PA Knowledge Base

Medication: A big responsibility

It is within the role of many PAs to support their employer with medication. This is a really important issue as the consequences of any mistakes could be life-threatening. The term medication includes prescribed medication, controlled drugs, over-the-counter medication and herbal remedies. All medications have possible side-effects, some worse than others.

 

Responsibilities and boundaries

If you know your job entails medication it’s important to try to get things right from the start by discussing individual boundaries and plans of action together. Some employers want to be in complete control of their own medication where as others might need some support. Try to clarify exactly how much support the person wants. Talk through the range of medication required, get information about what it’s for, and particularly any side-effects.

It’s not your responsibility to decide for your employer which medication they should take, or in which combination. If the person lacks the capacity to make decisions for themselves (e.g. if they have dementia) then a family member will have legal responsibility to make decisions on their behalf, so have this discussion with them. Ensure you have the number of the pharmacist for advice and information.

 

Principles

You need to be aware of the following:

  • Anyone may administer a prescription-only medication (except injections) providing it is in strict accordance with the directions of the prescriber, usually a doctor (The Medicines Act 1968).
  • People should receive the right medication at the right time and in the right way
  • Doses of prescribed medicines may NOT be varied without the doctors consent
  • Medication must never be given to control behaviour.
  • The medication that your employer takes is personal to them and this information should remain confidential. That said, if you believe the person is purchasing medication that may be detrimental to them, you can explain why this might not be appropriate as you have a duty of care to them.

 

PAs role in administration of medication

Administering medication includes handling, measuring and giving the required and correct medication to your employer in line with the given schedule or according to individual needs. You need to keep records of the medication given which note the type of medication, time, dosage, strength etc. You may also be asked to order, collect and store and dispose of medication. You should only give medication that you are trained to give.

 

Recording

Accurate record keeping is a useful and vital communication tool that helps to ensure that everyone involved in providing support has the same level of information. Every time you administer medication you need to check and record:

  • The time and frequency (e.g. 3 x daily, morning, lunch and evening)
  • The form of the medication e.g. orally, drops
  • The dose
  • Strength
  • Any special precautions, such as with or before meals
  • Maximum dose over a certain time period.

Information recorded should be:

  • Dated
  • Accurate and Complete
  • Up to date
  • Understandable and written in a way that shows respect for the individual
  • Written as soon after administration as possible
  • Signed off by the respective PA who prepared the medication.

Please note that if another PA prepared the medication earlier for you to administer at a later point, it is they who are responsible for the accuracy of the prepared medication.

 

Important checks

  • If you are part of a team then check what has already been administered.
  • Is it the right medicine, in the right dose and strength? Check the label on the packaging.
  • Is it being given at the right time?
  • Has the prescription altered?
  • Has any alcohol in consumed?
  • Are you respecting the persons dignity/right privacy as they take their medication?

 

Other considerations

  • Some medication can be made easier to take by mixing it with food or drink but this must only be done on the persons consent (or the consent of the person who has responsibility for them).
  • Slow or modified release medication should never be broken, crushed or chewed at all.
  • When you administer a non-prescribed medicine (herbal remedies or over-the-counter drugs) you need to check and record the medicine in the same way as you do with prescribed medicine. It is helpful to add to the daily record sheet the reason why the employer has taken non-prescribed medicine.
  • PAs need to be aware of the possibility of overdose with over-the-counter medication such as paracetamol found in many cold remedies.

 

Handling medication

YOU MUST NOT HANDLE MEDICATION. Handling medication directly is to be avoided, as you can absorb the drug yourself through the skin. This includes applying medication and creams to the skin. The risks may not be immediately apparent, but over time the cumulative effect can be very serious.

 

Reporting mistakes

If you make a mistake it is important that you report this to your employer and GP or prescribing doctor. This is vital to ensure the safety of the person taking the medication. It will also help to ensure that the mistake doesn’t happen again, as the reasons for the mistake can be investigated and mitigated in the future.