacist who fills the prescription for this information. Request a copy of the medication information sheet from the pharmacist and review it together. Ensure you understand all the answers to these questions before helping someone take their medication.

Let's discuss psychotropics and psychiatric disorders and medications used for treatment. Psychiatric disorders may involve serious impairments in mental or emotional functioning, which affect a person’s ability to perform normal activities and to relate effectively to others. Many individuals with developmental disabilities who also have a psychiatric disorder, and individuals who have been diagnosed with a mental illness are treated with psychotropic medications alongside other interventions.

Psychotropic medications are drugs that primarily target the central nervous system and have significant effects on mental activity, behavior, or perception. These medications are often prescribed to manage symptoms associated with various psychiatric disorders. Below, you will find detailed information on three specific classifications of psychiatric disorders for which individuals might be prescribed and take medication.

Mood Disorders: Mood disorders primarily encompass two main categories: depression and bipolar disorder. Depression, which persists for a duration of two weeks or more, can present itself through feelings of hopelessness or even self-destructive tendencies, such as a lack of desire to eat or get out of bed in the morning. To address and manage depression, anti-depressant medications are commonly prescribed as a form of treatment. Bi-polar Disorder, which is also known as Manic Depression, is a mental health condition that is frequently characterized by significant extremes in mood. These mood swings can range from periods of intense elation to episodes of deep despair. Additionally, individuals may experience manic periods, which are marked by excessive excitement, delusions of grandeur, or elevated mood states.
Schizophrenia, Schizophrenia is a complex mental disorder that can manifest in various symptoms. It often involves experiencing hallucinations, which are sensory misperceptions, and delusions, which are strange ideas or false beliefs, sometimes including paranoia. Individuals may have a distorted misinterpretation of reality and may retreat from it. They might also exhibit ambivalence, inappropriate emotional responses, and behavior that can be bizarre, withdrawn, or aggressive.
Anxiety Disorders: Anxiety disorders are characterized by feelings of tension, fear, apprehension, discomfort, and distress. These disorders can manifest in various forms, with two primary types being:
1. Generalized Anxiety Disorder, which involves persistent and excessive worry about various aspects of life.
2. Obsessive-Compulsive Disorder, which is marked by unwanted repetitive thoughts and behaviors.

Psychotropic medications, which include both antipsychotics and antidepressants, necessitate obtaining "informed consent" before they can be administered. This requirement means that, depending on the specific circumstances, either the parent, guardian, or the individual themselves must provide their consent for the medication to be given, particularly in a residential setting. This ensures that all parties are fully aware of the implications and agree to the treatment.

Now, let's delve into the significance of strictly following doctors' instructions regarding medical tests. Certain medications, including Tylenol, Lithium, and Depakene, have the potential to be toxic and may cause harm, particularly when used over an extended duration. Individuals react differently to medications, and some of these reactions are linked to the speed at which our bodies can metabolize or break down the medication.

For this reason, physicians sometimes start a new medication at low doses and increase it in response to signs of a positive effect such as a reduction in seizures or the development of better sleep patterns. Checking blood serum levels by analyzing the concentrations of medications in an individual’s blood can be important. For example: many anti-convulsants require an Anti Epileptic Drug Level every six months. Physician’s orders for lab tests and follow-up appointments must be followed.

Blood serum level tests play a crucial role in assisting the physician in evaluating the effectiveness of the medication being administered to the patient. These tests provide valuable insights that enable the physician to make informed recommendations regarding any necessary changes to the dosage, the strength of the medication, or even the specific medication being used. Additionally, they aid in developing a comprehensive treatment plan.

Let's talk about monitoring medication effects. The unintended effects of medication, called side effects, can occur at any time. Some mild side effects may disappear after a short time. Others will persist the entire time the medication is taken and sometimes beyond. Some side effects are life threatening. It is very important to learn about the medications each individual is taking, and to know what possible side effects may occur.

