DDOD OHIO MEDICAL CERTIFICATION CATEGORY ONE

DODD

Department of Developmental Disabilites

Route

Ways in which a medication is absorbed into the body

Doctor's Order

Permission from a physician to administer a medication. A pharmacy label is required for a doctor's order.

What are the requirements for medications that do not need a doctor's order?

1. Topical Medication

2. Over the counter

3. Musculoskeletal

4. For comfort

5. Pre-existing conditions that have been treated before hand.

Where can you find the medical certification cirriculum? (Ohio)

www.dodd.ohio.gov

How long does your medical certification last?

One year

How long is the recertification class?

2 hours

If you do not recertify before the anniversary of your medical cert class, what are the consequences?

You cannot administer medication.

How many days do you have to recertify after your anniversary before you are required to take the full 14 hour class again?

60 days.

Where can you find the status of your certifcation? How can you find it? (Ohio)

Visting dodd.ohio.gov, going to the registry, and entering the last four digits of your SSN.

What medications are you able to administer under a category 1 medical certification?

Topical and Oral medications

If you cannot find your certification in the offical database, what must you do?

Contact the nurse who taught your medical certification class.

How long is the medical certifcation class that you have to take before you're eligible for a written exam?

14 hours.

How early can you renew your certification?

Up to 6 months.

What can happen as a result of unsafe practices, going against the cirriculum, or non-compliance?

Suspension or revocation

Define revocation of your license.

Permanent removal of your license.

True or False: A revocation can be appealed.

True

True or False: You can independentally dose, change the frequency, or perform healthcare related activities that are not specified in the cirriculum?

False.

True or False: You can administer medication without a doctor's order.

False

True or False: Under a category one certification, you can administer medication via a feeding tube, IV injection, SubQ injections, intramuscular injection, and/or provide wound care.

False; Category One certification only includes topical and oral medication.

True or False: Regardless of certification, you can remind a client to take their medication, observe them to ensure they took their medication correctly, and assist a client with getting their medication from the container.

True.

What kind of assistance can you provide to a client who is able to self-administer their medication?

Physical assistance only.

Define delegation

Authority to perform a nursing task

What is a healthcare professional? Give three examples.

A medically licensed professional. E.g.: Nurse, Physician, Pharmacist.

What is the duty of a nurse?

Delegation of certified personell. Performs assessment.

What is a physician responsible for?

Perscribing medication, treatments, and tube feedings.

What does a pharmacist do?

Fill perscriptions and prepares the pharmacy label.

What is the duty of an agency/employer?

To ensure the certification of personell and ensure the cirriculum is being followed. Annual skill checks.

What is an Individual Specific Training? (IST)

A summary of an individual's current healthcare information.

What is the purpose of an IST?

to ensure the safest care and medical administration for an individual

What is included in an IST?

Physical, social, and emotional needs. Name and Photo of a client. Special instructions. Allergies.

How can you identify a client?

A name and photo provided in the IST or by another staff that is familiar with the client. Clients cannot identify themselves, and they cannot be identified by other clients.

What is a required for a person to self-administer their medication?

1. They must be able to identify their medication by shape, color, and/or size. They do not need to know medical terms.

2. They must know when the medication must be taken. They do not need to know a specific time.

3. They must know why they are taking the medication.

True or False: Medication that is self-administered need to be documented.

False.

What is an MAR?

Medical Administration Record

Who can fill a pill caddy?

A licensed healthcare professional.

What must you know about the medication you are administrating? What must you check before administrating? (DR. TIM)

Dosage

Route

Time (Frequency)

Individual

Medication and strength (Tylenol 500mg)

What is a PRN?

As needed medication

If a medication is missed, what must be documented?

Front of MAR: Initial in documentation box with a circle around the initials.

Back of MAR: What medication was missed; when it was meant to be given, and why it was missed.

Unusual Incident Report (UIR)

What is a UIR?

Unusual Incident Report

If a medication is missed, what is required to be written in a UIR?

