Introduction

This policy aims to ensure the standard of service delivery remains safe and high quality and to proactively reduce the number of medication associated adverse events. This document outlines the information required, and the expectations of a Hireup Support Worker when providing support to people who require medication administration and of the Client when medication administration is required on shift. 

This policy aims to provide guidance to Support Workers, outlining what duties are acceptable for them to complete and what duties are outside of the scope of a Support Worker.

All medications administered by a Support Worker will be accompanied by a Medication Authority Form (MAF) which will detail the appropriate route of administration. Common routes of medication administration include oral, sublingual, nasal, otic, ocular, topical, inhalation and rectal. Note: there are separate policies for subcutaneous injections and administration of Schedule 8 medications.

A MAF is to be completed by an appropriate, registered health professional, such as a treating doctor and should be reviewed every 12 months or as otherwise stated by the treating health professional. 

Hireup Values 

Hireup’s values provide us with the direction in which we engage with our community and develop policy and process across the business. 

We recognise that medication administration support is only a part of a person’s overall support needs. By upholding the value of ‘the person is the point’ we take an individualised approach to medication management.  

Hireup acknowledges Clients and their families are experts in their individual medication management. Central to this understanding is the principle of ‘championing choice’ and control for Clients to make informed decisions about their medication administration support. Whilst Hireup is not responsible for the assessment or development of a Client’s medication authority form, we support Clients to engage with suitable health professionals and to be involved in the planning and management of their medication administration, as well as any individual training arrangements. 

Definitions: 

Support Worker: a person that provides support to the Client, typically in a paid capacity.

Medication authority form: a document that outlines for service users:

• Name of each medication
• Purpose of each medication
• Dosage amount and frequency
• Route of administration
• Preparation instructions
• Storage instructions
• Potential side effects of the medication

Oral medication: medications that can be taken orally, such as tablets and liquids. This can also refer to medications that would be ordinarily administered orally that are prescribed to be given via a tube, such as a percutaneous endoscopic gastrostomy (PEG). This will be accompanied by a tube feeding care plan. The safest route of administration will be included on the person’s MAF. If the person has mealtime management needs, their mealtime management plan will outline any modifications that need to be made to the medication and the safest way to administer. 

Sublingual medication: medications that are delivered under the tongue and are absorbed through the mucous membranes of the mouth. 

Nasal medication: medications that are delivered through the nasal passage, usually in the form of a spray.

Otic medication: medications that are delivered through the outer ear canal, usually in the form of liquid drops.

Ocular medications: medications that are applied into the eye, usually in the form of liquid, gel or ointment. 

Topical medication: medications that are applied directly to the skin such as creams, ointments and lotions. 

Inhaled medication: medications that are inhaled through the mouth. Common medications include those used for asthma management. 

Rectal medication: medications that are administered through the rectum. Common medications include those used for bowel care management.

Percutaneous Endoscopic Gastrostomy (PEG): a flexible tube that is placed through the abdominal wall into the stomach, bypassing the mouth and the oesophagus.

Polypharmacy: the use of five or more medications, or two or more psychotropic medications, at the same time to treat one or multiple concurrent conditions. It includes the use of all prescription medicines, over-the-counter medicines, and complementary medicines. Polypharmacy is associated with an increased risk of medication-related adverse effects and poorer health outcomes.

Polypharmacy review: a review of all medications by a medical practitioner and/or pharmacist to assess interactions between medications to reduce or manage potential adverse effects.  

Guidelines:

Service Provider: 

As a service provider, Hireup will: 

• Work with the Client (or their Account Manager where applicable) to determine the support they require from Hireup, and determine what documentation is required.
• Support the Client (or their Account Manager where applicable) to complete a polypharmacy review where required.
• Determine areas of medication administration that are within the scope of practice for a Support Worker to provide.
• Regularly review the medication authority form to ensure the information provided is the most up to date and appropriate.
• Provide Support Workers with written procedures for the Provision of Medication Administration, in conjunction with the Client (or their Account Manager where applicable) and their treating Health Professional.
• Ensure Support Workers have access to plans and ensure these plans are only updated by a registered and relevant health professional.
• Identify areas of education for Support Workers.
• Provide Support Workers with appropriate training and assessment to ensure the safe provision of medication administration, including regular supervision.

Support Worker

A Support Worker MAY: 

• Administer medications directly from the labelled pharmacy container or from a dosing box, following written instructions on the medication authority form.
• Administer oral medication from a blister pack.
• Administer rectal medications following written instructions on both the medication authority form and the bowel care plan.
• Access supervision outside of scheduled supervision timeframes by contacting Hireup directly.

A Support Worker MUST: 

• Complete online training modules provided by Hireup within the allocated time frame unless otherwise specified by Hireup.
• Complete regular training in the administration of oral medications (including being informed and aware of risks associated with altering the dose of a medication in each Client’s individual medication administration support needs.
• Complete other relevant online training modules provided by Hireup prior to administering medications, unless otherwise specified by Hireup.
• Follow the support plan as provided and raise any concerns with the Client (or their Account Manager where applicable) immediately, as well as notify Hireup.
• Be aware that they must ensure the proper use of medication.
• Report when medication is refused, missed or vomited up.
• NOT give any medications to a Client that has not been ordered for that Client.
• NOT give any medications that are expired.
• NOT administer any medications that are not labelled appropriately or have been taken out of their packaging and are not identifiable.
• NOT change any part of the plan or deviate from the plan provided.
• Document the administration of medication as per the Client’s record keeping.
• Note: The safest form of oral medication is a blister pack, followed by administration directly from the Client’s labelled pharmacy container.
• Report any or variations in the Client’s health and wellbeing, and/or medication orders to the Client, (or their Account Manager where applicable) and/or their health professional where necessary, followed by an incident report to Hireup once safe to do so.
• Identify any gaps in knowledge and report these to Hireup for further advice.

Client

A Client MUST:

• Provide Hireup with an honest and accurate account of their support needs.
• Provide a support plan to Hireup that outlines their specific medication administration support requirements, completed by an appropriate, registered health professional.
• Have the plan reviewed by an appropriate, registered health professional when changes occur. At a minimum, the plan should be reviewed every 12 months unless otherwise indicated on the plan.
• Advise Hireup of any changes to support needs, requirements or the medication authority form.
• Report any concerns regarding Support Worker’s capability in providing medication administration support to Hireup for further advice.