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Autumn 2003

Be Very Clear when Administering Medication

HACSU officials are becoming increasingly alarmed about disability services members putting themselves at risk in administering medications to clients.

This follows a number of members employed in Disability Services contacting HACSU recently with concerns about this matter, some saying they are being pressured and or mislead by their employer.

This issue has been a contentious one for several years. The information HACSU is getting from concerned members suggests that more complex care needs are increasing the incidence and level of administration of medication.

In 2001 HACSU negotiated with the Department of Health and Human Services new regulations under the Poisons Act governing the administration of medication in community-based settings.

These new regulations, which came into force on 12th December 2002, have the force of law behind them, and both employers and employees must adhere to them.

HACSU has grave concerns that members may be administering medication outside of the guidelines.

HACSU is aware that many employers are pressuring members to administer medication, arguing members have a "duty of care" to clients to do so.

HACSU members need to be very clear about this situation.

The new regulations clarify the situation concerning disability support workers administering medication. Providing the new regulations are followed there is no legal impediment to support workers administering medication.

It is important to note that the regulations only allow for the administration of some medications, e.g. only schedules 2, 3 and 4 substances can be administered.

It has come to our attention that some organisations are requiring employees to administer schedule 8 drugs, e.g. morphine etc. The regulations do not allow this and members should refuse to administer such substances.

Regulation 98 of the Poisons Act states that support workers shall act in accordance with the Guidelines for the Administration of Medication for People with Disabilities in Community Based Disability Services (November 2001).

These guidelines apply specifically to non-nursing staff working in community based settings and aim to enhance the potential for people with a disability to live in the community in a supportive but least restrictive manner.

A service provider funded by the Department of Health and Human Services must enter into a service agreement with the department, which may contain administration of medication as part of the agreement.

If funded organisations have clients that require medication and that medication is to be administered by disability support workers the following provisions must be adhered to.

It is the responsibility of the organisation to ensure employees are competent, receive and complete Tasmanian Accreditation and Recognition Committee (TAREC) approved training in the administration of medication;

Organisations must have policies and procedures consistent with the Agency's current guidelines for the administration of medication;

It is the responsibility of boards of management of such funded organisations, or State Disability Services manager to ensure practices are consistent with Administration of Medication Guidelines.

In addition to the above provisions placed on organisations, disability support workers have a responsibility to observe the following.

Employees must be aware of their own skills, knowledge, experience, capabilities and limitations and inform the employer if they are not confident or do not feel competent in performing any tasks;

Employees must never administer medications beyond their skills and training, and assistance must be sought from appropriate personnel, such as a registered nurse, the client's doctor or pharmacist;

Employees must only administer medication after completing approved TAREC training and have been deemed competent;

Employees must complete a refresher course at least once every three years and have a current First Aid Certificate prior to undertaking such training.

In effect, organisations cannot require employees to administer medication to clients, and members should not do so, unless they have received First Aid training and their First Aid Certificate is current and they have successfully completed the appropriate accredited training.

Members should be aware that to do otherwise may be illegal and place them at risk.

The requirements placed on the employers/ employees in administration of medication to clients is defined in the guidelines and also includes the following:

• Self- medication and storage of medication which is managed by clients;

• General Procedures for the Administration of Oral and/or Topical Medication;

• Specific Procedures in the Administration of Stable Long Term Medication, Short Term- Prescribed Medication, Non-Prescription Medication, PRN Medication, STAT Medication;

• Audit of Medication and Dealing with and Recording Medication Error.

The above information is an overview only of the Guidelines for the Administration of Medication for People with Disabilities in Community Based Care and in no way covers all of the requirements placed on organisations and employees in providing competent care to clients.

For a full copy of the Guidelines access the HACSU web site or alternatively contact your local HACSU office for a copy.