Preamble
BigDog Support Services Pty Ltd (BigDog) has a commitment to the maintenance of safe and effective practices in assisting clients in the management of their individual medication regimes to the level of support they require.
Each client requiring medication is confident that BigDog administers, stores and monitors the effects of their medication and works to prevent errors or incidents.
4.3.1 Medication Records
Medication received on behalf of clients by workers will be recorded on a Medication Receipt/Disposal form. Outgoing empty packs will also be recorded on this same form. Medication Registers will be created for each client’s medication detailing the names and dosages of all medications contained in the medication packs. This information will also be recorded on the Client Medication Register
Each worker will record the time the medication assistance is given on the appropriate Client Medication Register form.
The worker assisting the client will observe while the client ingests the medication. In cases where the client refuses the medication or is unable to ingest the medication (e.g. vomiting) a note should be made on the Client Medication Register. A medical practitioner needs to be consulted via the office should refusals continue to occur
4.3.2 Medication Management Training
All BigDog support workers are required to undertake NGO Training Medication Management module at the time of their induction and thereafter every 12 months.
One of the recommendations to reduce medication errors and harm is to use the “seven rights” when assisting someone to take their medication. Even though the role of the support worker is to assist the client only, there is still a duty of care to ensure that the following aspects are considered.
The seven rights of medication assistance are as follows:
1. Right Medication – ensure that the medication is the right medication
2. Right Client – ensuring that the medication is labelled for that client
3. Right Dosage – ensuring that the dosage recorded is the same as that taken
4. Right Route – ensuring that the self-medication is in the correct manner
5. Right Time – ensuring that the medication is being taken at the time recommended
6. Right Reason – taken only as necessary
7. Right Documentation – use the appropriate documentation to record the event
Common Forms of Medication
4.3.3 Safe Storage
In all situations where BigDog is involved in medication assistance it will be the responsibility of support workers to ensure the security of all medication.
Where there are specific storage requirements (e.g. refrigeration) it will be the responsibility of the client to provide appropriate facilities.
Injectable medications (e.g. insulin) are to be retained in a locked facility and a used sharps container is to be provided for disposal of used implements.
All sharps and syringes are to be logged as used and disposed of in the Sharp’s Container. It should be noted that only registered nursing personnel, other appropriately trained staff or the individual themselves are to use these products. Support workers have a responsibility to maintain the register and the security of these implements. Protocols will be in place on an individual basis.
BigDog considers the following medical practitioners to be qualified or authorised with assisting clients with medication.
General Practitioner
Medical Specialist
Registrars of Hospitals
Attending Ambulance Officers
Attending District Nurses (RN’s)
Pharmacist
Registered Community Mental Health workers with appropriate documentation from qualified personnel
Procedures
Medication
If a client requires assistance to take medication that can only be obtained via prescription, a written permission form must be completed and signed by a general practitioner or specialist.
BigDog will only assist with medication where a pharmacist has dispensed medication into a Webster-Pak. Staff will not handle medication in any other form of containers unless directly requested by the client, Statutory Health Attorney or qualified medical officer. Staff will only assist clients to take medication that is available without a prescription if authorised in writing to do so, by the client, Statutory Health Attorney or qualified medical officer.
Assisting a Client to Self-medicate
1. Support worker will show the medication to the client
2. Support worker will assist the client to identify their name as per blister pack
3. Support worker will assist the client in identifying the appropriate time and dosage.
4. When the client has identified their medication the support worker will assist the client in releasing the medication from the pack.
5. On emptying the capsule, the support worker will remove any remaining foil/paper from the rear of the pack and ensure no medication remains within the capsule.
6. The support worker is to ensure medication is placed in a hygienic accessible position for the individual client (this may require individual consideration)
PRN Medication
PRN medication is to be clearly identified and the medical directives for usage clearly established and included in the client’s file.
No staff member is to assist a client with PRN medication without having conferred with a director, or the coordinator on call.
Some clients who self-determine medication needs including PRN will be identified to support staff. In these situations, staff shall record all such assistance as above on the required Medication PRN Form.
Staff will report any issues of concern regarding medication to On-Call e.g. missing medication, client non-compliant behaviour, and adverse reactions or unaccounted for discrepancies in registers.
Staff should report to a coordinator in the first instance for each client if stocks of regular medication are insufficient for the support period. Rostered Friday staff will ensure adequate supplies of medication for the ensuing week including long weekends.
It will then become the responsibility of the Directors to assist the client in the gaining and filling the necessary prescriptions.
Coordinators will routinely, on a monthly basis, check medications for expiry dates. All out of date medication is to be recorded on Medication Receipt Disposal Form and returned to the office or returned to the Pharmacy of origin with advice to the office.
Summary
BigDog records clearly identify the medication and dosage required by each client, including all information required to correctly identify the client and to assist with self-medication.
All workers understand 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.
