Care and Administration of Medicines

Unit 1
Responsibility, Accountability & Confidentiality

|Q1. Define responsibility - what does it mean? |
|Responsibility is an expectation to carry out your duties to the very best of your ability in accordance with your position and your |
|level of training. |

|Q2. Define accountability - what does it mean? |
|Accountability is an obligation to an individual or an organization that has the right to ask. You are able to explain, to justify |
|your actions and your work practice. |

|Q3. Define confidentiality - what does it mean and why is it important? |
|Confidentiality is a non disclosure of personal information regarding a client, other than to those professionals who ‘needs to know’|
|and for whom the client has given express consent for them to be informed. It is important to keep confidential as some records may |
|contain highly sensitive information about the services users. Sharing confidential information may make the service user feel |
|vulnerable and at risk. It is also good practice, and if personal Information was shared the service user will no longer have trust |
|in the care that the service is given. |

|Q4. What kinds of responsibility dose the care worker have? Name four. |
|As a care worker your main responsibility is for the people that you are caring for as their welfare is paramount. |
|You have the responsibility to use the systems and the procedures correctly and to a high standard. |
|You have the responsibility to report any flaws or gaps in the systems or procedures when they are in use. |
|You have the responsibility to contribute to a safe working environment for yourself and for the service users. |
|It is more than simply being aware of potential hazards. You must take steps to check and deal with any sources of risk. |

|Q5. What kinds of accountability dose the care worker have? Name six. |
|As a care worker you accountable to your employer once you have received the right training for your job role. |
|You are Accountable to the client by ensuring that the correct medicine is given appropriately. |
|As a care work in accountable to the clients parents as the client is in your care. |
|As a care worker in the care industry you are accountable to OFSTED as they inspect and regulate your service. |
|You’re accountable to society as you must not engage in any criminal act. |
|As a care worker you are accountable to your profession as we follow the guidance of an appropriate professional body. |

|Q6. What three factors are the foundations of a competent care workers practice? Explain why for each one. |
|You must always work according to the employer’s policies and procedures. Your contract of employment states that you must adhere to |
|them, in order to safeguard client care. |
|Be aware of your limitations, If you knowledge or skills are insufficient to allow you to cope with certain aspects of your job role |
|then you must not undertake these tasks, or assume responsibility for them. |
|You are also responsible for reporting any unsafe practice that you might witness; you have a duty of care to your clients and to |
|other staff and not reporting any unsafe practice makes you just as guilty of unsafe practice as the member of staff that is doing |
|it. |

|Q7. Professional care values mean taking responsibility for and being accountable for your practice, what three things dose this |
|involve? |
|Following approved procedures. |
|Taking responsibility for provision of good care. |
|Providing care according to the care plan. |
|These are professional care values. |

|Q8. Why are policies and procedures so important with regard to safer handling of medicines? |
|Policies and procedures are so important when regarding to safer handling of medicines because they are there to safeguard carers and|
|employers rights and to safeguard the rights of the clients. Having signed a contract, if we ignore these terms our employer would be|
|justified in taking disciplinary action against use (employee). |

|Q9. List six ways a care worker can promote professional practice to all service users, family and others? For example promoting safe|
|environment. |
|Six ways that a care worker can promote professional practice to all services users, family and others can be: |
|To respect the client’s dignity, choice, privacy and confidentiality. |
|To provide an environment that is safe to work in and to visit and adheres to all aspects of the Health and Safety at Work Act. |
|That no harm should be caused to your clients, colleagues or visitors by your actions. |
|That by your actions you promote self-esteem and independence. |
|To keep to all aspects of your work contract. |
|To carry out the duties that has been delegated to you in the appropriate manner. |

|Q10. In the safe handling of medicines three factors are vital, the client may ask for answers to questions on these. What might they|
|be? You need to have accurate knowledge on each one. |
|Firstly, your service user may ask you about the nature of the medicine or drug they have been prescribed. Though your level of |
|expertise may not be the same as a qualified nurse, you should still be able to give a general guidance to the client concerning the |
|basic nature of their medication. |
|Secondly, your client may ask you what their medicine is given for. |

|Q11. What six questions could the service user ask you about medicines or tablets? |
|Six questions that a service user may ask you about their medicines or tablets can be? |
|What is wrong with me? |
|How long a, I going to have to take this? |
|What are the side effects of this medication? |
|Do I need this? |
|Why did the doctor give me this? |
|Why this medication? |

|Q12. Annie is a resident in the care home where you work, she doesn’t like taking her medicine and refuses to do so as she believes |
|they are harming her. a) What action must you take? b) What information do you record on her care plan? |
|If a service user refuses to take their medication I would not insist that they should take it. I would seek the guidance of someone |
|in authority and I would record the incident and the action that I took in the services users care plan. I would also make contact |
|with their GP / prescriber for advice if need. |
|On the services users care plan I would record: |
|The medication the service user refused to take. |
|The reason for the refusal. |
|The time of day this occurred. |
|What action has been taken. |
|What was done with the refused dose. |

|Q13. What is your workplace’s policy on client/service user refusing to take their medication? |
|If a client refuses their medication an X will need to be put in the box on the medication sheet. Then on the back of the medication |
|sheet two staff will need to write why the medication was refused and sign it. Then it will also have to be put on the clients |
|contact sheet. The client’s GP will also have to be called and staff will need to tell the GP about the refusal of the medication and|
|the GP will advice if the client’s health is at risk. |

|Q14. What actions do you take in the event of the wrong medication being given? Think about your workplace’s policies and procedures |
|in your answer. |
|If the wrong medication is given to a client advice must be sought immediately from there GP or pharmacist. If the clients GP cannot |
|be contacted then the on call GP will have to be. As soon as the client is at no harm from ill health then the duty officer will have|
|to contact the line manager and give a full debrief. On the back of the clients medication sheet it will have to be put that a |
|mistake was made and if any action or advice that was given, it will also have to be signed by the two staff that gave the wrong |
|medication. The parents or the guardians of the client will have to be informed and to be kept up dated. The client’s social worker |
|will also have to be notified. |

