Management of Medication for Ndis Providers

Management of Medication Definition

A medication is a substance used to prevent, diagnose, manage or treat an illness, disease, health condition or behaviour. Medications may help relieve symptoms, improve health, replace substances the body needs or support a person’s overall wellbeing.

Medication Administration Classifications

• Regular Medication (Packed) – Medication that the participant usually takes that is packed within a dosage aid. E.g., Tablets.
• Regular Medication (Non-Packed) – Medication that the participant usually takes that can’t be packed within a dosage aid. E.g., Liquids
• Short Term – Medication that has a start and end date. E.g., Antibiotics, Eye Drops
• When Required (PRN) – Medication is taken when the participant requires.
• Over-the-counter – Medication is purchased from a chemist or pharmacy, e.g., Cold Mixtures

Medication Dosage Aids

Medication dosage aids are devices or systems used to help a person take the correct medication, dose and amount at the correct time. Examples include:

• Dosette boxes: Containers divided into sections for different days and times.
• Webster packs or blister packs: Pharmacy-prepared medication packs organised by day and time.
• Medication cups: Used to measure and administer some liquid or tablet medications.
• Oral syringes: Used to measure liquid medication accurately.
• Measuring spoons: Special spoons designed for measuring liquid medication.
• Pill cutters: Used to split tablets, but only when approved by a pharmacist or health professional.
• Medication reminder alarms: Alerts a person when medication is due.
• Electronic medication systems: Devices that provide reminders, release medication or record when doses are taken.
• Inhaler spacers: Devices that help deliver inhaled medication more effectively.

Dosage aids must be used according to the medication instructions, the person’s medication information and organisational policy and procedures. Workers should not alter, crush, split or mix medication unless this has been authorised by an appropriate health professional.

Types of Medications

Medications can be provided in different forms. The form of medication determines how it is used and how it enters the body, such as:

• Tablets
• Capsules
• Liquids
• Creams and ointments
• Inhalers
• Injections
• Patches
• Drops
• Suppositories

Management of Medication Ndis Practice Standards

• Outcome: Each participant requiring medication is confident their provider administers, stores and monitors the effects of their medication and works to prevent errors or incidents.

To achieve this outcome, the following indicators should be demonstrated:

• Records clearly identify the medication and dosage required by each participant, including all information required to correctly identify the participant and to safely administer the medication. 
• All workers responsible for administering medication understand the effects and side-effects of the medication and the steps to take in the event of an incident involving medication. 
• All medications are stored safely and securely, can be easily identified and differentiated, and are only accessed by appropriately trained workers.

Management of Medication Scope of Practice

All managers and workers can assist with or administer medications only if they have been trained and assessed in a theory and practical-competent, and formally authorised by the provider, and if the task is explicitly outlined in the participant's medication, support plan and documentation. Worker training should be a mixture of internal and external training for standard and high-intensity medication administration.  

Management of Medication Clinical Limitations 

All managers and workers cannot prescribe, select, commence, cease, change, or clinically review participant/s medications. These clinical decisions belong strictly to qualified medical or health practitioners or specialists. 

Management of Medication High-Intensity & Behavioural Supports

Medication management such as subcutaneous injections, feeding-tube or PEG tube medication administration and PRN medication as a chemical restraint require specialised training and clear policies, procedures and practices for managers and workers. Refer to High-Intensity and/or Implementing Behaviour Support

Management of Medication Documentation

You must maintain accurate, real-time paper-based records and/or digital tracking system if you administer a medication to a person or ndis participant. 

• Medication Management Policy and Procedures
• Individual Risk Assessment Form
• Medication chart (completed by GP)
• Medication Administration Consent Form/s
• Clarification of the Purpose of Medication Form  (completed by GP)
• PRN support plans
• Progress notes
• Communication diaries
• Drugs of Addiction Medication Count Form
• Disposal of Medication Form
• Out-of-Home Form
• Medication Collection or Delivery Form

Management of Medication Storage and Packaging

Medications must be securely stored while respecting the participant's independence. The decision where to store a participants medication is based on their own level of risk regardless of where the person lives. This level of risk must also include all other people around the person. Medications MUST remain in their original pharmacy packaging AND labeled or dosage aid. All mangers and workers MUST never administer loose or unlabeled pills.

Management of Medication Incident Management

Any missed dose, wrong medication, dosage, time, person, route, refusal, or adverse reaction must immediately activate your incident management system, disaster and emergency system and escalation of urgent or non-urgent events system.  Remember a system is a:

• Policies
• Procedures
• Form/s
• Plan/s
• Register/s

Management of Medication Polypharmacy & Reviews

For participants taking 5 or more medications (or more than 2 antipsychotics), this is called polypharmacy. Refer to Practice Alert - Polypharmacy. You should help coordinate and assist a person to attend medication reviews with a GP every 3 to 6 or as required depending on:

• diagnosis or disability 
• participant health & medical needs 
• behaviours
• changes or concerns
• medication stock level
• recommendations from medical, specialist or allied health professional. 

Medicines Associated with Swallowing Problems

Choking is a major cause of preventable deaths for people with disability. These deaths can be prevented by reducing a person’s exposure to factors that may increase their risk of choking. Certain medicines administered to people with disability can increase the risk of choking in two ways: 

• by causing swallowing problems (dysphagia) 
• by causing drowsiness (sedation).
• Practice Alert - Medicines Associated with Swallowing Problems 

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