St Joseph's Village Nursing Home

Medication management system

The medication management system at St Joseph's Village promotes the safe and optimal use of medicines for residents.

An up-to-date accurate record of the medication history of each resident (including those who self-administer) is maintained on the hostel medication chart and is consistent with all recommended requirements. The medication chart is maintained by the general practitioner and the record form is also forwarded with the residents to external visits with doctors/specialist clinics. A 'resident's ongoing diagnostic history' sheet has been developed and implemented to provide more detailed documentation of a resident's medical history for consideration by other health care service providers and for transfer of residents.

Residents and care staff are advised of the importance of keeping an accurate record of medications. Medication charts are reviewed every three months and rewritten every six months by the medical practitioner. Medication charts are audited regularly for their legibility, compliance with regulatory requirements, and also their documentation of telephone orders, allergies and alterations to dosage.

An independent medication review is carried out by an accredited clinical pharmacist. Each resident is reviewed annually and a written report is forwarded to the medical practitioner for review and comment. Confirmation that a review has occurred, is made on the hostel medication chart and a record is also kept by the Director of Care Services. The Clinical Pharmacist is available to residents to provide drug information and to educate them in drug usage and side effects.

The registered nurse monitors resident response to medications and other clinical issues on a daily basis. Consumer medicines information requests are forwarded to the supply pharmacist for action.

All care staff who administer medications have undertaken CSE Certificate III (aged care). Ongoing education and training is supplied by the care manager and pharmacists. Medication administration competencies have been developed and implemented for all aspects of medication administration, including oral tablets/capsules from dose administration aids, liquid formulations, eye drops, ear drops, ointments and nebulised medication. The competency of a CSE to administer medications is assessed three times by the care manager prior to commencing medication administration. The assessment is then undertaken on an annual basis and documented. Procedures for assessment of the competency of a resident to undertake self-administration of medication have been developed and implemented. Medication incident reports are forwarded to the care manager for review and implementation of further action, eg. further staff training/education.

The results of medication incidents/errors are reported to and evaluated by the medication management committee, and quality management committee.

The introduction of the Webster multi dose system was undertaken with a view to minimising the incidence of medication errors. This system is utilised for all oral tablets/capsules, and procedures have been developed in accordance with best practice. Signing sheets/administration records for medication administration are utilised for items included in the Webster Pak and items which cannot be packed (eg. nitrate patches, liquids). Resident photos are attached to both Webster Paks and hostel medication charts and regularly reviewed to ensure accurate resident identification. Incidents of pharmacy initiated errors are forwarded to the care manager to discuss with the supply pharmacist. The medication incident data for St Joseph's Village is benchmarked against 83 other low care facilities via quality performance systems.