|Q15. The National Care Standards Act (2000) Name three requirements of this act in regard to the safe handling of medicines. |
|The three requirements of The National Care Standards Act (2000) are: |
|Records must be clear, consistent and up to date. |
|The pharmacist who supplies the home with medication works closely with designated officer and helps to maintain records about the |
|current medication for each resident. |
|Only medication supplied for a particular client may be given to that client; medication for a particular client must not be shared |
|with another individual. |

|Q16. Case Study You have joined a care home as a new member of staff. You have had three years experience as a care assistant and |
|have an NVQ level 2 in Health and Social Care. You are working on night duty with another care worker responsible for administering |
|medication for the morning drug round. She decants medication from the drug trolley into plastic pots with strips of paper with the |
|client’s names on. These pots are then left overnight in the kitchen. You know from previous experience that this is bad practice, |
|you have told your superior but she has dismissed your worries. Explain why this is bad practice, what are your responsibilities |
|regarding this matter? Who is accountable and why? |
|All medication must be kept in a locked medication cabinet (as this is bad practice not to do so) and a locked room. All medication |
|must not be left around or prepared in advance, all medication must be prepared when the client is ready to administer and done one |
|at a time. This is because if several medications are prepared early they could easily get mixed up or perish. It is our duty as |
|carers to report any bad practice by reporting to the approiate person/persons as we would be accountable because we know this was |
|happening, and the other care worker would also be accountable for carrying out this bad practice in which could lead to the ill |
|health or even death to the client. |

|Q17. What six things must be included in a confidentiality policy? |
|Your obligations as a carer in respect of client confidentiality. |
|The penalties carers or other staff members will incur for breaching the code of confidentiality. |
|What can be written down about a client. |
|Where the information concerning clients is to be stored. |
|What a client’s rights are in respect of what is written and recorded about them. |
|The rules concerning what information care workers can disclose about their clients when on and off duty. |

|Q18. List the people who may have access to confidential information and explain why? |
|Care Colleagues |
|To ensure continuity of care. This information should be up to date and accurate. |
| |
|Police |
|If they are working directly with the client’s case. |
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|Medical Professionals |
|This list could include GPs, nurses, health visitors, occupational health practitioners, physiotherapists etc. |
| |
|Relatives and Friends |
|They might need or want details of their relatives’ health. If feasible you might obtain your client’s permission to give out this |
|information. Don’t forget – not all families have good relationships. |
| |
|Social Workers |
|If they are working directly with the client’s case. |
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|Courts |
|With a court order when evidence is needed |

|Q19. Who is responsible for giving permission to disclose confidential information? |
|Information about clients is privileged and the client must give permission for information about them to be passed to a third party.|
|If the client is happy that the information can be passed on, then the carer can do so. If, however, the client is incapable of |
|giving consent for the release of confidential information, the carer must seek the advice o a senior person. For instance, it may be|
|that a close relative or solicitor has Enduring Power of Attorney for such clients and their permission will need to be sought for |
|the disclosure of information. |

|Q20. Explain what the following terms mean in regard to confidentiality? |
|Trust |
|In a care situation trust is essential; if a carer does not keep information confidential then there can be no trust between the |
|carer and the client. If there is no trust the client may be unable to express their feeling. The client may become frustrated and |
|this will damage their quality of care. |
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|Safety of information |
|The security of the client’s records. This information is the client’s property. Personal information can be used to exploit and |
|manipulate an individual, and this is why the law protects the security of client records in care situations. |
| |
|Self esteem |
|If clients feel valued and respected they will have a strong belief in their own worth. If carers respect client confidentiality they|
|demonstrate that they value and respect their clients. Valued and respected clients are happier and happier clients. |

|Q21. Is it ever justified to breach confidentiality? Explain why. |
|Confidentiality can be broken when it is clear that keeping confidences may lead to an individual’s welfare or safety to be at risk, |
|or if a criminal action has been committed. |

|Q22. What should you do if the client states they wish to see their own notes/medical records? |
|Under the Access to Health Records Act and the Data Protection Act the client has the legal right to know what has been written about|
|them in their files or recorded, so if they wish to see their own notes/medical records then they have a right to do so. |

|Q23. Access to Health Records Act (1990) |
|Data Protection Act (1998) |
|Briefly explain what you understand the requirements to be for both these acts. |
|Access to Health Records Act (1990) |
|This is an act to establish the right of access to health records by the individuals to whom they relate and other persons; to |
|provide for the correction of inaccurate health records and for the avoidance of certain contractual obligations and for connected |
|purposes. |
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|Data Protection Act (1998) |
|This act sets rules for processing personal information and it applies to paper records as well as data that is held on computers. |
|The main requirements that this act states is that all data held in respect of any individual must: Be secure at all times. Not be |
|kept for longer than is necessary. Be fairly and lawfully processed. Be accurate. Not be transferred to other countries without |
|adequate protection. Be processed in line with people’s rights. Be processed for limited purposes. Be adequate, relevant and not |
|excessive. |

Unit 2
Medicines supply, storage and disposal

|Q1. What are the four acts of legislation that you need to know about in regard to the safe administration of medicines? |
|The four acts of legislation that you need to know about in regard to the safe administration of medicines are: |
|Health and Safety at Work Act (1974) |
|The Medicines Act (1968) |
|The Misuse of Drugs Act (1971) |
|The Care Standards Act (2000) |

|Q2. What dose COSHH mean? What must an employer do in regard to this? |
|COSHH means Control of Substances Hazardous to Health Regulations (1999). |
|With regard to this the employer must take all reasonable measures to protect their employees from the potentially dangerous |
|substances or materials that the employee may come into contact with at work. An employer’s failure to act on these regulations is |
|likely to result in prosecution. |

|Q3. Are there hazardous substances where you work? List 4 examples. |
|In my place of work four of the hazardous substances are: |
|Cif Cleaning Cream |
|Toilet Duck 3 in 1 Cleaner |
|Flash All Purpose Floor Cleaner |
|Hob Brite Ceramic & Halogen Hob Cleaner |

|Q4. How would hazardous substance be stored where you work? |
|In my place of work all hazardous substances are stored in a locked COSSH cupboard. All medication is stored in a locked medication |
|cupboard. |

|Q5. What is the name of the person responsible for ordering, storing and receiving medicines in a care home? |
|In a care home the name of the person responsible for the ordering, storing and receiving medicines is the ‘designated officer’. |