When you visit the doctor, be sure to inquire about any specific reactions or side effects that should be reported to them immediately. Additionally, your local pharmacy is an excellent resource for gaining insights into the effects of medications. Every time you receive a new medication, it should be accompanied by an information sheet detailing its effects. Pharmacists are well-versed in the intricacies of drugs, their potential side effects, and possible interactions.

Consulting both the doctor and the pharmacist is a beneficial approach as it leverages two crucial expert resources available within the healthcare system. This strategy ensures comprehensive guidance on medication use. Additionally, it is advisable to document any potential side effects on the individual's Medication Sheet and to attach the medication information sheet. This practice aids in maintaining an organized and informed approach to medication management.

Identifying physical and behavioral changes that may result from medication effects can be challenging, as a single sign or symptom often has multiple potential causes. For example, a behavioral change may stem from a recent medication adjustment or from an alteration in the individual’s environment; similarly, a sore throat may signal the onset of a cold or represent a medication side effect. Your primary responsibility is to observe, report, and document any change—whether in daily routines, behavior, communication, appearance, physical health, or overall mood—consistently and accurately. Interpretation of these changes is the responsibility of the prescribing physician, not the caregiving staff.

Drug interactions may occur between multiple medications, between medications and certain foods or drinks, or when alcohol is consumed with a medication. Alcohol, in particular, is dangerous when combined with medications such as antianxiety agents (Librium, Valium, Xanax), antidepressants, antiseizure medications, antihistamines, ulcer and heartburn medications (Zantac, Tagamet), and certain heart and blood pressure medications.

If you suspect an individual is experiencing an adverse reaction to a medication, urgent medical care is required. Contact the doctor immediately and follow all instructions provided. Be prepared to report a complete list of the individual’s medications, any noticeable physical symptoms (such as pallor, flushing, tearfulness, unusual facial expressions, or red skin spots), changes in behavior or activity, and any verbal reports from the individual describing discomfort. You should also document when symptoms first appeared and provide information about recent eating and drinking patterns, appetite changes, nausea, vomiting, diarrhea, constipation, or any difficulties with urination. Additionally, include relevant medical history such as recent illnesses, injuries, chronic conditions, or known allergies.

Severe allergic reactions—particularly anaphylaxis—require immediate emergency attention. Individuals with known severe allergies to medications, foods, or insect stings should wear a medical identification bracelet. Anaphylactic shock may occur within minutes of exposure and can involve difficulty breathing, swelling of the lips, tongue, or face, and skin reactions such as hives, itching, or warmth. If any of these symptoms appear soon after taking a medication, eating a food, or being stung by an insect, call 911 immediately.

Understanding and correctly interpreting medication labels is essential for safe administration. Each medication has both a generic name and a trade (brand) name—for instance, acetaminophen is the generic name for Tylenol. Prescribers and pharmacies may use either name, and pharmacies often dispense generic equivalents (GEQ) unless the doctor specifies "dispense as written" (DAW). All medications must remain in their original containers with the pharmacy label intact. Pharmacy labels contain critical information, such as the pharmacy name and address, prescription number, the individual's name, prescriber name, medication name and strength, dosage instructions, manufacturer, quantity, fill date, expiration date, remaining refills, and often the condition being treated.

Abbreviations frequently appear on medication labels and must be understood to avoid serious errors. Common abbreviations include: QD (once daily), BID (twice daily), TID (three times daily), QID (four times daily), PRN (as needed), HS (at bedtime), AC (before meals), and PC (after meals). Always refer to the Medication Administration Record (MAR) and ask questions whenever an instruction is unclear. Your vigilance and willingness to seek clarification directly impact client safety.

Medication dosage instructions may involve tablets, capsules, or liquids, which are measured in units such as milligrams, grams, milliliters, teaspoons, or tablespoons. Labels for liquid medications always indicate the strength of the medication. Medication labels must never be scratched out or altered; any change requires a new physician order and a replacement prescription from the pharmacy. Warning labels affixed by the pharmacist provide additional safety instructions—for example, “Take with plenty of water,” “May cause drowsiness,” or “Take on an empty stomach.”

