hcv training part 2: camp camp

Camp CAMPHCV Training Part 2:

Camper Medication Check-in

Training 2 of 3…

2

Make sure to do all three presentations, even if you have attended before!

• This training is the second of three online trainings that all HCVs must complete prior to arriving at CAMP

• It is very important that all three are completed before you arrive, since in person orientation time is limited

• In our attempt to provide the best experience and care for our campers and staff, we do update this info, as needed

Objectives• To familiarize new and returning HCVs with CAMP

Camper Medication Check-in Policies and Procedures

• To prevent medication errors when checking in camper medications

• To prevent INJURY OR DEATH OF OUR CAMPERS

Check-in Demonstration

Visit the following link to watch a demonstration of the medication check-in process:https://tinyurl.com/CampCAMPMedCheck-in

https://tinyurl.com/CampCAMPMedCheck-in

View of the MAR

Camper,Ima Happy

120-12

CP, Seizures, VI, Benedryl,seasonal,

W/C:Manual, NeedAsst:Communication Device, SpecialDiet, Heat:Fair, G-tube, SZ, SzStatus:Y,++MedInstr, ,

see paper file for more care and medical info frommom and dr.

DanielsAbby

15?

Quadapledgic CP,paralytic scoliosis, SI,

sinuses, W/C:Manual, NeedAsst:Non-verbal, Special Diet,Heat:Good, G-tube, Feeding Pump, Suction, Bac. Pump,

Miles,Susie

1212

Dystonic spastic quadCP, constipation, VI, GERD, cyclical vomiting

Fentanyl,Dermabond,

W/C:Manual, NeedAsst:Non-verbal, Special Diet,Heat:Poor, Other,J tube for feeding and some meds, bodybrace,

SEE NURSE JUDY AT CHECK IN – recent illness…get infoand restrictions of J tube at check in, along withwearing instructions for body brace..jrf Sib to Aaron

syndrome, delayedgastric emptying,

Nolan,Jan

1513

arthrogryposis, ADHD,depression, eczema, quadriplegia, scoliosis,

strattera,concerta, clariton,

W/C:Electric, MOM: Y, Heat:Fair, Other,hoyer, sling, pottychair, and tray that attaches to new electric chair,battery charger,

note equip will bring...make sure counselor +1 trainedon usage before parents leave....jrf

PowersLily

152

Autism, ID, Scoliosis, Gluten/Wheat, Lactose,

NeedAsst:Limited abilities - CAN communicate daily needs,MOM: Y, BEHAV, Special Diet, Heat:Good,

GFCF DIET - PM meds done about 10pm and only inraspberry sorbet - see Nurse Judy

Quick,Allison

1212

CP, cecostomy, latex,shrimp,

W/C:Electricr, BEHAV, Heat:Poor, Other,cecostomyadapted toilet,

DISCUSS cecostomy site and medication with parentat check in....have parent demostrate procedure if needed....jrf

Williams,Jennifer

1710

SBifida, Hydrocephalus,ID, Scoliosis,

Latexprecaution,Ceclor,

W/C:Manual, Heat:Fair, Does she cath? IF yes, record info and put on MAR.

NAME AGE DEV

DIAGNOSESMED

TIMES ALLERGIESCARE

Instructions Restrictions

Additional Info/Comments

“CHEAT SHEET” EXAMPLE

(This is a “fake” Cheat Sheet used for training purposes only – not real campers)

Preparing for Medication Check-in• Each volunteer will receive a box that contains the

following: ○ Tip sheet ○ Example MAR○ Pen○ Sharpie○ Post-its○ Tape○ Large Ziploc bags

• Each volunteer will have his or her own metal cart with separate blue bins to organize campers’ medications

• You should also bring your clipboard with each of your campers’ MAR, your “cheat sheet,” and camper profiles

Preparing for Medication Check-in

1. Prepare a blue bin for each of your campers using a Post-it to label each individual bin with their namesa. Use tape to reinforce the

Post-it to the blue bin

2. Once the blue bins are labeled, set them on your metal cart in alphabetical order to help you find the campers quickly

Medication Check-in: Introduction• Introduce yourself to the camper and caregiver

○ Include your name and profession○ Ex: Hello, my name is Dee and I am a nurse. I will

be giving you your medications while you are at camp

• Look at, speak to, and interact directly with the camper, even if they appear to have little or no comprehension

• This is a sign of respect that lets the camper and caregiver know that you view them as a person and value their dignity

• If the counselor is present, introduce yourself to them○ Record the counselor name on your cheat sheet

Beginning the Check-in1. Get original medication bottles and

a “med minder” organizer from the caregiver

2. Set the med minder aside for now and line the medication bottles up on one side of your workspace

3. Starting with the first medication listed on the MAR, find the respective medication bottle

4. Check the prescription label against the MAR to verifya. Drug Name/ Strengthb. Instructions

i. Confirm any special notes from caregivers on far right of MAR

Beginning the Check-in (continued)

