Agency Form
This form is filled out each shift by the staff who is administering medication.
The responsibility form
Name one of the Six Rights of Medication Administration.
Right Person
Right Dose
Right Medication
Right Route
Right Time
Right Documention
What does “PO” stand for?
By mouth (oral)
What should you do FIRST if a med is dropped?
Reassure the person and pick it up with gloves
What does PRN mean?
“As needed” or “when required”
This form is filled out when an individual goes for a home visit, to program, or out with staff.
The medication transfer form
What is the “Right Time” window for medication administration?
1 hour before or 1 hour after the scheduled time
True or false
Anyone supported with CLC can administer their medication as it is their right.
False
A self-administration of medication form must be prepared by health and wellness and signed by their doctor.
If you discover a documentation error on the MAR, what do you do?
Do NOT alter; complete a medication error report and notify the manager
What must you do after giving a PRN?
Sign the front of the MAR and complete chart on reverse of MAR
Document administration and effectiveness on ShareVision
This form is used when we remove a bsp/seizure/inhaler from the home
The PRN release form
Which “Right” ensures you are using the MAR and label to confirm who receives the med?
Right Person
What should you do before giving eye drops?
Wash hands, apply gloves, wipe eye from inner to outer, avoid contaminating the dropper
Name two examples of medication errors.
Wrong person, wrong med, wrong dose, wrong route, wrong time, missing documentation (any two)
What must be in place before giving a PRN medication?
A PRN protocol with matching labels on the protocol, medication and verbiage on the MAR
Staff would reference this form if a medication was missed
What is the missed medication and medication discrepancy form.
What must be done immediately after giving medication to complete the process?
Document on the MAR (Right Documentation)
Name two steps in inhaler administration.
Shake inhaler, prime if needed, exhale completely, seal lips, press inhaler while inhaling, hold breath 10 sec (any two)
What form do you complete if a medication is discarded or expired?
Medication Discarded/Expired form
What should you do if a person refuses their medication?
Fill out medication refusal incident report and follow steps listed, document refusal on MAR,
Staff sign this only after giving medication.
What is the MAR (medication administration record)
What are ALL six rights?
Right Person
Right Medication
Right Dose
Right Route
Right Time
Right Documentation
List four of the eight routes of absorption.
Oral, topical, ophthalmic, otic, nasal, IM/IV/SQ, rectal, vaginal, G/J tube (any four)
What is the rule about documenting care?
If it wasn’t documented, it wasn’t done (legal record)
What steps should you take if you give the wrong medication?
Call pharmacy and manager/ health and wellness, monitor person, seek medical care if needed, document incident