Learning about medications includes knowing what each medication is for, the correct dosage and frequency, the start and end dates, what to do if a dose is missed, special storage instructions, and any dietary or activity restrictions. Your Program Coordinator will support you in understanding these elements and in locating this information when needed. Medication safety also includes documenting every dose taken or missed on the Monthly Medication Sheet, also known as the MAR. Accurate and complete documentation is an essential part of providing safe, effective care.

The implementation of a Medication Sheet for each person, also known as a Medication Administration Record or Mar, enhances medication safety and minimizes the likelihood of mistakes. This sheet allows the staff to record every medication dose administered, any errors in medication, and other relevant details that aid in the medication administration process.

The DSC or staff must record each medication dose immediately after administration and should prepare medications for only one person at a time. The Medication Sheet should contain essential information about the individual, such as any known drug allergies, and details of the individual's medications, including the medication name, dosage, and the prescribed times and methods of administration.

Following the five rights is basic to medication safety. The DSC or staff needs to be sure they have the. 1. Right individual. 2. Right medication. 3. Right dose. 4. Right time. 5. Right route. Never administer medication to an individual from an unlabeled container! Adhering to the five rights is the most effective method for a Direct Support Coordinator or DSC to avoid medication errors.

Whenever you assist a client, make sure to read and compare the medication label with the mar three times before administering the medication. If you find any discrepancies at any point, do not proceed. The error could be related to the person, the medication, the dosage, the timing, or the method of administration. Consider all these factors carefully and determine the appropriate action. If in doubt, consult your Program Coordinator or, if necessary, the pharmacist. In some cases, an adult may independently take their own medication. If an adult is to independently self-administer medication, a physician must provide a written statement that the individual is able to administer and store his or her own medications and the facility must keep that on file.

The Department of Health and Human Services has established stringent guidelines for medication storage, which are as follows: 1. Medications should be kept in locked cabinets or drawers unless otherwise directed. The storage area must be cool, dry, and shielded from direct sunlight. 2. Medications are required to be stored in their original containers as provided by the dispensing pharmacy. 3. The medication cabinet must be kept clean, organized, and spacious enough to accommodate the items. 4. There should be adequate lighting in this area. 5. Medication should never be left unattended. 6. Any controlled substances must be double locked. 7. Refrigerated medications must be in a locked container or safe. Refrigerator temperature should be in the 36-to-40-degree range. 8. Topical medications, such as ointments, etc. must be stored separately from oral medications. If they are in the same cabinet, they must be in a separate basket or container. Nobility Reigns has their creams, and liquids in Ziplock bags. Topical medications must also be locked. 9. Never leave the medication storage area open. 10. Medications must not be stored over a stove, or near a heat source. Heat can change the chemical properties in medications. 11. Medications should never be stored with any other products. Should you observe any breaches of these guidelines, promptly notify your Program Coordinator to ensure the issue is promptly addressed and rectified.

Disposal and destruction of medications: Any medications that are discontinued, contaminated, deteriorated, or expired must be disposed of. Such medications must be labeled accordingly and stored separately from other medications in a secured cupboard or container. It is mandatory for all employees to fill out the medication disposal form for each medication that is destroyed.

Correct Route: Always read the medication label to determine the correct route for administration. Tablets, capsules, and liquids typically have an oral route, meaning they are taken through the mouth. This is the most common and convenient method for administering medications. Other routes include:

Ophthalmic, for eye drops or ointments.
Nasal, for nasal sprays.
Otic, for ear drops.
Topical, for skin applications like dermal patches or ointments.
Rectal, for suppositories.
Injectable, for shots. In a residential setting, if individuals require injections, tube feeding, or glucose monitoring, additional training will be provided if allowed according to the medical protocol established for the individual and their Individualized Service Plan.