|Q6. What is meant by ‘Controlled Drugs’? Give 6 examples. |
|Six examples of controlled drugs are: |
|Ritalin |
|Methadone |
|Morphine Sulphate |
|Diamorphine |
|Fentanyl |
|Oramorph |

|Q7. Define the role of the ‘designated officer’ in a care home. |
|The role of the ‘designated officer’ in a care home is that they take responsibility for the ordering, storage, and receipt of |
|medications and checking all the details of the medication e.g. drugs, clients name, details, dose etc. |

|Q8. Who administers medicines where you work? |
|In my place of work there are two people who can administer medicines and they are: |
|The Registered Officer |
|The Designated Officer |

|Q9. Who administers controlled drugs in your workplace and where are they stored? |
|In my place of work there are two people who can administer controlled drugs and they are: |
|The Registered Officer |
|The Designated Officer |

|Q10. What is meant by the following and what are the main features of each one? |
|Medicines Act (1968) |
|The local retail pharmacist is the person given responsibility for supplying medication to care homes. The pharmacist can only do |
|this on receipt of a prescription from an authorized person e.g. a GP or a district nurse. |
| |
|The Administration and Control of Medicines in Care Homes and Children’s Homes Act (1971) |
|It’s to record all the medication used in the care homes, safe practice of medication to appoint a register or designate a designated|
|officer and relates to the receipt and storage and administration of medicines. |
| |
|The Misuse of Drugs Act (1971) |
|It regulates the use of medicines that are potentially addictive and, therefore, classed as ‘dangerous’. These drugs are known as |
|controlled drugs (or CDS). They require strict legal control. |

|Q11. Explain the process that happens when a supply of medicines is required by a care home? |
|The process that happens when a supply of medicines is required by a care home is: |
|A prescription renewal is obtained from the designated officer and sent to the GP. |
|The GP will authorize the prescription. |
|The prescription is then forwarded to the local pharmacist for dispensing or returned to the care home from where it is taken to the |
|local pharmacist. |
|When the drugs are delivered the designated officer must check that the supply is the same as ordered. Any discrepancies must be |
|referred back to the pharmacist. The drugs must be stored in the correct manner for that place of work |

|Q12. Explain the policy of your workplace with the pharmacist when medication is delivered. |
|In our care home we go to the GP surgery with a repeat prescription for the drugs required then to the pharmacist in which is in the |
|surgery. We then arrange a time to collect the medication. The pharmacist makes sure that the medication is labeled with all the |
|relevant details. Name of mediation, dose, name of client and date checked. |

|Q13. What is the role of the pharmacist in dispensing medicines to a care home? |
|The local pharmacist will dispense the medication once they have received the authorized prescription. The pharmacist will then |
|prepare the medication for the collection or, in some cases, will have arranged to deliver the medication directly to the care home. |
|The pharmacist will check the medication and run through a check list. |

|Q14. What 10 things must be provided by the pharmacist when medication in containers is dispensed? |
|Ten things that must be provided by the pharmacist when medication in containers is dispensed are: |
|Name of drug |
|Dosage |
|Amount of the drug to be taken |
|Name of the recipient |
|When the drug should be taken |
|Route of administration |
|Special instruction |
|Warnings or cautions |
|Name of pharmacist |
|Use by date, keep out of reach of children |

|Q15. What dose MAR means? |
|MAR means Medication Administration Record. When a doctor or nurse prescribes medicine for a particular client that information is |
|immediately recorded on the clients MAR sheet. |

|Q16 What does the term ‘client specificity’ mean? |
|The term ‘client specificity’ means only those medicines prescribed for a specific client must be used by that client. |

|Q17. When a medication order arrives at the workplace what information should be recorded in a care home? |
|All the medicines arriving in a care home must be checked and recorded by the designated officer. The care home records must show the|
|following: |
|Dates of receipt |
|Names and strength of the medicines |
|Quantity received plus and carried over from previous cycle |
|Residents for whom the medicines have been prescribed |
|Signature of the staff member who received the medicines |

|Q18. How should medicines be stored? List 3 examples. |
|Medicines should stored in: |
|The drugs trolley |
|The medicine cupboard |
|The medicine fridge |

|Q19. What is the ideal storage area for medicines in a care home? |
|The ideal storage area for medicines in a care home is a room which cannot be accessed from the outside. If this is not possible, |
|then bars at the windows of the storage room must be installed. |

|Q20. What must be stored in the allocated room? |
|The things that must be stored in a allocated room is the: |
|medicine trolley |
|controlled drugs |
|drugs fridge |
|all lotions |

|Q21. Records of receipt, storage, disposal and administration of medicines are very important, explain why. |
|It is important that records are kept are kept relating to the receipt, storage, administration and disposal of medication for the |
|safety of the client, the care home. The care home has to act within The Medicines Act (1969) and Misuse of Drugs Act (1971), The |
|Care Standards Act (2000). It is also a good safe working practice and it also prevents any misuse or accidents with medication. |

|Q22. In a hospital where would controlled drugs be stored? |
|In a hospital the controlled drugs are stored in a cupboard-within-a-cupboard which is mounted on a wall. On opening the inner |
|cupboard an alert light is displayed at the nursing station and on the cupboard itself. |

|Q23. What procedure must be followed when administering controlled drugs? |
|The procedure that must be followed when administering a controlled drug is that two carers must check the drugs name, date and |
|expiry and the dose. Then calculate how much medication remains for the client, then the register is then updated and both of the |
|care staff has to sign and check. |

|Q24. In order to reduce the risk of errors when dispensing medication what checks must be done? |
|The medication checks that should be done when dispensing medication are the drug’s name, date of expiry and dosage and must then |
|calculate how much medication remains. |

|Q25. What type of medicines should be stored in a medicines fridge and why? |
|Some of the types of drugs that should be kept in a medicine fridge are medicines like Antibiotics and insulin. If these are not kept|
|at a set temperature they can lose their effectiveness. |

|Q26. Give some examples of drugs that should be kept in a fridge? |
|Some drugs that should be kept in a fridge are drugs like: |
|Antibiotics |
|Insulin |
|This is because they can lose their effectiveness if not kept cool. |

|Q27. What is the procedure for the safe disposal of drugs? Who is involved? |
|The procedure for the safe disposal of drugs is that the drugs need to be taken back to the pharmacy and the pharmacist will dispose |
|of them safely. |

