home medication problem care
DESCRIPTION
The purpose of the resource guide is to provide direction when you have identifiedpossible medication-related problems.Each section of the screening tool and the resource guide is colour coded. If aproblem is identified on the screening tool, go to the corresponding colour sectionof the resource guide and follow the A.C.T.I.O.N. plan.TRANSCRIPT
2 Medication Problem A.C.T.I.O.N. Plan • © 2004 Canadian Pharmacists Association. All rights reserved.
Medication Problem A.C.T.I.O.N. Plan
The purpose of the resource guide is to provide direction when you have identified
possible medication-related problems.
Each section of the screening tool and the resource guide is colour coded. If a
problem is identified on the screening tool, go to the corresponding colour section
of the resource guide and follow the A.C.T.I.O.N. plan.
What A.C.T.I.O.N. means:
A Assess/observe the situation
C Contact your supervisor
T Talk to family member if present
I Identify how you can help
O Open the chart and document
N Note to follow-up
A Resource Guide for Home Support Workers
3Medication Problem A.C.T.I.O.N. Plan • © 2004 Canadian Pharmacists Association. All rights reserved.
Problems taking medication correctly (5 rights) . . . . . . . . . . . . 5
Physical or cognitive problems . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Barriers and other problems . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Change in client condition . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Change in client medication . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Table of Contents
SECTION A
SECTION B
SECTION C
SECTION D
SECTION E
5Medication Problem A.C.T.I.O.N. Plan • © 2004 Canadian Pharmacists Association. All rights reserved.
Have you noticed any of the following behaviours that might suggestthat the client has not taken his/her medication correctly?
Right Patient:
■ Client is taking medication prescribed for someone else
Right Medication:
■ Client took the wrong medication
Right Dose:
■ Client took the wrong dose (e.g., too little/too much medication or nomedication taken)
Right Time:
■ Client took the medication at the wrong time
Right Route:
■ Client used the wrong method/way to take medication*
* An example of wrong method/way:■ Client did not take wrapping off the suppository before inserting it
CONTACT your supervisor
Any problems . . .
■■ PROBLEMS TAKING MEDICATION CORRECTLY (5 RIGHTS)
Stop here
YES
ACTION
Medication Problem A.C.T.I.O.N. Plan • Copyright © 2004 Canadian Pharmacists Association. All rights reserved.
SEC
TIO
N A
NO
7Medication Problem A.C.T.I.O.N. Plan • © 2004 Canadian Pharmacists Association. All rights reserved.
CONTACT yoursupervisor and inform
him/her that the client ishaving difficulty seeing
IDENTIFY how you can help■ Bring eye glasses, contact lenses
or magnifying glass to the client■ Open the curtains and/or turn on
the lights■ If the client is still having difficulty
seeing, contact your supervisor
Client has difficulty seeing
■■ PHYSICAL OR COGNITIVE PROBLEMS
NO
■ Does the client have eye glasses, contact lensesor use a magnifying glass?
■ Is the room too dark?
YES
AND/OR
TALK to family memberif present
OPEN the chart and document what you have done
NOTE to follow-up next visit to seeif client is still having problems
ASSESS/OBSERVEthe situation
SEC
TIO
N B
SEC
TIO
N B
8 Medication Problem A.C.T.I.O.N. Plan • © 2004 Canadian Pharmacists Association. All rights reserved.
Client has difficulty hearing
■■ PHYSICAL OR COGNITIVE PROBLEMS
CONTACT your supervisorand inform him/her that the
client is having difficultyhearing
IDENTIFY how you can help■ If the hearing aid is not
working properly, check to seeif it needs batteries
■ If it is still not working, contactyour supervisor
NO
■ Does the client have a hearing aid?■ Is the hearing aid not working properly?
YES
AND/OR
TALK to family member ifpresent
OPEN the chart and document what you have done
NOTE to follow-up next visit tosee if client is still having problems
ASSESS/OBSERVEthe situation
SEC
TIO
N B
9Medication Problem A.C.T.I.O.N. Plan • © 2004 Canadian Pharmacists Association. All rights reserved.
Client has difficulty taking or preparing medication
■■ PHYSICAL OR COGNITIVE PROBLEMS
CONTACT yoursupervisor immediately
and inform him/her thatthe client is having diffi-culty swallowing; open
the chart and documentwhat you have done
YES
Is the client unableto swallow or havingdifficulty swallowing?
YES
ASSESS/OBSERVEthe situation
Is the client having difficulty cutting tablets,using inhalers, giving injections, measuringmedications, etc.?
CONTACT your supervisor and informhim/her that the client is having difficulty
taking or preparing medications
TALK to family member if present
IDENTIFY how you can help■ Ask the client why he/she thinks he/she is
having trouble■ If the pills are too large or the client has a
dry mouth, give the client a drink of water
OPEN the chart and document what youhave done
NOTE to follow-up next visit to see if client isstill having problems
SEC
TIO
N B
10 Medication Problem A.C.T.I.O.N. Plan • © 2004 Canadian Pharmacists Association. All rights reserved.
Client has difficulty openingmedication bottles
■■ PHYSICAL OR COGNITIVE PROBLEMS
CONTACT your supervisor and inform him/her that the client ishaving difficulty opening medication bottles
■ Is the client having difficulty with stiffness, painful hands, orshakiness?
