Medication Assistant Training Demonstrative Skill

Medication Assistant Training Demonstrative Skill Assessment Unit #5: Infection Control – Hand Washing Employee Name: ______________________________________________

Date: ______________

RN Name: ____________________________________________________ Requirement:

Successfully complete skill via this demonstrative skill assessment pursuant to ARSD 20:48:04.01:14. www.state.sd.us/doh/nursing

Hand Washing Skill 1. 2. 3. 4. 5. 6. 7. 8.

□ Pass

□ Fail

Turn on water and adjust to a comfortable warm temperature. Wet hands and wrists. Apply soap over hands and wrists, working into a generous lather by scrubbing vigorously. Use friction while scrubbing vigorously Clean beneath the fingernails, around the knuckles, and along the sides of the fingers and hands. Rinse hands and wrists completely under running water. Pat hands and wrists dry with a paper towel. Turn off water using a clean paper towel.

Supervising RN Signature _______________________________________________________________ Mirabelle Management, LLC ©2007

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Medication Assistant Training Demonstrative Skill Assessment Unit #5: Infection Control – Alcohol Based Hand Sanitizer Employee Name: ______________________________________________

Date: ______________



Alcohol Based Hand Sanitizer Skill 1. 2. 3. 4. 5.

□ Pass

□ Fail

Put a generous amount of hand sanitizer into the palm of your hand. Rub all over your hands to get them very wet. Wash between your fingers and on your nails. Scrub them together without adding any additional water. Shake your hands to let them air dry. Do not use a towel.


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Medication Assistant Training Demonstrative Skill Assessment Unit #5: Infection Control – Glove Removal Employee Name: ______________________________________________

Date: ______________



Glove Removal Skill 1. 2. 3. 4. 5.

□ Pass

□ Fail

Remove the first glove with your gloved hand. Ball up the first glove in the palm of your gloved hand. Slide your ungloved fingers inside your gloved hand at the inside of the wrist. Pull the glove off over the balled up glove in the palm of your hand. While only touching the inside of the glove, dispose of the gloves.

!!! Never let your ungloved hand touch the contaminated/outside of the glove.


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Medication Assistant Training Demonstrative Skill Assessment Unit #5: Infection Control – Disposal of Gloves and Contaminated Bandage Employee Name: ______________________________________________

Date: ______________



Disposal of Gloves and Contaminated Bandage Skill 1. 2. 3. 4. 5. 6.

□ Pass

□ Fail

Remove the first glove with your gloved hand. Ball up the first glove in the palm of your gloved hand. Pick up the contaminated bandage with your gloved hand and place in its palm. Slide your ungloved fingers inside your gloved hand at the inside of the wrist. Pull the glove off over the balled up glove in the palm of your hand. While only touching the inside of the glove, dispose of the gloves and the bandage.

!!! Never let your ungloved hand touch the contaminated / outside of the glove or the contaminated bandage.


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Medication Assistant Training Demonstrative Skill Assessment Unit #7: Medication Administration Systems – Bubble Pack/Punch Card Med Removal Employee Name: ______________________________________________

Date: ______________



Bubble Pack/Punch Card Med Removal Skill

□ Pass

□ Fail

1. Wash your hands and apply gloves. 2. Take the client’s meds from the medication storage area, performing the first of 3 safety checks – checking label and MAR for the 5 rights. 1. Right client 2. Right medication 3. Right dose 4. Right route 5. Right time 3. Continue with safety checks, verifying: Allergies, expiration of drug, and specific instructions. 4. Check label and MAR a second time for each step above. 5. Remove the medication from the bubble pack/punch card, breaking the foil seal on the back of the card before pushing med out from the front of the card. Place the med into the medication cup. 6. Perform third safety check:  Check label with MAR, verifying 5 Rights.  Check for any allergies, expiration date on drug label, and any specific instructions.  Replace cap if applicable.  Return medication container to proper storage area.  Secure medications: lock cart or med room before leaving. 7. Dispose of gloves; wash hands. 8. Document (6th Right).


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Medication Assistant Training Demonstrative Skill Assessment Unit #7: Medication Administration Systems – Medications Dispensed from a Bottle Employee Name: ______________________________________________

Date: ______________



Medications Dispensed from a Bottle Skill

□ Pass

□ Fail

1. Wash your hands and apply gloves. 2. Take medication from medication storage area, performing the first of 3 safety checks - Check label and MAR for 5 Rights: 1) Right client 2) Right medication 3) Right amount 4) Right time 5) Right route 3. Continue with safety checks, verifying: Allergies, expiration of drug, and specific instructions. 4. Check label a second time for each of the previous items. 5. Remove the cap from the bottle, placing it upside down on the counter (inside of cap is facing up). This is to prevent anything contaminating the inside of the cap, possibly contaminating the contents of the bottle when replaced. 6. Pour the correct number of pills from the bottle directly into a med cup. 7. Replace the cap on the bottle being careful not to contaminate any part of the cap. 8. Before administering to client, perform third safety check:  Check label with MAR to be sure correct drug and amount have been set up.  Return medication container to storage area.  Secure medications: lock cart or med room before leaving. 9. Dispose of gloves; wash hands. 10. Document on the MAR (6th Right).