Medications come in a multitude of forms, including tablets, capsules, chewable tablets, injections, powders, solutions, emulsions, suspensions, lotions, creams, ointments, effervescent granules, aerosols, gasses, and suppositories.

Capsules: Capsules are small gelatin containers that dissolve in the stomach, releasing the medicine inside.

Tablets: Tablets are compacted or shaped forms of powdered drugs that disintegrate when wet. Scored tablets have a line indicating where they can be split in half. Ointments and creams are applied externally to the skin or mucous membranes. It's important to know you may only crush tablets or open capsules if instructed by the prescribing doctor. The facility must have this order on file.

Suppositories are inserted into the vagina or rectum, where they melt at body temperature, allowing the drug to be absorbed by the mucous membranes. These are typically kept in a locked box in the refrigerator. Elixirs are drug solutions in a liquid form.

Drugs are available in multiple forms. If someone has difficulty taking medication, discuss their needs and preferences, and consult with the doctor about alternative medication forms or methods of administration.

An individual has the right to refuse medication. It is the responsibility of the staff to assist and encourage the person in taking their medicine. If an individual refuses medication, inquire as to the reason.

Medication should not be crushed or concealed in food to ensure its intake, unless instructed to do so by a medical doctor. In 99% of cases, you can find a method to motivate the person to take their prescribed medication without resorting to coercion.

Let's discuss reasons for Medication Refusal and Helpful Suggestions. Here are some common reasons why an individual might refuse medication and how to assist:

Unpleasant Taste: Offer ice chips before administering the medication to help mask any bad taste. Consult with the doctor or pharmacist to see if the medication can be diluted or if a compatible juice, like apple juice can be used to improve taste. Ensure this information is noted on the prescription label. Provide crackers, apples, or juice after taking the medication to help eliminate the aftertaste.

Unpleasant Side Effect – Drowsiness: Report the side effect to the prescribing doctor and inquire if the medication can be taken at a different time, such as before sleep, or if there are alternatives or treatments for the side effect.

Lack of Understanding: Offer clear reminders about the medication's name and purpose, for example, this is Depakene, which helps prevent your seizures. It's important to involve individuals in their healthcare, including understanding their medications, appointments, and healthy lifestyle choices. As a Direct Support Coordinator with Nobility Reigns, you should, support the individual by addressing their concerns and assisting them in medication adherence.

Discuss the need for the medication, but do not argue. It may help to show the individual a statement written by the physician; for example, Alma, you take your heart medication every day.

Medication refusal needs to be documented on the medication sheet and brought to the attention of the prescribing doctor or pharmacist. The doctor may be able to accommodate an individual’s medication preference or special health consideration.

Any unused dose should be set aside and destroyed per Nobility Reigns policy. Remember: Never force an individual to take medication: Clients have the right to refuse medication.

If an individual refuses medication often or has a history of refusals the physician can provide instructions on how you should proceed.

Over a five-year period, the Food and Drug Administration FDA conducted a detailed evaluation of nationwide reports concerning fatal medication errors. They identified that the most frequent types of errors involved administering an improper dose 41%, giving the wrong drug 16%, and

using the incorrect route of administration 16%. These errors often stemmed from a lack of skill, insufficient knowledge, and communication breakdowns.

Given the critical nature of these errors, which can be life-threatening, the role of Direct Support Coordinators DSCs in ensuring the safe administration of medications is paramount. Extensive training is provided to DSCs to underscore the importance of preventing these errors by teaching effective and safe medication administration techniques. Despite thorough training, medication errors can still occur.

Common errors include the wrong individual receiving medication, incorrect dosages being administered, medications taken at the wrong time, the incorrect route of administration being used, or medications not being taken at all. When such errors occur, it is imperative that they are meticulously documented on an Incident Report and the Medication Sheet. These documents should be marked distinctly with the DSC’s initials and a red ink circle around the error.