5. Open the bottle and note if the pills are tablets/capsules, color, shape, and any imprint or markings (record under “Description” on the MAR)

6. Once you’ve completed checking the prescription bottle against the MAR, move that bottle to the other side

7. Repeat steps 4-6 for each medication listed on the MAR, working in order from top to bottom

8. Check the med minder to ensure that it was set up correctly (more information later)

Checking the Medication Bottles Against the MAR

Checking the Drug Name & Strength • If the drug name on the MAR does not match the medication

bottle○ Write the name on the bottle by the entry on the MAR to

avoid confusion○ Ex: Brand vs. Generic

■ Depakote (100mg) (Valproic Acid)

• Make sure you record the strength per pill, not the total for the whole dose○ Ex: Valium 2 mg

■ Means each tablet is 2mg■ Instructions may read, “Take two tablets by mouth

daily”● You give 2 tablets for a total of 4 mg per dose -

but only record strength as 2 mg

Checking the Instructions • If the MAR does not match the instructions on the

medication bottle○ Ask the caregiver how they normally give the med

■ Be sure to note how to successfully administer the medication under “Special Instructions” on the right side of the MAR

■ Ex: crushed, not crushed, mixed in a food such as applesauce, etc.

■ Be specific!

○ If this does not match the bottle, ask for a doctor signed note with the new instructions■ They were notified that this would be required

○ If they do not have this, CALL the Head Nurse now

Administration Times• Standard CAMP med administration times:

– 0800 (8am) Before Breakfast– 1200 (12noon) Before Lunch– 1430 (2:30pm) Mid Day– 1800 (6pm) Before Dinner– 2000 (8pm) Bedtime

(Some events may have a later lunch or mid day dose, but you will be notified before check-in)

• Verbally verify the administration times with caregiver○ They often confuse 1800 with bedtime meds

• Do NOT agree to any other administration times or giving medication with a meal without getting okay from the Head Nurse before the caregiver leaves check-in

• If medication requires with food, we will provide pudding, applesauce, or other food at the administration table

No Original Medication Bottles?• What if the caregiver did not bring the original medication

bottles?– State law says we must have the original labeled Rx

bottle as our “doctor’s order”– CALL the Head Nurse to the table

■ As the employed CAMP med staff member, she must take care of this

– DO NOT LET THE CAREGIVER LEAVE THE TABLE UNTIL THIS IS TAKEN CARE OF

– Only exception■ If it is OTC, you can identify the pill, and the amount is

normal for the age/weight■ Inform the caregiver that we need the bottle next time■ Note the MAR■ Let the Head Nurse know later

Updating the MAR: Adding Medications• If you get to the end of the MAR list and there are still

bottles you haven’t checked○ Add medications to the MAR following the same

procedures

• Do not keep any medication of any kind, unless on the MAR

• If you need an additional MAR or have any questions, then call the Head Nurse

Updating the MAR: Multiple/Different Doses• If the medication is the SAME dose given multiple

times per day○ It can be on the same line

• If the medication is given in different doses○ It must be on separate lines

■ Ex: Tegretol 100mg, give 1 tab in morning, 2 tabs at lunch and 1 tab at bedtime

■ then list Tegretol 100mg, 1 tab with times 0800 and 2000, on separate line list Tegretol 100mg, 2 tabs with time of 1200

Medication (strength)

Description Amount Time Given

Sun

Tegretol (100 mg) 1 tab 0800, 2000

Tegretol (100 mg) 2 tabs 1200

Updating the MAR: Making Changes• If you need to change info on the MAR

○ Mark one line through the old entry○ Note new info, IF you can while still clear and easy to

read■ If not, mark through whole line and rewrite below

• If a medication is listed on the MAR, but there is no bottle○ Ask the caregiver if the medication has been

discontinued■ If yes, then mark one line through the entry and

note “discontinued”Medication (strength) Description Amount Time Given Sun

Singulair (10 mg) 1 tab 0800 2000

Tegretol (100 mg) changed 2 tabs 1200

Keppra (1 mg) discontinued 1 tab 0800, 2000

Tegretol (100 mg) 1 tab 0800, 2000

Tegretol (100 mg) 2 tabs 1200

Special Products: Blister Packs• If medications are in “blister packs”:

○ Check label against MAR, like a bottle○ Mark with “CAMP start” and your initials above next

dose on card○ Make sure there are enough doses for this event○ Put in labeled plastic bag as you would bottles○ Check with the Head Nurse later to see procedure for

med administration from blister pack○ If previous doses were given out of order, call the