■ Is this difficulty related to clumsiness or weakness?
■ Is there another problem that is preventing the client fromopening his/her medication bottles?
YES
ASSESS/OBSERVEthe situation
TALK to family member if present
OPEN the chart and document what you have done
NOTE to follow-up next visit to see if client is still having problems
IDENTIFY how you can help■ Follow agency policy on medication procedures
SEC
TIO
N B
11Medication Problem A.C.T.I.O.N. Plan • © 2004 Canadian Pharmacists Association. All rights reserved.
IDENTIFY how you can help■ Follow agency policy on medication procedures
Client has difficulty remembering
■■ PHYSICAL OR COGNITIVE PROBLEMs
CONTACT your supervisor and inform him/her that the client ishaving difficulty remembering
■ Is the client confused or having memory problems?
■ Have you noticed your client forgetting to take his/her medication?
YES
ASSESS/OBSERVEthe situation
TALK to family member if present
OPEN the chart and document what you have done
NOTE to follow-up next visit to see if client is still having problems
SEC
TIO
N B
12 Medication Problem A.C.T.I.O.N. Plan • © 2004 Canadian Pharmacists Association. All rights reserved.
Client does not understand
■■ PHYSICAL OR COGNITIVE PROBLEMS
IDENTIFY how you can help■ Follow agency policy on medication procedures
CONTACT your supervisor and inform him/her that the client does notunderstand something about his/her medication or he/she has forgotten
■ Has anyone explained the purpose of the medication to the client?
■ Has anyone ever explained to the client what medication to takeand/or how and when to take medication?
ASSESS/OBSERVEthe situation
TALK to family member if present
OPEN the chart and document what you have done
NOTE to follow-up next visit to see if client is still having problems
If NO or if client has forgotten
■ the purpose of medication
■ what medication to take
■ how/when to take medication
SEC
TIO
N C
13Medication Problem A.C.T.I.O.N. Plan • © 2004 Canadian Pharmacists Association. All rights reserved.
ASSESS/OBSERVEthe situation
CONTACT your supervisor and inform him/her thatthe client is unwilling to take medication
■ Ask the client why he/she is not willing to takemedication
■ Why does the client feel this way?
TALK to family member if present
IDENTIFY how you can help■ Follow agency policy on medication procedures
OPEN the chart and document what you have done
NOTE to follow-up next visit to see if client is stillhaving problems
Client unwilling to takemedication as prescribed
■■ BARRIERS AND OTHER PROBLEMS
SEC
TIO
N C
14 Medication Problem A.C.T.I.O.N. Plan • © 2004 Canadian Pharmacists Association. All rights reserved.
ASSESS/OBSERVEthe situation
CONTACT your supervisor and inform him/herthat the client may not be filling prescriptions
because of financial difficulties
■ Are there any medications that the client has notpurchased because of financial difficulties?
TALK to family member if present
IDENTIFY how you can help
OPEN the chart and document what you have done
NOTE to follow-up next visit to see if client is stillhaving problems
Client has financial difficultypaying for prescriptions
■■ BARRIERS AND OTHER PROBLEMS
YES
TALK to family member if present
IDENTIFY how you can help
OPEN the chart and document what you have done
NOTE to follow-up next visit to see if client is stillhaving problems
SEC
TIO
N C
15Medication Problem A.C.T.I.O.N. Plan • © 2004 Canadian Pharmacists Association. All rights reserved.
Client physically unable to leavehome or has no transportation
■■ BARRIERS AND OTHER PROBLEMS
ASSESS/OBSERVEthe situation
CONTACT your supervisor and inform him/her that theclient is having difficulty either leaving home and/or
has no transportation
YES
■ Ask the client what is making it difficult for him/herto leave the home
■ Does this affect the client’s ability to receive medicalcare and/or get prescriptions?
SEC
TIO
N C
16 Medication Problem A.C.T.I.O.N. Plan • © 2004 Canadian Pharmacists Association. All rights reserved.
Client needs more caregiversupport with medication
■■ BARRIERS AND OTHER PROBLEMS
ASSESS/OBSERVEthe situation
CONTACT your supervisor and inform him/her thatthe client does not have a reliable caregiver to help
with medications
TALK to family member if present
IDENTIFY how you can help
OPEN the chart and document what you have done
NOTE to follow-up next visit to see if client is stillhaving problems
NO YES
■ Was there a previouscaregiver who is no longerinvolved?
■ Does the client have areliable caregiver to helpwith medications?
SEC
TIO
N C
17Medication Problem A.C.T.I.O.N. Plan • © 2004 Canadian Pharmacists Association. All rights reserved.