|Q28. What should happen to unused medication? Why is this important? |
|Any unused medication well need to be taken to the pharmacy for the pharmacist to safely dispose of them and this is important |
|because keeping any unused medication can make greater risk of an accident or misuse of the medication. |

|Q29. Why would unused drugs have to be disposed of? |
|Any unused drugs have to be disposed of to avoid any misuse or any accident in the care home. |

|Q30. What is the procedure when a client passes away and you need to dispose of their medication? |
|When a client passes away their medication should be kept in the care home/unit for seven days, once seven day are up then the drugs |
|should be returned to the pharmacist, this is just in case there is a coroner’s inquest. |

|Q31. What happens to spillages and spoiled medicines? What is the policy where you work? |
|In my place of work the policy when a spillage or spoiled medicines occur we have to put the tablet into an envelope and return it to|
|the pharmacy and ask for a replacement and tell them why we were returning the medication. |

|Q32. If dispensing from a monitored dose system and a spillage occurs, what should you do? |
|If dispensing from a monitored dose system and a spillage occurs the care home would need to ensure that a replacement was obtained. |
|In returning the medication to the pharmacy the designated officer can indicate that a replacement is needed and this will be quickly|
|supplied. |

|Q33. How do you monitor expiry dates where you work? |
|In my place of work we monitor expiry dates of medication by checking every day and every time we use a medication the expiry date on|
|the box and on tablet strip before administering to the client. In my place of work we do this twice a day. |

|Q34. Why should you not use medicines beyond its ‘sell by’ date? |
|You need to use medicines by their sell by date because once past they are likely to develop harmful bacteria that may cause the |
|client harm or ill health. |

Unit 3
Medications and Prescriptions

|Q1. What does the Committee on Safety of Medicines do? What is their role and responsibility to the public? |
|The Committee on Safety of Medicines review the safety of medicines that are available to the public. |

|Q2. What doses N.I.C.E stand for and what is their function? |
|N.I.C.E stands for The National Institute for Clinical Excellence and their function is that they recommend what medications doctors |
|can prescribe on the National Health Service. |

|Q3. What legislation applies directly to care settings? List 3 examples. |
|1. Medicines Act 1968. |
|2. Misuse of Drugs Act 1971. |
|3. Misuse of Drugs (Safe Custody) Regulations 1973. |

|Q4. What is the policy where you work for the safe handling and administration of medicines? Attach a copy of this policy if you have|
|it? |
|The Manager/ Duty Officer is responsible for the administrating the medication, all medication must be correctly labled with the |
|doctor’s prescription and initially accompanied by consent forms, the medication cabinet must be locked at all times and the key is |
|to be held by the Duty Officer and two people (staff) to check medication quanty and dates, and two staff to record written |
|administered and ordered. |

|Q5. Give four examples of classifications of medicines and give an example of each one. |
|The four classifications of medicines are: |
|1. Antibiotics - Penicillin |
|2. Analgesics - Paracetamol |
|3. Antidepressants - Prozac |
|4. Other drugs - there are many types of other drugs available for example cardiac problems are treated with a group of drugs that |
|slow down and steady the heartbeat. |

|Q6. List seven examples of drugs from the ‘other drugs’ classification. |
|1. Antacids |
|2. Insulin |
|3. Steroids |
|4. Laxatives |
|5. Diuretics |
|6. Hormone Replacement Therapy |
|7. Anti-coagulants |

|Q7. What is meant by homely remedies? Give 3 examples. |
|Homely remedies are simple remedies that can be given to a client without having to be prescribed and can be bought from the |
|pharmacist. For example: |
|1. Glycerine and lemon |
|2. Cod Liver Oil |
|3. Evening Primrose |

|Q8. How are these remedies recorded? |
|Homely remedies have to be record that they have been given in the same way as you would when administering a prescribed medication. |

|Q9. What dose ‘approved name’ mean? |
|The approved name is the pharmaceutical term or what is known as the generic name for a drug. |

|Q10. What dose ‘proprietary name’ mean? |
|The proprietary name is the brand name for that particular drug. |

|Q11. Where can you get information to help you to find out about drugs? Give three examples. |
|You can get information to help you find out about drugs from three main sources, which are: |
|1. Information that is supplied with the drug. |
|2. Reference information. |
|3. Client information. |

|Q12. What two publications provide key information on choice, prescription and administration of drugs? |
|The British National Formulary (BNF) is an excellent book that provides key information on choice, prescription and administration of|
|drugs and the other publication is the Monthly Index of Medical Specialties (MIMS). This is also a good book that gives you this |
|information. |

|Q13. Where are there other sources of information about medicines? |
|The other sources of information about medicines can be found at your local pharmacist and your GP’s surgery. |

|Q14. List 6 painkillers/analgesics that can be bought at a chemist or supermarket. |
|Anadin |
|Paradol |
|Nurofen |
|Sudafed |
|Sinutab |
|lemsip |

|Q15. From your list above note down the proprietary and approved or generic name of each drug. |
|Anadin = Aspirin |
|Paradol = Paracetamol |
|Nurofen = Ibuprofen |
|Sudafed = Phenylephrine |
|Sinutab = Paracetamol Phenylpropanolamine |
|Lemsip = Paracetamol Phenylepltrine |

|Q16. Look up the following drugs and complete the answers. |
| |
|Drug |
|Dose |
|Frequency |
| |
|Ampicillian |
|250mg |
|125mg – child up to 10 years |
|Every 8 hours or doubled in severe infection |
| |
|Lactulose |
|15ml initially |
|2-5ml child under 1 year |
|5ml 1-5 years old |
|10 ml 5-10 year old |
|Twice daily |
| |
|Brufen |
|200mg tablets |
|100ml syrip |
|600ml granules |
|As directed on packaging |
| |
|Anusol |
|1 x suppository |
|1 at night 1 in the morning 1 after bowel movement. |
| |
|Canestan |
|Apply to affected area 1% |
|2 to 3 times daily |
| |