Comprehensive documentation should include the date, time, specific medication involved, a detailed account of the event, notifications made to relevant parties, the attending doctor’s name, instructions that were given, and the subsequent actions taken.

DSCs are advised to utilize the drug inserts provided by pharmacies as a reference to address common medication-related queries.

Nevertheless, these inserts may not always provide adequate guidance for more complex situations, such as when an individual accidentally receives a higher dosage of their medication than prescribed, or if they are given medication prescribed to someone else.

In such critical scenarios, it is crucial for the DSC to immediately contact the individual’s prescribing physicians, which may include specialists like Primary Care Physicians, Psychiatrists, or Neurologists.

Furthermore, all residential facilities are expected to maintain a readily accessible supply of drug inserts for DSCs to consult as questions or concerns about medications arise. These facilities should also have detailed policies and procedures in place for managing medication errors. These policies should provide explicit guidelines on how to accurately document such incidents, whom to notify, and the proper steps to follow afterward.

Emphasizing prevention as the primary approach, DSCs are trained to stay vigilant, strictly adhere to the Five Rights of medication administration right individual, right medication, right dose, right time, right route, avoid distractions, have a thorough understanding of the individuals under their care and their specific medication needs, and consult the Program Coordinator for assistance with any uncertainties in preparing, assisting, or documenting medication administration.

Ensuring that a medication count is completed before beginning the administration process is also emphasized as a crucial step in safeguarding against errors.

Now let's discuss medication administration guidelines.

The following is the step-by-step process for assisting an individual with administration of medications. Remember to complete the medication count before medication administration if required!

Help the individual whom you are assisting to wash his or her hands.
Wash your hands. Hand washing reduces the risk of contamination.
Get the Medication Sheet for the individual you are assisting. Double check that you have the medication administration record for the right individual also called a Mar's. It’s important for you to work with only one individual at a time and to complete the task with that individual before assisting another.
Collect supplies: Remove medications from their secure storage. It's advisable to store all medications for one person in a single labeled unit. Obtain paper cups or approved cups for tablets and capsules, and a calibrated plastic measuring cup or medication spoon for liquids. Have a glass of water ready. Gather tissues. Have a pen on hand.
When retrieving each medication container from the individual's storage, read the label and compare it to the medication administration record for the Five Rights: Right individual, Right medication, Right dose, Right time, check the time on your watch, phone, or clock, and Right route.
Tablets or capsules: For bubble packs or strip packaging, push all the tablets and capsules from the bubble pack or strip packaging into a small cup.
For liquid medication: Always shake liquid medications before pouring. Pour the correct dose into the plastic measuring cup held at eye level. View the medication in the cup on a flat surface. Pour away from the medication label to avoid staining it with spills. If any medication spills on the bottle, wipe it away.
When using a measuring spoon: Locate the marking for the dose. Hold the device at eye level and fill to the correct dosage marking. Pour away from the medication label to avoid spills. If any spills on the bottle, wipe it away. Use only a calibrated measuring cup or spoon for liquid medications. Regular eating spoons are not accurate enough and should never be used. Wash the calibrated measuring device and air dry on a paper towel.
Talk with the individual you are assisting about what you are doing and about why he or she is taking each medication.
Before providing the medication, verify the label against the Medication Sheet to ensure the Five Rights: Right individual, Right medication, Right dose, Right time confirm with your watch, phone, or clock, and Right route.
Position the medication within easy reach for the person.
Offer a glass of water. At least four ounces. It is a good idea to suggest to the individual that he or she tilt his head forward slightly and take a small sip of water before placing the pill in the mouth. Wetting the mouth may make swallowing easier and tilting the head slightly forward as opposed to throwing it back may decrease the risk of choking. If pills are not taken with liquids, they can irritate the throat and intestinal tract and they may not be correctly absorbed. Some medications must be taken with food, and there may be other special instructions. Make sure that you have read any warning labels and are familiar with any special instructions for taking the medication.
Make sure that the individual takes the medication and drinks water. Stay with the individual until you are sure that he or she has swallowed the medication. If the individual has difficulty drinking an adequate amount of water or swallowing liquids, the staff can ask the doctor about the individual taking the medication with: Jell-O that is semi-liquid or jellied apple juice or other medication-compatible juice thickened with cornstarch or another thickening agent. Medications should never be disguised by putting them in food or liquid. Tablets should never be crushed unless the prescribing physician gives the specific direction to do so. Capsules should not be opened, and their contents emptied out. If the individual has trouble taking a medication, talk to the individual about their needs and preferences and then talk to the doctor about optional ways to take the medication.
Record that the individual took his or her medication by initialing the date and time in the proper box on the Medication Sheet.
Return the medication containers, strip packaging and or bubble pack to the individual’s storage unit. As you do so, read the labels to check that the individual’s name on the medication container label is the same as the name on the storage unit.