Head Nurse to table

Special Products: Inhaled Products• For inhalers

○ Try to make sure there is enough for entire event○ Note frequency of usage if directions are PRN

• For nebulizers○ Make sure you have all of the parts to the machine

■ Cord, tubing, and neb cup○ Count to make sure there are enough medication

vials for entire event○ Check the expiration date○ Note “specific instructions” on how to give treatment

(right side of MAR) ○ You may label and give to CCC LATER, if they have a

locked storage unit and have been trained to administer

Special Products: Liquids and Topicals• For liquids

○ Show only in mLs or ccs, NOT tsp or tbsp■ 5 mls in one teaspoon (tsp)■ 15 mls in one tablespoon (tbsp)

• Make sure there is enough liquid in the bottle to last the entire event

• For topicals/shampoos/dental creams○ Note the specific location applied to

■ Ex: Apply to face, arms, hands, head, teeth○ You may label and give to CCC LATER for usage in

cabin, if they have a locked storage area

Special Products: Over-the-counter Medications• Over the Counter Meds (OTCs)

– Do not need a prescription ■ Verify appropriate dose for age or weight, as

listed on the bottle– Caregivers were asked to bring the original bottles

for OTCs also, to enable us to identify and give correctly

– If PRN, note amount usually taken and for what specific ailment

■ Right hip pain, headache, cramps, etc.

Special Products: Over-the-counter Medications• If OTC PRN meds are listed on MAR, but caregivers

did not bring○ Leave them on the MAR○ Note info on what specific ailment normally given ○ Note “did not bring” under special instructions on

the right side

• If they bring OTC meds that are not listed on the MAR○ Add to MAR and follow normal OTC procedures

Let’s practice!WHAT WOULD THIS MEDICATION LOOK LIKE ON THE MAR?

Medication (strength) Description Amount Time Given Special Instructions

Notate times in this row

HINT: DESCRIPTION SHOULD HAVE 4 PARTS1. CAPSULE? TABLET? LIQUID?2. COLOR3. SHAPE4. TEXT/IMPRINT

Let’s practice!WHAT WOULD THIS MEDICATION LOOK LIKE ON THE MAR?


Notate times in this rowKALYDECO (150 MG) (IVACAFTOR)

TAB, BLUE OVAL V 150

1 TAB 0800, 2000



Let’s practice!

HINT: HOW MANY ML’S IN A TEASPOON? TABLESPOON?

Let’s practice!

Medication (strength) Description Amount Time Given Special InstructionsNotate times in this row

LEVETIRACETAM (100 MG/ML)(KEPPRA)

LIQUID, CLEAR

10 MLS 0800, 2000

HINT: HOW MANY ML’S IN A TEASPOON? TABLESPOON?



Let’s practice!

Let’s practice!


Notate times in this rowALPRAZOLAM (0.5 MG) (XANAX)

TAB, WHITE, ROUND, E 195

1 TAB GIVE WHEN SHE FEELS ANXIOUS



Ima’s father hands you this medication and tells you that she takes it as needed for headaches but it is not on her MAR. This chart is on the back of the packaging. How would you fill out the MAR?

Let’s Practice OTC medication

You ask her father how old she is and how much she weighs.Ima is 10 years old and weighs 80 pounds.


Notate times in this rowCHILDREN’S TYLENOL

RED LIQUID 15 ML GIVE WHEN SHE HAS HEADACHES. MAX EVERY 4 HOURS

Over-the-counter medicationHINT: USE WEIGHT-BASED DOSING IF POSSIBLE.

Checking the Med Minder Against the MAR

Checking the Med Minder• Check the Med Minder to make

sure that it has been set up correctly

• The Med Minder should match exactly what is on your MAR now

• If the caregiver did not bring a med minder, then we will use one of CAMP’s and set-up after check-in

• Med Minder should be labeled with the campers name and meds in each timed dose

○ If not, put the campers name on the med minder now

• If using med minder with times on it, use tape to mark to show correct CAMP time (0800, 1200, etc)

Correctly Labeled Med Minder

Checking the Med Minder• Open all compartments for 0800, or first time of day

meds given

• Check to make sure each pill that is on the MAR for that time is in each day’s space○ You must check each day!○ Noted shape and color will come in very handy○ MUST BE EXACTLY WHAT IS ON THE MAR○ BE VERY CAREFUL

Do you see the mistake?Hint: Look at Monday and Wednesday

Checking the Med Minder• If incorrect, go over the pills with caregiver, one by one

• Repeat this process each time meds are given

• If there is a dose due during the check in process, ask parent if it has been given yet○ If needed, give it now

• IF YOU HAVE ANY QUESTIONS, CALL THE HEAD NURSE

Finalize Medication Check-in

Special Considerations and Final Questions• Ask if the camper has

any G-tube feeding, supplemental feedings, nebulized or topical medications○ If so, a