Client keeps old or expired bottles of medication
■■ BARRIERS AND OTHER PROBLEMS
ASSESS/OBSERVEthe situation
CONTACT your supervisor and inform him/her that the clienthas old or expired bottles of medication or that the client is
using these medications
■ Does the client have old or expired bottles of medication(including over-the-counter medication, vitamins, andherbal products)?
TALK to family member if present
IDENTIFY how you can help■ Follow agency policy on medication procedures
OPEN the chart and document what you have done
NOTE to follow-up next visit to see if client is stillhaving problems
YES
SEC
TIO
N C
18 Medication Problem A.C.T.I.O.N. Plan • © 2004 Canadian Pharmacists Association. All rights reserved.
Client has poor storageconditions of medication
■■ BARRIERS AND OTHER PROBLEMS
ASSESS/OBSERVEthe situation
CONTACT your supervisor and inform him/her thatmedication storage conditions are poor
■ Does the client keep medication in unlabelled containers?■ Does the client keep medication too near a stove or in
too much sunlight?
TALK to family member if present
IDENTIFY how you can help■ Follow agency policy on medication procedures
OPEN the chart and document what you have done
NOTE to follow-up next visit to see if client is still havingproblems
YES
SEC
TIO
N D
19Medication Problem A.C.T.I.O.N. Plan • © 2004 Canadian Pharmacists Association. All rights reserved.
Have you noticed any changes in your client’s condition?
■ Change in bowel patterns (diarrhea, constipation, gas)
■ Change in bladder patterns (frequency, odour, colour)
■ Change in behavior, memory, mood, or thinking pattern
■ Change in mobility (problems wtih walking, standing up, dizziness, falling)
■ Change in appetite (increased/decreased appetite, nausea, dry mouth, thirst)
■ Change in energy level (more tired than usual or more energy than usual)
■ Change in sleeping pattern (difficulty staying awake/falling asleep)
■ Change in comfort level (unusual discomfort, pain, headache)
■ Other ____________________________________________________________
CONTACT your supervisor
Stop here
YES
ACTION
Any changes . . .
■■ CHANGE IN CLIENT CONDITION
NO
SEC
TIO
N E
21Medication Problem A.C.T.I.O.N. Plan • © 2004 Canadian Pharmacists Association. All rights reserved.
Are you aware or have you been informed of any recent changes inthe client’s medication either after a visit to the doctor or dischargefrom the hospital?
CONTACT your supervisor
Stop here
YES
ACTION
Any changes . . .
■■ CHANGE IN CLIENT MEDICATION
NO
22 Medication Problem A.C.T.I.O.N. Plan • © 2004 Canadian Pharmacists Association. All rights reserved.
This program was developed by the Canadian Pharmacists Association in
collaboration with the Canadian Association for Community Care and Canada’s
Association for the Fifty-Plus. The project was funded by the Population Health
Fund, Health Canada.
The Medication Problem A.C.T.I.O.N. Plan kit contains information representing the opinions and experience of health
care professionals who developed the program. Every effort has been made to provide useful and accurate informa-
tion. However, the Canadian Pharmacists Association, the Canadian Association for Community Care and Canada’s
Association for the Fifty-Plus are not responsible for the use or the consequences of the use of the information in this
program. Users are advised that the information presented is not intended to be all inclusive. Consequently, health
care professionals and other users of the program are encouraged to seek additional and confirmatory information
to meet their practice requirements as well as the information needs of their patients.
PROJECT STEERING COMMITTEE
Kirsten Woodend, Co-chair, Canadian Pharmacists Association
Taylor Alexander, Co-Chair, Canadian Association for Community Care
Judy Cutler, CARP, Canada’s Association for the Fifty-Plus
Barbara Ryan, Access Health Care Services Inc.
Jeannine Boyd, Canadian Home Care Association
Ron Silver, Westboro Pharmasave
Barb Farrell, Sisters of Charity of Ottawa Health Service
Linda MacKeigan, University of Toronto
Nancy Unsworth, VON Ottawa Carleton Branch
Andrea Moser, Family Physician, Care of the Elderly, Huntsville
Malcolm Anderson, Queen’s University
Stephanie Gariepy, Access Health Care Services Inc.
Anne Dawson, Seniors Representative
Barbara Levitan, ParaMed Home Health Care
Sarah Mifflin-Bloom, Project Coordinator, Canadian Pharmacists Association
Sandra Young, Research Assistant, Canadian Pharmacists Association
Lyne Stuewe, Research Assistant, Canadian Pharmacists Association
23Medication Problem A.C.T.I.O.N. Plan • © 2004 Canadian Pharmacists Association. All rights reserved.
Medication Problem
A Resource Guide for Home Support Workers
A.C.T.I.O.N. Plan
1785 Alta Vista Drive, Ottawa, ON K1G 3Y6
Tel 613 523-7877 Toll Free 1 800 917-9489
Fax 613 523-0445 [email protected]
www.pharmacists.ca
Medication Problem A.C.T.I.O.N. PlanA Resource Guide for Home Support Workers