1. Who was consulted?

2. What was reported? (Why was the medication missed?)

3. What directions were given?

4. What actions were taken?

How many times must you check the pharmacy label against the MAR?

Three Times. Once when taking the medication out. Once before you put the medication in the cup. Once after you put the medication in the cup and before you administer the medication.

What must you do after you administer a medication before documentation?

Stay with the client to ensure they have swallowed their medication.

When should you document an administered medication in the MAR?

Immediately after you watch the client swallow their mediction.

What is the first step to preparing medication administration?

Washing your hands and putting on gloves.

What should you do before taking out medication?

Check MAR to see if the medication has already been administered.

True or False: If someone has signed off on a medication you are responsible for administiring, you should still give the medication.

False.

If you notice a medication has been given when it was not supposed to or a medication has been missed, what should you do?

Investigate and report it as a UIR.

True or False: You should prepare every clients medications at once.

False. You should only prepare medication for one client at a time.

If a medication looks different than what you are used to seeing, what should you do?

Check the pharmacy label to make sure the medication description matches what is in the container.

True or False: If there are two different medications assigned to be given within the same medical window, you can give them both at the same time.

False. They must be given at separate times. The medications may not be safe to take within the same time.

Medical window

The amount of time in which a medication must be administered. Typically within an hour before or after the posted time.

What is the DOT System? Is it required?

A system in which a small dot is placed in the MAR box as medications are placed in the cup to ensure they have been administered before passing. It's used as an extra check. It is not required but it may be helpful if a client needs multiple medications.

True or False: It is considered falsifcation if you initial a MAR before administing medication.

True. Falsification can result in legal action.

True or False: It is okay to use unlabled medication or medications with an illegible label.

False. If there is no label or the lable is illegible, you need to contact a healthcare professional for clarification.

True or False: You can place the medications in your hands.

False. You should always place medication in a cup.

When administiring pills, how should you take them out of the bottle or container?

Pour the required amount onto the lid of the container, and then transfer the pills from the lid to the cup. Pouring directly in the cup may result in confusion if you pour too many and have other medication in the cup already.

What should you do if you have a medicine that you need to crush but it is labeled do not crush?

Contact the physician for further instruction. You must have a doctor's order to crush the medication.

True or False: If you drop a medication on the floor or surface, it is still okay to give that medication to a client.

False. You must report it to your supervisor and wait for further instruction for disposal. A new medication should be administered.

True or False: If you did not prepare the medication, you are still allowed to administer it as long as you are certified.

False. Administiring medications that you did not prepare makes you liable for any errors that may come as a result.

True or False: It is okay to give a medication if the pharmacy label and MAR do not match.

False. You need to call a healthcare professional for clarification.

What is required of staff if a client is put on a new medication?

The client must be closely supervised to see how they react to the new medication. If the staff that administered the medication is not going to be around long enough to provide supervision, they must let the other staff know.

How do you transfer medication from a bubble pack to a cup?

Place the bubble over the cup and push down so that the medication falls in the cup.

What is a multidose pack?

A medication pack that contains all medication for a given time placed in a single bubble. Labels must be destoryed after medication is successful administered and documented.

True or False: If the medication does not the match the pharmacy label, you can still pass the medication.

False. Call the pharmacy for clarification.

What are PRNs and OTCs given for?

To give relief for a specific symptom.

What is an OTC?

Over the counter medication

What is required for an OTC and PRN?

It can be bought over the counter at the pharmacy, but a doctor's order must be given to administer.

True or False: Clients can share OTCs?

Only if they share the cost and there are pharmacy labels for each of the clients for the same OTC.

When should PRNs be given at the discretion of the caregiver?

When a client is exhibiting observable behavior such as extreme itching (non-verbal cues).

When should a PRN be given at the discretion of a client?

When they verbally ask/express that they are in discomfort.

True or False: You must document PRNs.

True. They must be documented in the back of the MAR.

What is required to give a PRN on a pharmacy label?

1. Medication and Strength.

2. Individual's name

3. Specific time/frequency (e.g. every 4 hours; cannot be a range).

4. Specific dosage (e.g. 1 tablet; cannot be a range).

5. Reason for medication. (e.g. temperature of over 100 degrees; "fever" is not specific enough.)

How long can a client be given PRNs before a healthcare professional should be contacted?