Supplemental Feeding and Medication Form needs to be filled out

• Review and verify seizure and allergy information with the caregiver before they leave the medication check-in table and notate it on the MAR

FROM MAR:

Have caregiver verify MAR is correct and have them sign ItI have reviewed, approved, and agree with meds and changes.Parent Signature:

NEW DOCTOR’S ORDERS:

Seizures: DIAGNOSES: CP-spastic quadSZVI

Status: YesEmergency medication: Diastat 15 mg given RectallyFor seizures lasting for more than 5 minutes

Med Staff Initial:

Consolidate Medications• Place all medication bottles in a

Ziploc bag○ Put med minder in a separate

bag

• Label each bag with the campers’ first and last name in large letters using the Sharpie

• Place medication bags in designated blue bucket

• Put blue bucket on rolling shelf

• If you have nebulizer or other container that does not fit in bucket, make sure that it is labeled with camper name and place on shelf

Finalize MAR• Print your name, sign, and

initial the back section on the MAR

• Initial area to show that you checked the MAR against the original bottles and med minder

Take Notes on Cheat Sheet• Mark the times of day this camper gets meds in

designated area of your cheat sheet and make sure the counselor knows this as well○ Fill out the medication administration form for your

campers’ CCC

• Your cheat sheet is a great place to make any personal notes or reminders you may need

• This sheet will be turned in and shredded at the end of the event due to HIPAA

Once Medication Check-in is Complete• Take rolling shelf with the blue buckets and MARs

back to the appropriate medication room in the healthcare center

• It is important that these medications are NEVER out of the control of a HCV until they are locked in the med room○ Do not leave them alone or with non-HCV staff in

the dining area

• Do not let campers near the blue bins at any time during or after check-in

Return to Medication Room• Often there is a scheduled administration time

immediately following the medication check-in ○ (respite weekends = 1200, summer = 1800)○ Quickly prepare the medications due at this time as

soon as you get back to the med room○ Report to the designated area to administer that

medication○ Often the camping staff are holding a meal to make

sure that HCVs have given meds■ Coordinate with the Head Nurse to make sure

you are on time

Return to Medication Room (continued)• If you have no medications due immediately or after

that set is given○ Organize your medications to make it easier to

prepare, administer, and document

• Review each MAR and check the blue bucket for:○ Refrigerated meds in designated refrigerator○ Any special food available, like yogurt, etc○ Any topicals or nebulizers meds ready for cabin

Refrigerated Medications• Place medication in a separate Ziploc bag and clearly

label with the camper’s first and last name and tribe○ Do NOT leave in insulated cooler. This does not

allow cool air to reach the medication

• Put Ziploc bag in the designated refrigerator and mark location on left side of MAR

• If they brought a cooler, place the cooler on the rolling cart and make sure it is labeled with camper name

• If they brought freezer packs, place in a labeled Ziploc bag and place in healthcare center freezer

○ Note the bottom of Check Out area to remember meds and freezer packs

Topical or nebulizer medications to be administered in the cabin

• Put these medications in a separate bag, clearly labeled with○ Camper first and last name○ How/when/where to use medication

₋ Ex: Apply small amount to face after shower at night₋ Ex: 0800 and 2100 - Give one vial of Xopenex via

nebulizer followed by one vial of Pulmicort – do not mix

• Arrange to give to CCC (only if locked storage available), along with nebulizer and any other supplies needed○ Explain usage to CCC, answer any questions, verify

they understand usage, and make sure they have a locked chemical closet to secure meds and equipment

○ Mark “Medication in Cabin” on left of MAR

***Diastat for Status Seizures***If your camper has Diastat for Status Seizures:• Check to make sure the

medication is not expired• Place the Diastat in a separate

Ziploc bag with lubricant packet and two gloves○ Clearly label the bag with:

₋ Camper full name₋ Specific instructions

on use (mg to give, how many minutes, if you should repeat, if you should call 911) and last time used

○ Leave this bag in the camper blue bucket for easy access if needed

○ Add “Diastat” to camper name tag on blue bucket

Epi Pens• Follow similar

procedure as Diastat

• Place in separate Ziploc bag, clearly label with name, allergy, and any other instructions needed

• Place in blue bucket

• Add “Epi Pen” to camper name tag on blue bucket

If you are unsure or have any questions

• Do not hesitate to ask the Head Nurse or a designated experienced HCV

• Someone experienced will be available if you need assistance

• “The only dumb question is the one not asked”

You have completed part 2 of the 3 required training

• Please return to the website and click on Part 3: Medication Administration to CAMPers

• After you have completed all 3 parts of the training, make sure you click on the Survey Monkey link to complete the test

hcv training part 2: camp camp

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