|Q17. Complete the following answers in the table, showing the different ways that medication can be dispensed. Some can be dispensed|
|in more than one way. Ask your manager for a copy of BNF or MIMS to help you. Place a tick in the appropriate box. |
| |
|Name Of Drug |
|Tablet |
|Syrup / |
|Inhaler |
|Injection |
|Patch |
|Topical |
|Spray / |
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|Powder |
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|Drops |
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|Dispirin |
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|Becotide |
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|Calpol |
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|Pirton |
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|Diamorphine |
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|Insulin |
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|Flixonase |
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|Otrivine |
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|Fematrix |
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|Amoxycillin |
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|Betnovate |
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| Nurofen |
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|Q18. Give three examples of information that a client should know about their medication. |
|Three examples of information that a client should know about their medication are: |
|The medications that have worked for them in the past and those which have not. |
|Their adverse side effects to a specific medication. |
|Their allergic reaction to a specific medication. |

|Q19. List 10 ways in which medication can be prescribed. |
|Ten ways in which medication can be prescribed are: |
|Tablets |
|Liquids |
|Suppositories and Pessaries |
|Inhaled |
|Drops / Sprays |
|Ointment |
|Ear Drops |
|Nasal Preparations |
|Transdermal |
|injections |

|Q20. What dose prescription mean? |
|A prescription means a written instruction to a pharmacist to dispense the medicine that is indicated on it. |

|Q21. Who has the authority to write a prescription? |
|The only persons that have the authority to write a prescription are qualified professionals like doctors, dentists and some |
|specially trained nurses. |

|Q22. What information would you expect to find on a Prescription? |
|The information that you would expect to find on a prescription would be the date, the full name, address and date of birth of the |
|client, the dose and the dose frequency of the medication. It will have to be signed in ink by the prescriber. |

|Q23. Name three methods of administering medication by injection. |
|The three methods of administering medication by injection are: |
|Intra-muscular (into the muscle) |
|Intra-venous (into a vein). |
|Subcutaneous (under the skin). |

|Q24. Is there a type of injection that can be administered by a trained care worker? If so what is it? |
|The type of injection that can be administered by a trained care worker is Subcutaneous (under the skin) |

|Q25. Mr. Jones is 74 years of age, he is prescribed the following medication; Prozac, Betnovate, Stemitil, Thyroxine. For each drug |
|answer the following questions using a copy of BNS or MIMS to help you. |
|What form can the above medicines take? |
|Prozac = Capsules, Liquid |
|Betnovate = Cream, Ointment, Lotion scalp application |
|Stemetil = Tablets, Syrup, Suppositories, Injections |
|Thyroxine = Tablets |
| |
|What strengths do they come in? |
|Prozac = 20mg, 5ml |
|Betnovate = Potent and Moderately Potent 1% |
|Stemetil = 25mg, 100ml, 5mg |
|Thyroxine = 100 – 200 Micrograms |
| |
|For what medical conditions would they be prescribed |
|Prozac = Depression |
|Betnovate = Sever inflammation skin disorders |
|Stemetil = Nausea, Vertigo, Vomiting (severe) |
|Thyroxine = |
| |
|Mr. Jones tells you that his medication is not helping him and refuses to take them what should you do? |
|If Mr. Jones told me that his medication in not helping him and refuses to take them any more I would explain to him that the |
|medication takes a while to work and explain to him that he will see an improvement and get his GP to speak to him. I would ask him |
|if he is having difficulty in taking the medication and offer to call his GP for a possible different form. |

|Q26. In a clients care plan what nine things would you expect to be able to find? |
|In a clients care plan the nine things that you would expect to be able to find are: |
|Name, age, medical condition |
|Any daily changes |
|Medication |
|Drug allergies |
|Ability |
|Mobility |
|Weight |
|Preferences |
|Religion |

|Q27. Why is it important to keep details of a client up to date on their care plan? |
|It is important to keep the details of the clients care plan up to date as its to ensure that the doctor or carers know what drug |
|allergies or any special condition that the client may have and also for the clients best welfare. |

|Q28. If as a care worker you need to provide information about a change in a client’s condition to a doctor or nurse, what |
|information will you need to provide them with? List five items. |
|If I needed to provide information about a change in a clients condition to a doctor or a nurse, the information that I will need to |
|provide will be: |
|what the clients symptoms are, any change |
|are they experiencing and pain or discomfort |
|any change in sleeping Patten |
|eating problem |
|any change of moods or lack of energy |
|any change in toileting or any additional symptoms |

|Q29. If as a care worker you suspect a urinary tract infection in a client, what information should you provide for the doctor to aid|
|them in diagnoses and treatment? |
|If I suspected a client had a urinary tract infection the information that I should provide to the doctor to aid them in a diagnoses |
|and treatment would be: |
|the amount of urine by keeping record |
|the quantity and colour |
|take a sample to the doctor or nurse |

|Q30. What are the common side effects of antibiotics? |
|The common side effects of antibiotics are: |
|Skin rashes |
|Diarrhea |
|Nausea |
|Vomiting |

|Q31. What would you do if you suspected a client had an adverse reaction to their medication? |
|If I suspected that a client had an adverse reaction o their medication I would immediately report and condition. I would not |
|administer any more of the medication and consult my manager and speak to the clients GP id not then the on call doctor and I would |
|record all the findings. |

|Q32. What is the procedure if a client refuses their medication? |
|If a client refuses their medication I would not insist that they should take it. I would seek the guidance of someone in authority |
|and I would record the incident and the action that I took in the services users care plan. I would also make contact with their GP /|
|prescriber for advice if need. |

Unit 4
Quality Assurance and Record Keeping

|Q1. With regards to medication why do care homes/ agencies need to implement quality assurance and audit procedures? |
|It is a legal and safe requirement, it helps to maintain good quality of care and quality control, to ensure caring for vulnerable |
|clients, god means of measuring good and bad practice, to give a very effective way of giving medical care, a clear and safe working |
|practice with respect to The Administration of Medication. |

|Q2. Explain the role of the care standards commission. |
|The role of the Care Standards Commission is to measure the performance of each care home and if the care home’s practices are found |
|to be unacceptable, an action plan is introduced which recommends specific improvements. If the care home does not follow the action |
|plan for the improvements then it will lose it registration and will be closed down. |

|Q3. What are the 4 stages of the audit process? |
|The four stages of the audit process is: |
|Assessment |
|Implementation |
|Measurement and recording |
|Monitoring and action |