Never leave the medication container unattended or give to someone else to return to the locked storage container or area. When assisting an individual with other types of medications such as topical creams and ointments, ear drops, nose drops, and eye drops, consult with the prescribing physician and the pharmacist for specific procedures for administration of the medication. Also, refer to the Administration Guidelines which describe the process for assisting with these types of medications.

Welcome to the next part of our Basic Medication Administration training at Nobility Reigns: administering topical medications. This section covers the correct techniques, procedures, and considerations for applying topical medications. These medications are crucial in client care, offering localized treatment for conditions like skin irritations, wounds, or muscle pain.

Proper administration ensures that these treatments are both safe and effective, minimizing risks and maximizing therapeutic outcomes for our clients.

To administer topical medications safely and effectively, it is important to follow specific guidelines. Begin by preparing the environment and gathering necessary supplies, such as gloves, the prescribed medication, and any additional materials like applicators or gauze. Ensure the area is clean, well-lit, and free from distractions.

Review the medication order carefully, verifying the medication, dosage, application site, and frequency against the Medication Administration Record, sometimes referred to as the Mar, and check the expiration date. Before and after administration, wash your hands thoroughly with soap and water, and always wear gloves to prevent contamination and protect both yourself and the client.

When ready, explain the procedure to the client, including the purpose of the medication and what to expect, while maintaining their privacy and dignity. Inspect the application site for any abnormalities, such as rashes, wounds, or signs of infection, and report unusual findings to the appropriate managing coordinator before proceeding.

Apply the medication as instructed: for creams and ointments, use a clean applicator or gloved fingers to spread a thin, even layer, while patches require clean, dry skin free of hair, with application sites rotated as directed. Avoid rubbing the medication unless specified, as this may affect absorption. After applying the medication, dispose of used materials, such as gloves and applicators, in appropriate containers.

Monitor the client for any adverse reactions, such as redness, itching, or swelling, and document the medication, dose, application site, time, and any observations or client feedback in the Mar. Adhering to these guidelines ensures the safe and effective use of topical medications, promoting the well-being and comfort of our clients. Thank you for your continued commitment to excellence as we advance through this training.

Welcome to this part of the medication administration training. Here, we will concentrate on the correct methods for giving nose drops and sprays, ear drops, and eye drop ointments. These skills are crucial for ensuring medications are delivered effectively while upholding the comfort, dignity, and safety of those we care for.

Administering medications through these routes requires careful attention to detail, hygiene, and technique to avoid contamination, discomfort, or errors. Each method involves specific steps to ensure the medication is delivered effectively and that individuals are supported throughout the process.

In this section, we will cover:

Nose Drops Sprays: Techniques for clearing nasal passages and ensuring proper delivery of medication.
Ear Drops: Steps to position individuals correctly and administer ear medications without contamination.
Eye Drops and Ointments: Guidelines for applying medication to the eyes while safeguarding against cross-contamination and discomfort.

