DDA's S8

"Websterpack are designed for self adminstration, if the resident can't take the drugs out of the pack themselves then they require medication administration by a Div 1 or Endorsed Div 2." <--- All Medication in Aged Care Facilities here in SA is packed in a webster or some form of webster system. To enable PC's and EN's to administer medications.

I think PCA's are great but they are PCA's not nurses, and should not be put in that role, <---- The way the nursing shortage is going the new Cert III that is reuqired by PCs to get work in aged care is the old EN course. So PC's that are finishing off there study course, are able to give meds and do a lot of general basic nursing duties. Depending on where you work and I only speak for SA here, depends on what ur job entails,. I go to some places where Iam in charge, doing the meds, wounds, supervising care staff, doctors visits, and so on. Other places Iam a carer and attend to ADL's and Personal Care.

No point in a PCA counter signing anything, they have no understanding of what the drug really is. <---- I fully agree with the point of why counter sign for a S8 when you dont know what it is, but it still happends, go to a Nursing Home, and you have the RN asking PC's to counter sign and 8/10 times the PC has no idea what they are signing, or if a dug calc has to be worked out it is generally only the RN doing the calc and the PC taking the RN's word bout it.

Aaron

Just on this issue there was a hostel that just tried to sack 30 rndiv2's because PC are cheaper and can do meds. I think the system of Governmnet sucks in allowing this to occur. As I said before PC has its place and so does Nurses but when the lines are blurred it causes havoc.

Geez I really don't think I would get old and go into any home, you just don't know who is looking after you.

As for all meds being packed into self admin systems thats a danger in its self, massive amount of mistakes have occured using those systems. I spend a good 3 hours a night rechecking webster paks for a 106 residents multi-packs and at least 1/3 are wrong, each time they come up for the new week. And its painful when they change drugs on you without sending the updated forms. If I had a dollar for everytime that happened I wouldn't be working nights. LMAO

Sorry bad day at the office, my rant has now finished and I will go and get coffee.

This is an ongoing issue in aged care.

I will refer you to the Guidelines for Medication Management in residential Aged Care Facilities

“For residents who are not self-administering, medication administration should be

undertaken by a registered nurse or authorised enrolled nurse. If a registered nurse

or an authorised enrolled nurse is not available, it is recommended that the facility

provide medications in dose administration aids. In all cases, medication should only

be administered by qualified or suitably trained staff.” (page 10)

Further, when you refer to page 24 in the Manual, medications must be administered by a registered nurse in a nursing home. You’ll find that in low care facilities eg hostels, PCAs and CSs are being handed the responsibility of administering medications.

To my current knowledge, if a Schedule 8 drug is packaged in a multidose system (those webster packs where there are a few different pills in each compartment) the PCA/CS can administer it IF they have been assessed as medication competent. The rationale behind this is that the PCA/CS is unable to identify the S8D from all the other medications (silly, I know, but there it is). A drug register is not used.

Registered nurses are not allowed to administer medications in a multidose system, as we must account for and identify each separate medication.

If the S8D is packaged and stored separately, ONLY a registered nurse can administer it. A PCA/CS/EN/EEN can check the drug, but not give it. In this case a drug register is signed by the RN and other person.

KingAaron, I would not administer a drug of any description unless you are aware of the law in your state AND your facility has documented policy on your role. All people not just RNs are responsible for their actions, and in a health facility this is proscribed by your qualifications. If an adverse incident occurs that requires legal intervention, every single person is questioned as to what involvement they had in every single tiny aspect of that person's care. I am not just speaking as an RN. I was an EN for many years, and in my hospital policy was for ENs not to give meds, despite their qualifications. Be anal about it - I was. If an RN gave me any medication I refused to give it, even if I had seen what it was and I had seen the med chart. The other ENs were the same, and the RNs found it annoying especially seeing as they had all come from facilities where there are medication endorsed ENs, but they followed our lead, realising their own qualifications and reputations were on the line.

Remember, a facility would be mad if they had policy which contravened the law; they'd also be crazy if they didn't have policy at all because they would be leaving themselves wide open to litigation. Ask to see it. You are protecting not just yourself, but those you work with, and as in my case, they may not be aware of the facility policy. Go well, and be careful.

HI

Its funny how across the country our basic job description si the same, yet we can and can't do so many different tasks, Iam not not out in the field nursing, iam doing Recuritment and Allocation work now, whilst I complete my course. My last role @ a Low Care Facilitiy, as I was emplyed as a Team Leader, doing medication rounds was my main job for a shift, among many other things. Our policy for administering S8 (we have 3 residents on a S8 TDS) was so long as it was in a webster pack, then I could adminster it, mind you the pack remains locked up and normal S8 security so to speak, ie: key on seperate, 2 to sign, count book, and the actual pill counted x3 a day. If for whatever reason a resident was dishcarged from hospitial, or came back with a packet of S8 medication, then I either had to get the DON to come in and give it when it was due, and then send it to the chemist to be packed.

Always interesting to get the other states point of view, in relation to different things, Thanks to everyone for their point of view with this matter.

Aaron

Molly, I am in the Northern Territory. King Aaron, you are right, it is so interesting how things change between states and institutions. Yet EN training is becoming more uniform as it has now been introduced into universities. If only the nursing boards, and care institutions would do the same...

BTW I was just thinking - there are private companies that employ non nurses to go out and ensure that pts unable (eg due to memory loss) to take their medications observe them doing so from their Webster packs. And the disability organisations also have carers that dispense from Webster packs too.

The policy of my hospital though doesn't allow ENs to give meds. :( Alot of the girls/guys who have spent a considerable time in their course studyng pharmacology are understandably quite upset, as they fear they may lose their knowledge.