|Q4. What is the pharmacist’s role when providing advice to care homes about storage and monitoring of drugs? |
|Pharmacists also have the role about providing advice to care homes about the storage and the monitoring of drugs. |

|Q5. The pharmacist must inspect all documentation relating to medicines and medication, list 7 items that should be included. |
|The 7 items that the pharmacist must inspect within the documentation are: |
|Policies |
|Procedures |
|MAR Sheet |
|Records of ordering |
|Records of receipt of medication |
|Medications that have been transferred out of the home |
|Medications returned to the pharmacy for disposal |

|Q6. What other items may the pharmacist need to check? |
|The other items that the pharmacist may also what to check are: |
|Storage systems |
|Drug rounds |
|Clients who are self-medicating |

|Q7. Why does a pharmacist need to conduct an inspection? |
|Pharmacist need to conduct inspections as they are part of their legal obligation to ensure that the care homes are working in |
|accordance with current legislation regarding drugs and that they are operating safe practices. |

|Q8. Why is it important to keep client’s care plans, records and notes up to date? |
|It is important to keep clients care plans, records and notes up to date as it’s a legal obligation to do so. It is also important as|
|the client’s needs might change and without of date information the needs of the client cannot be met. Also with visiting doctors and|
|nurses who may not know the client well, will need to check their medical records and these must be accurate and up to date. Reliable|
|medical records greatly assist medical professionals in their jobs of diagnosis and treatment. |

|Q9. How is medication recorded in your workplace? |
|In my workplace the medication is recorded by the use of the medicine administration record chart (MAR) and we also keep a record of |
|all the medication given along with the times, dates and to whom in our daily log books. |

|Q10. Information in a client’s medication profile should include; List as many items as you can. |
|The clients name. |
|Date of birth |
|Details of any known sensitivity to medication e.g. penicillin or aspirin |
|Any information provided by the pharmacist on foods etc. that might react with the medication. |
|Names of all medication |
|Dates prescribed |
|Prescriber |
|Quantities |
|Doses |
|Forms |
|Strengths |
|Routes of administration |
|Time to be given |
|Date medicine received |
|‘homely’ remedies taken by client |
|Medications ceased and who authorized this |
|Any conditions that may affect medication being taken |

|Q11. The Royal Pharmaceutical Society has a policy for clients who self medicate, what is this policy? |
|The Royal Pharmaceutical Society’s policy for clients who self medicate states that a record should be maintained of the medicines |
|given to a self-administering service user, including the date and signature of the responsible care worker. This information will |
|assist staff to monitor compliance with therapy. |

|Q12. What is the procedure to follow when giving medication to a client? |
|The procedure to follow when giving medication to a client is that you must observe the client actually taking the medication. You |
|must not leave the medicine with the client assuming that they will take it later. You must only sign a prescription chart saying |
|that the client has taken the medication if you know that they have done so. If the client does not take the medication it must be |
|clearly documented in their records. The medication in my workplace is always given in pairs. |

|Q13. In your workplace what is the policy for recording errors in the administration of medication? |
|In my workplace the policy for recording errors in the administration of medication is that advice must be sought immediately from |
|the GP or pharmacist if the error is a wrong tablet / dose etc. The manager / Duty Officer should inform the line manager. If the |
|medication has not been signed for, it needs to be followed up immediately. If it is then confirmed that the medication was given, a |
|note of this needs to be written on the back of the client’s medication sheet. Medication must not be signed for in retrospect. |

|Q14. Records need to be easily understood by people who need to consult them e.g. doctors, nurses, and care workers. What are the |
|principles for good record keeping? |
|The principles for good record keeping are that they must be clear, accurate and up to date. The principles can be put into bullet |
|points, which are: |
|Understandable and coherent |
|Accurate |
|Up to date |
|Written as soon after the event as possible |
|Sighed |
|Legible |
|The language used shows respect towards the client |

|Q15. There are three fundamental things to consider when ensuring accurate records are completed, what are they? |
|The three fundamental things to consider when ensuring accurate records are completed are: |
|Write legibly and in permanent black ink-pencil can be erased. |
|If you make a mistake cross it out and initial it. |
|Sign and date and indicate time if this is appropriate. |

|Q16. What are the requirements of the National Care Standards Commission in relation to record keeping? |
|The requirements of the National Care Standards Commission in relation to record keeping is that it requires care homes records and |
|documents to be kept to a specific, legal standard. |

|Q17. Explain what ‘access to health records’ means and does it give the right to the client to view their own records? |
|The access to health records means that it gives all care home clients the right to access their own records. The clients should be |
|able to read, understand and enjoy what you have written about them and what you do for them. |

Unit 5
Safe Administration of Medication

|Q1. What do the following terms mean? |
|intra-ocular |
|These are eye preparations that are instilled in the case of drops or applied in the case of ointments. |
| |
|intra-aural |
|These are drugs that are instilled via the ears. |

|Q2. List four routes for the administration of medicines. |
|Inhalation |
|Intra-Muscular |
|Sublingual |
|Rectal/Vaginal |

|Q3. Describe the special precautions that need to be observed when administering medication by the following routes? |
|Oral |
|When giving out tablets you must always check the instructions e.g. some might be taken on an empty stomach and some must be taken |
|with food. |
| |
|Inhalation |
|You need to administer the correct dose of medication which is measured by the amount of puffs specified by the doctor. |
| |
|Rectal/Vaginal |
|The client or carer must always wash their hands before and after the procedure and always wear disposable gloves, and it’s very |
|important to maintain the client’s dignity. |

|Q4. Explain the process for giving the following. |
|Pessary |
|For vaginal pessaries the client should lie on their back with their knees bent up and slightly apart. The pessary is then inserted |
|readily into the vagina. |
| |
|Suppository |
|For suppositories the client needs to lie on their side with their knees bent up. The suppository can then be easily inserted into |
|the rectum. There is often a difficulty in retaining the suppository since stimulation of the rectum causes an urge to empty the |
|bowels. This possibility must be considered and a bedpan or commode should be readily available. |
| |
|Subcutaneous medication |
|Subcutaneous injections place drugs into the fat layer under the skin. This is done with a small fine needle and is less painful than|
|an intra-muscular injection. Some of your clients may carry this out themselves or a district nurse or a senior member of the care |
|may do this for them. Who gives such medication will vary according to your clients and the type of organization in which you work. |
| |
|Topical cream or ointment |
|The topical application of creams should be applied in the manner specified on the instruction sheet contained within the pack. Some |
|creams have to be applied in a thin film and left, but others may need to be well rubbed in. Again in these cases, hands should be |
|washed before and after application and carers should wear disposable gloves. |