By the end of this session, you will have the knowledge and confidence to administer these types of medications safely and effectively.

Your role is vital in promoting health and well-being, and mastering these skills ensures the best outcomes for those we serve. Let’s begin!

1. Nose Drop Spray Administration: To administer nose drops or sprays effectively, start by ensuring cleanliness and hygiene. Wash your hands thoroughly and put on gloves. Inspect the dropper tip for any chips or cracks that could compromise the medication or cause discomfort.

Inform the individual of the medication's name and its purpose, promoting trust and understanding.

Encourage the individual to gently blow their nose to clear the nasal passage. Have them tip their head back while either sitting or lying flat for optimal medication delivery. Draw the medication into the dropper and place it just inside the nostril, approximately one-third of an inch, being careful not to touch the sides of the nose with the dropper. Administer the prescribed medication dose.

After administration, encourage the individual to keep their head tilted back for 3–5 minutes to allow the medication to take effect. Provide a tissue for any nasal drainage. Conclude by removing gloves, washing your hands, and documenting the administration accurately. 2. Ear Drop Administration: Begin ear drop administration by washing your hands and donning gloves. Shake the medication container and warm it by rubbing it between your palms to prevent discomfort. Inform the individual of the medication's name and purpose to ensure they are comfortable with the process.

Position the individual with the affected ear facing upward. Draw the prescribed amount of medication into the dropper. Pull the mid-outer ear backward and upward to straighten the ear canal for proper delivery. Administer the prescribed number of drops without allowing the dropper to touch the ear, ensuring no contamination occurs.

Instruct the individual to remain in the same position for 3–5 minutes to allow the medication to flow into the ear canal effectively. Finally, wash your hands and document the medication administration.

3. Eye Drop Ointment Administration: For eye medication administration, wash your hands and put on gloves. Inspect the dropper tip or ointment tube for any chips or cracks. Inform the individual of the medication's name and purpose, ensuring their cooperation and comfort.

Position the individual with their head tilted back and looking upward or lying down if preferred. Draw the prescribed medication into the dropper or prepare the ointment by squeezing a ½-inch ribbon onto the applicator tip. Gently separate the eyelids by lifting the upper lid with your forefinger and pulling the lower lid downward with your thumb. Approach the eye from below and avoid entering the individual’s direct field of vision.

For drops, administer them near the center of the inside lower lid, ensuring the dropper remains at least one inch above the eye. For ointment, apply a thin ribbon along the inside lower lid and break off the ribbon by relaxing pressure and pulling the tube away. Avoid contact between the dropper or tube and any part of the eye to prevent contamination.

Allow the individual to close their eyes gently and remain in position for 3–5 minutes.

Excess medication should be wiped from the eye with a tissue. If both eyes require treatment, change gloves after treating the first eye to prevent cross-contamination. Finally, remove gloves, wash your hands, and document the medication administration, noting any observations or reactions.

This training guide provides you with the essential knowledge and techniques for administering nose drops sprays, ear drops, and eye drop ointments.

By following these guidelines, you ensure safe, effective, and hygienic care, promoting the well-being and comfort of the individuals you serve. Thank you for your commitment to excellence and professionalism in medication administration and participating in this medication administration training.

Throughout this class, we’ve covered the essential techniques and guidelines for administering medications safely and effectively. Your attention to detail and commitment to these procedures are vital in ensuring the health, safety, and well-being of the individuals in your care. As we conclude, remember that proper hygiene, clear communication, and accurate documentation are key to successful medication administration.

By adhering to the guidelines provided, you can perform these tasks confidently and professionally, maintaining the highest standards of care at Nobility Reigns.

Please take a moment to review your notes and reflect on what you’ve learned. When you’re ready, proceed to take the exam to demonstrate your understanding of this course. Good luck and thank you for your dedication to excellence in care.

Exam