3 days in a row.

How long do symptoms have to persist after being given a PRN before a healthcare professional is contacted?

72 hours.

CHECK DR. TIM and Reason of this PRN.

Aspirin 300mg; take two tablets by mouth every 8 hours as needed for headaches. Patient Name: Jessica Smith.

(D)osage: two tablets

(R)oute: by mouth

(T)ime: Every 8 hours.

(I)Individual: Jessica Smith

(M)edication and Strength: Aspirin 300mg.

Reason: Headaches. Must be at the discretion of the patient.

How should liquid medication be measured?

On a flat surface, at eye level, using a container that provides exact measurements. Medication should be poured slowly and cannot be returned to the container if excess medication is poured.

How should medications be warmed?

By placing it in a closed palm for several minutes. Microwaves and hot water may cause the liquid to heat up too hot and burn a patient.

Oral Route

Absorbed by swallowing. Written as by mouth, PO, or oral. You must watch a patient swallow the medication before you it is documented.

Topical

Absorbed through skin.

Creams, powder, lotion, gels, and transdermal patches are considered...

Topical medications

Medications administered underneath the tongue and needs to dissovle 30 minutes before or after eating/drinking are...

sublingual route

Where are buccal route medications administered?

Between the gums/teeth and cheek

Route in which medication is dissolved on the top of the tongue.

Oral Disintegration route

What order are ear, eye, and nose drops given?

It will depend on the instructions given by a physician. The order of medication can be found in the MAR. Look to see if time needs to pass before administiring the next medication.

What is the process for administiring eye drops?

1. Have the client sit or lay down.

2. Open the eye with your index finger and thumb.

3. Approach from the side and hold the dropper at eye level.

4. Place allotted amount of drops into the eye, making sure not to touch the dropper to the eye.

What is the process for admnistiring eye ointment?

1. Have the client sit or lay down.

2. Gently pull down the lower eyelid to create a pocket.

3. Approach from the side and hold the dropper at eye level.

4. Place allotted amount of ointment into the eye, making sure not to touch the dropper to the eye.

What is the process of administrating eardrops?

1. Have the client sit or lay down.

2. Orient them so that their ear is horizontal with the ceiling/floor.

3. Pull the mid-outer ear gently.

4. Administer drops.

5. Keep client level to for 3-5 minutes to ensure the medicine does not run out of the ear.

What is the process of administrating nasal medication?

1. Have tissues available.

2. Have the client blow their nose.

3. Have the client position their head down and clean the applicator tip.

4. Place plunger in nose and administer medication in appropriate amount.

5. Tell client to sniff/breathe through their nose.

True or False: A person should tip their head back if they are experiencing a nose bleed.

False; a person should tilt their head forward.

How long should you pinch the soft part of the nose during a nose bleed to stop it?

10 minutes

What should you do if a nose bleed doesn't stop after 10 minutes of pinching the nose?

Pinch for 15 more minutes

How long should a nose bleed persist before you call 911?

30 minutes

Other than a nosebleed that persists for 30 or more minutes, when should 911 be called for a nosebleed?

If the blood is thin or yellow in color.

Transdermal Route

Topical medication applied via a patch left on the body for a period of time

How is a transdermal patch applied?

1. Wash your hands and put on gloves.

2. Remove any old patches and clean the area.

3. Place new patch on a different spot than where the previous patch was.

4. Avoid putting patch on scars, callouses, folds, bruising, or irritation.

What should you do if a transdermal patch falls off?

Call a healthcare professional for furhter instruction. DO NOT place a new patch on the client.

True or False: You can shave a client before applying a transdermal patch.

False; You may clip the hair close to the skin, but you cannot shave.

Why should you wear gloves when applying topical medication to a patient?

Topical medications are absorbed through the skin, and your skin would be absorbing the medication with the protection of gloves.

What forms of medication are given through rectal routes?

Suppositories and Enemas