|Q5. Name two routes of administration that can only be carried out by a doctor or trained nurse. |
|The two routes of administration that can only be carried out by a doctor or a trained nurse are Intravenous and Intra-muscular. |

|Q6. Identify which are true or false by circling correct answer. |
|You should only give medicine that has been prescribed for that particular person. |
|True / False |
|Medication must not be shared between clients. True / False |
|Always observe the sell by dates on medication. True/ False |
|Out of date medication can develop harmful bacteria. True/ False |
|Carers can use cotton buds to aid the flow of ear drops. True / False |

|Q7. What dose MDS stand for? Describe what it is used for. |
|MIDS stand for Monitored Dose Systems. Some MIDS involve tablets or other oral medication (not liquids or soluble medication) being |
|produced in blister packs for easier dispensing by the client or the carer. |

|Q8. Describe the NOMAD system of medicine administration. |
|The NOMAD system consists of a medication box in which compartments containing medication doses are arranged in days of the week and |
|with the times for the dispensing of medication clearly indicated. A tablet or capsule is placed in each compartment and the client |
|or carer can then take or dispense the medication at the time specified on the box. |

|Q9. List the drawbacks of using a drug administration system. |
|The drawback of using a drug administration system can be |
|That it may not be suitable for all medication; |
|It can be cumbersome |
|Can result in mistakes. |

|Q10. List six examples of drug unsuitable for use with MDS’ or NOMADs. |
|Soluble or effervescent tablets |
|Gaviscon tablets |
|Epilim |
|Glyceryl Trinitrate |
|Magnesium Trisilicate tablets |
|Ear and eye drops |

|Q11. Which members of staff are involved in dealing with medicines in a workplace? |
|In a workplace the members of staff that are involved in dealing with medicines is the designated person and a second person. All |
|staff members are involved when they are the designated person and a second person. |

|Q12. Describe the medicine administration system in use in your workplace. |
|The medicine administration system in use in my workplace is: |
|Check clients details |
|check recording |
|check dates |
|times of medication |
|correct medication & amount |
|check if already had |
|2 x people to check & sign |
|Check has taken |
|Record immediately |
|Sign & date record |
|Record any side effects |

|Q13. What could happen is this system was not followed? |
|For the client |
|If this system was not followed the client could become ill or even die. |
| |
|For the care worker |
|If this system was not followed the carer could be dismissed and even prosecuted, it is in the carers contract to ensure safe |
|handling & administration of medication and to comply with the Care Standards Act (2000). |

|Q14. What is the policy of your workplace with regard to staff training for dealing with medication? |
|The policy of my workplace with regard to staff training for dealing with medication is that we meet the mandatory requirement for |
|the post that we are in and that we do all the nesscersey training required, inc this NCFE level 2 certificate in Safe Handling of |
|Medicines. |

|Q15. When giving out medication what must you always check? List 6 points |
|The name of the client. |
|The name of the drug. |
|The dosage. |
|Special instructions/warnings/cautions |
|Expiry date. |
|Quantity dispensing. |

|Q16. What is the purpose of a MAR (medicine administration record)? |
|The purpose of the MAR sheet is to inform you about specific information concerning the medication that each client has been |
|prescribed. |

|Q17. If you stop a course of medication, if a client has a reaction for example, who would you inform immediately? |
|If you stop a course of medication and the client has a suspected adverse reaction you must immediately inform the senior member of |
|staff on duty and the clients GP and tell them your reasons/actions for doing so. |

|Q18. List ten items of information that should be included in client’s MAR sheet. |
|Name of the client. |
|Date of birth. |
|Prescribed medication |
|Dosage. |
|Strength of the medication. |
|Frequency with which the medicine must be taken. |
|Page number, for example 1 of 2, 2 of 2. |
|Special instructions. |
|Start and completion dates for the taking of the medicine ( this is particularly important in the case of antibiotics where a course|
|of medication is usually prescribed for a specific number of day) |
|Any known allergies. |

|Q19. What action should you take if a client refuses medication? |
|If a client refuses to take their medication you must not insist that their should take it. Then you should record that they refused |
|their medication and report the it to your senior member of staff who will take it down the right channels. You will then need to |
|contact the clients GP and let them know and to see if there is any ill affects that you should know about. |

|Q20. Why should medication only be prepared by a carer who has been trained to do so? |
|The medication needs to only be prepared by a carer who is trained in doing so as all carers are accountable for their actions and if|
|a carer makes a mistake in giving out medication they will be held accountable for their mistake. |

|Q21. What checks should you consider before dispensing medication to a client? |
|There are five checks that you should do before dispensing any medication to a client and there are: |
|The clients name is there and correct. |
|The name of the medication. |
|The dosage prescribed. |
|That the medication is in date and, having given the medication. |
|Have you recorded having given the medication. |

|Q22. What is the procedure to be followed when giving medication? |
|When giving medication you will need to ensure: |
|You wash your has as necessary. |
|You have identified the correct client. |
|You have the MAR sheet. |
|You have the correct drug. |
|The drug is being given at the right time. |
|That the drug has not already been given already. |
|That all special instructions are followed (e.g. with food or on an empty stomach) |
|That the client has a drink with which to take the tablet. |
|That the client is in a position that will enable them to safely take the medication. |
|That the client has taken the medication. |
|That you record immediately and sign the prescription record. |
|You notify any side effects observed and record immediately. |

|Q23. Medication comes in a variety of doses, why is it important to differentiate between micrograms and milligrams? |
|It is important that you can differentiate between micrograms and milligrams so as to ensure that no mistakes are made. For example |
|an overdose of medication. |

|Q24. Why is it important to identify clients before giving medication? How would you ensure the correct person is given medication? |
|It is very important to identify the client before giving any medication to them as the wrong medication may be given to the wrong |
|client which in turn may put that client to ill health or even death. |
|To ensure that you are giving the right medication to the right client, a photograph of each client will need to be attached to their|
|MAR sheet. |