Supporting Documents
Policies
3.4.5 Code of Conduct
Individual Needs Safety, Well-being and Human Rights
Forms
Incident Report Form
Medication PRN
Medication Receipt/Disposal
Client Medical Form
Client Medication Register
Client Risk Assessment
Information
Human Services Quality Framework October 2021 Version 8
Management of Medication Manual 2022
NDIS Practice Alerts
NDIS Practice Standards November 2021 Version 4
NGO Training
Comprehensive Health Assessments (PA03)
Dysphagia (PA04)
Epilepsy Management (PA05)
Management of Medication
Medicine and Swallowing Problems (PA07)
Polypharmacy (PA01)
Transitions of Care (PA02)
Legislation
Child Protection Reform and other Legislation Act 2022 (QLD)
Disability Services Act 2006 (QLD)
Disability Services and Inclusion Act 2023 (Cwth)
Health Act 1937 (QLD)
Health Regulation Act 1996 (QLD)
National Disability Insurance Scheme Act 2013 (Cwth)
NDIS (Provider Registration and Practice Standards) Amendment Rules 2021
NDIS Practice Standards and Quality Indicators
BigDog Support Services Pty Ltd (BigDog) is a registered NDIS provider and is required to apply the scheme’s practice standard and quality indicators.
The standards have been developed to create an important benchmark to assess provider performance and ensure that high quality and safe supports and services are provided to NDIS participants.
The four core modules are:
1.0 Rights and Responsibilities;
2.0 Governance and Operational Management;
3.0 The Provision of Supports; and
4.0 The Support Provision Environment.
The supplementary modules cover:
5.0 Specialist Support
5.1 High intensity daily personal activities.
5.3 Implementing behaviour support plans.
4 3 Management of Medication
Each participant requiring medication is confident their provider administers, stores and monitors the effects of their medication and works to prevent errors or incidents.
4.3.1 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.
4.3.2 All workers responsible for administering medication understand the effects and sideeffects of the medication and the steps to take in the event of an incident involving medication.
4.3.3 All medications are stored safely and securely, can be easily identified and differentiated, and are only accessed by appropriately trained workers.
Human Services Quality Standards
The Human Services Quality Standards set a benchmark for the quality of service provision. Each Standard is supported by a set of performance indicators which outline what an organisation is required to demonstrate to meet that standard.
4 Safety, Wellbeing and Rights
The safety, wellbeing and human and legal rights of people using services are protected and promoted
4.2 BigDog proactively prevents, identifies and responds to risks to the safety and wellbeing of people using services.
4.3 BigDog has processes for reporting and responding to potential or actual harm, abuse and/or neglect that may occur for people using services.
6 Human Resources
Effective human resource management systems, including recruitment, induction and supervisory processes, result in quality service provision.
6.1 BigDog has human resource management systems that are consistent with regulatory requirements, industrial relations legislation, work health and safety legislation and relevant agreements or awards.
6.3 BigDog provides people working in BigDog with induction, training and development opportunities relevant to their roles.
Delegation of Authority
Steven
Courtney
David
Monique
Version Details
This policy will be reviewed every twelve (12) months unless circumstances deem it necessary to review earlier. The review process will involve an analysis of the usefulness of the policy and to note any changes which are required to improve the policy.
If minor changes are made in wording or to clarify the intent, the version number will indicate this by adding a ‘point’ i.e. Version 1.0 indicates the original version and 1.1 with the first round of minor changes made. A significant change or intent of the policy will be indicated by a whole new number i.e. Version 2.0.
The following rules also apply in interpreting this policy:
• Headings are for convenience only and do not affect interpretation.
• A singular word includes the plural and vice versa.
• A word that suggests one gender includes the other genders.
October 2013
February 2015
July 2016
June 2018
January 2019
January 2020
Standards replace Service Standard Indicators
Training sub-heading added to Supporting Documents
Word converted to Office 2013 DOCX
term 'Client' to NDIS term 'Participant'
Changed to a procedure
Added information regarding permission for different types of medication
January 2021
Added 5 Rs paragraph
Added Community Mental Health to CMH
Changed eg. To e.g.
Changed policies to procedures
Changed ‘designated medical officers’ to ‘coordinator on call.’
Procedure
Updated logo
Included Common Forms of Medication section
Updated to new logo and style guide
HSQF Standards Indicators and Policy matched with NDIS Practice Standards and Quality Indicators
Front cover updated to Standards colour identification
Supporting Policies updated
Updated Responsible Officers details
Date V Details
Changed ‘the director’ to ‘the directors’
Introduction of BigDog NGO Training Portal and modules
January 2022
January 2023
January 2024
5.2 Updated responsible officers, training, and practice alerts
NDIS Practice Standards November 2021 Version 4
6.0 Included Human Services Quality Standards and Child Protection Act and the term “Participant” is returned to “Client” to allow for policies to cover NDIS and Child Safety.
Term “Employee” changed to “Worker” for consistency.
6.1 Disability Services Act 1986 replaced with Disability Services and Inclusion Act 2023 and policy review process included.
Included Medication Training in NGO Induction Group