|Q25. Why is a name band not appropriate in a care home? |
|Name bands are not appropriate in a care home as the care home is the clients home, also the clients in a care home do not change a |
|rapid as clients in a hospital would do. The care staff on the whole stays the same in a care home. |

|Q26. What actions should be taken is an error is made in giving medication? |
|If an error has been made in giving medication you should ask your manager to check the client then you will need to tell the client |
|what has happened. Once you have done this you will need to seek medical advice from the clients GP, if the clients GP cannot be |
|reached then you will need to call the on call GP. You will then have to Inform your employer or the home manager and complete the |
|correct forms, e.g. accident book. A record of what had happened will need to be kept on the clients care plan. Once this is done you|
|will then have to inform the client’s relatives and let them know what had happened. A report will have to be filled out and sent to |
|the registration authority. |

|Q27. Why should you always obtain a clients informed consent prior to any dispensing of medication? |
|You should always obtain a clients informed consent prior to dispensing of any medication as it is a legal requirement, there is |
|exception to this rule. In order to make any informed choice the client needs to know full information about the drugs being |
|prescribed for them. |

|Q28. What do the following terms mean? |
|PRN- whenever necessary or as required. |
|AD LIB- to the desired amount. |
|PC- after food. |
|QDS- four times daily |
|STAT- at once |

|Q29. Give an example of PRN medication. |
|An example of a PRN medication is Asprin. Which we all take for a variety of minor aches and pains. |

|Q30. If a client appears to be in pain and may need PRN medication, what five points do you need to check before giving the client |
|medication? |
|The five points that needs to be checked before giving PRN are: |
|Find out whether the client has already been prescribed any PRN medication. |
|Find out how bad the pain is and whether the client feels they need a drug. |
|Find out what the pain is - is it a new pain or an old pain. |
|Find out when medication was last given and if the correct time has elapsed between dose. |
|Talk to your manager about giving the medication and document in the client’s care plan the outcome of your discussion. |

|Q31. What documentations sets out guidelines for administration of medicines by elderly people? |
|Administration and Control of Medicines in Care Homes and Children’s Services, June 2003. Is the documentations that set out |
|guidelines for administration of medicines by elderly people. |

|Q32. What is one of the aims of the Care Standards Act in relation to the administration of medicines? |
|One of the aims of the Care Standards Act is that all clients, if they are capable should be encouraged to self medicate. |

|Q33. What are the main benefits for clients of self medication? |
|The main benefit for a client who is self medicating is that it will preserve their independence and it helps them to retain their |
|identity and sense of self worth. If the clients are in short term care it will prepare them to return to the community where they |
|will look after their own medication. |

|Q34. List the factors that must be considered if a client wishes to self medicate, are they capable of safely doing so? |
|The factors that are considered before the client is able to self medicate are: |
|Is the client able to read the labels on the bottles/boxes. |
|Can the client open the containers. |
|Dose the client understand what the medicine if for. |
|Dose the client understand the special instructions (if any) to be followed. |
|Dose the client understand the dose to be taken. |
|Is the client aware of the need to check for possible side effects of their medication. |

|Q35. What are the conditions necessary for a client who wishes to self medicate? |
|In order for a client to self medicate an assessment will have to be done first, then the conditions are: |
|The client will need a lockable cabinet in which they can store their medication. |
|The client must have a key to the cabinet. |
|The client must give their written consent stating that they are undertaking to self-administer their own medication. |

|Q36. What are the guidelines regarding record keeping for clients who are self medicating? |
|With a client who is self medicating he/she is responsible for taking their own medicines and an administration record need not to be|
|kept by the staff. If we order or if we receive any of the medicines for the client then a record of medicines that are received by |
|us may be kept. If we have received the medication from the chemist, a record of us transferring the medication to the client |
|including the date time must be kept. |

|Q37. What is your workplace’s policy for self medication? |
|If a client wishes to self medicate, the duty officer on duty must ensure that all the medicines that are held by the client are |
|being used solely for that reason. The duty officer should note any occurrence or any change in the arrangement of self |
|administration of medicines, e.g. illness, deterioration of the mental state of the client. If the duty officer on duty feels that |
|the client can no longer self medicate then he/she should confer with their GP if possible or temporarily remove the medicines until |
|that is possible. |

|Q38.a) If a client wishes to self medicate but suffers with sever osteoarthritis and is wheelchair dependant, will this be a problem?|
|Why? |
|With a client who suffers with sever Osteoarthritis and is wheelchair dependant it may cause a problem if wanting to self medicate |
|for a number of reasons. |
|The client may not be able to open the containers. |
|The client may not be able to read the labels. |
|Can the client get to the medication in the drug cabinet . |
|The client who is self medicating should be carefully monitored and any difficulties should be reported. It may be necessary to |
|reassess the client’s suitability to self-medicate but also giving as much independence to the client. |

|Q38.b) What effects physically or psychologically could the client experience if not allowed to self medicate? |
|If the client is not allowed to self medicate then it may take their self-worth and independence away and may bring on depression. |
|The client could also become too depended on the staff. |

|Q39. List 6 possible adverse side effects a client may experience when taking a prescribed drug? |
|Nausea |
|Vomiting |
|Diarrhoea |
|Constipation |
|Headache |
|Dry Mouth |

|Q40. If a client has an allergy to a particular medication, or has had a previous adverse reaction, list four points you should |
|follow to maintain client safety. |
|Record the information about the drug(s) that the client is allergic to on the care plan and the prescription. |
|Obtain a medic alert bracelet or other warning identification for the client. |
|Inform the client’s doctor about known allergies. |
|Inform all other care staff of suspected allergic reaction. |

|Q41. Describe what a ‘severe adverse drug reaction’ is. |
|A severe adverse drug reaction is a serious physical side effect to a medicine. |

|Q42. List three symptoms of a severe side effect of medication. |
|The client may develop swelling of the hands face and body. |
|The client may have reddening of the skin, sweating, blotches or a feeling of faintness. |
|The client may have difficulty with their breathing. |

|Q43. What would you do if a client experiences an adverse reaction to medication? |
|If a client experiences an adverse reaction to medication I would: |
|Alert my manager and immediately contact the prescribing doctor. |
|Observe the client closely |
|Document the effects of the drug |
|Treat the current symptoms. |
|I would record the adverse reaction in the client’s records. |