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Medication Assistant Training Demonstrative Skill Assessment Unit #7: Medication Administration Systems – Liquid Meds Dispensed from a Bottle Employee Name: ______________________________________________

Date: ______________



Liquid Meds Dispensed from a Bottle Skill

□ Pass

□ Fail

1. Wash your hands and apply gloves. 2. Take medication from medication storage area, performing the first of 3 safety checks - Check label and MAR for 5 Rights: 1) Right client 2) Right medication 3) Right amount 4) Right time 5) Right route 3. Continue with safety checks, verifying: Allergies, expiration of drug, and specific instructions. 4. Check label a second time for each of the previous items. 5. Remove cap from bottle, placing it upside down on the counter (inside of cap is facing up). Hold the label side of the bottle next to your palm; pour the liquid at eye level to the prescribed amount in the container. (Holding the bottle in this way will keep the label dry and intact should any liquid drip or spill from the bottle). 6. Pour to the level of the meniscus in the container. The meniscus is the curved upper surface of a liquid in a container…it’s where the liquid meets air! 7. Before administering to client, perform third safety check: Check label with MAR to be sure correct drug and amount have been set up. 8. Replace cap, being careful not to contaminate any part of the cap. 9. Return medication to storage area; lock cart or med room before leaving. 10. Dispose of gloves; wash hands. 11. Document on the MAR (6th Right). Supervising RN Signature _______________________________________________________________ Mirabelle Management, LLC ©2007

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Medication Assistant Training Demonstrative Skill Assessment Unit #7: Medication Administration Systems – Crushing Tablets Employee Name: ______________________________________________

Date: ______________



Crushing Tablets Skill

□ Pass

□ Fail

1. Wash your hands and apply gloves. 2. Take medication from medication storage area, performing the first of 3 safety checks - Check label and MAR for 5 Rights: 1) Right client 2) Right medication 3) Right amount 4) Right time 5) Right route 3. Continue with safety checks, verifying: Allergies, expiration of drug, and specific instructions. 4. Check label a second time for each of the previous items. 5. Put the tablets between 2 soufflé cups. 6. Pull down the handle of the crusher. 7. A mortar and pestle (a hard bowl in which substances are put and ground) is also effective. 8. Before administering any medication to client, perform third safety check: Check label with MAR to be sure correct drug and amount have been set up. 9. Replace cap if applicable. 10. Return medication container to storage area. 11. Secure medications; lock cart or med room before leaving. 12. Just before giving the drug, mix with small amount of soft food such as applesauce or per orders/specific instructions. 13. Dispose of gloves; wash hands. 14. Document on the MAR (6th Right). Supervising RN Signature _______________________________________________________________ Mirabelle Management, LLC ©2007

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Medication Assistant Training Demonstrative Skill Assessment Unit #7: Medication Administration Systems – Pill Cutting Employee Name: ______________________________________________

Date: ______________



Pill Cutting Skill

□ Pass

□ Fail

1. Wash your hands and apply gloves. 2. Take medication from medication storage area, performing the first of 3 safety checks - Check label and MAR for 5 Rights: 1. Right client 2. Right medication 3. Right amount 4. Right time 5. Right route 3. Continue with safety checks, verifying: Allergies, expiration of drug, and specific instructions. 4. Check label a second time for each of the previous items. 5. A sharp knife or pill cutter may be used. 6. Perform the third safety check before offering the med to the client. 1. Return medication container to storage area. 2. Secure medications; lock cart or med room before leaving. 7. Dispose of gloves; wash hands. 8. Document on the MAR (6th Right).


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Medication Assistant Training Demonstrative Skill Assessment Unit #10: Common Routes of Medication & Procedures – Oral Medications Employee Name: ______________________________________________

Date: ______________



Oral Medications Skill

□ Pass

□ Fail

1. Wash your hands and apply gloves. 2. Take medication from medication storage area, performing the first of 3 safety checks: Check label and MAR for 5 Rights: 1) Right client 2) Right medication 3) Right amount 4) Right time 5) Right route 3. Continue with safety checks, verifying: Allergies, expiration of drug, and specific directions 4. Check label a second time for each of the previous items. 5. Never touch the medication with your ungloved hand. Punch out or prepare medication by placing med directly into a med cup. 6. Perform third safety check: Check label with MAR to be sure correct drug and amount have been set up. 7. Replace cap if applicable. 8. Return medication container to storage area. 9. Secure medications: lock cart or med room before leaving. 10. Offer a full glass of water (unless contraindicated). 11. Do not give meds with grapefruit juice. Grapefruit juice can interact with medications and lessen or obliterate their effectiveness. 12. Remove your gloves; wash your hands. 13. Document on the MAR (6th Right). Supervising RN Signature _______________________________________________________________ Mirabelle Management, LLC ©2007

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Medication Assistant Training Demonstrative Skill Assessment Unit #10: Common Routes of Medication & Procedures – Sublingual Medications Employee Name: ______________________________________________

Date: ______________



Sublingual Medications Skill

□ Pass

□ Fail

1. Wash your hands and apply gloves. 2. Take medication from medication storage area, performing the first of 3 safety checks: Check label and MAR for 5 Rights: 1) Right client 2) Right medication 3) Right amount 4) Right time 5) Right route 3. Continue with safety checks, verifying: Allergies, expiration of drug, and specific directions 4. Check label a second time for each previous item. 5. Before offering medication to client, perform third safety check.  Check label with MAR to be sure correct drug and amount have been set up.  Replace cap if applicable.  Return medication container to storage area.  Secure medications: lock cart or med room before leaving. 6. Place tablet under client’s tongue.  Instruct client to keep medication in place until it completely dissolves.  No fluids until medication is completely dissolved. 7. Discard gloves, wash hands. 8. Document on the MAR (6th Right).


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Medication Assistant Training Demonstrative Skill Assessment Unit #10: Common Routes of Medication & Procedures – Buccal Medications Employee Name: ______________________________________________

Date: ______________



Buccal Medications Skill

□ Pass

□ Fail

1. Wash your hands and apply gloves. 2. Take medication from medication storage area, performing the first of 3 safety checks: Check label and MAR for 5 Rights: 1) Right client 2) Right medication 3) Right amount 4) Right time 5) Right route 3. Continue with safety checks, verifying: Allergies, expiration of drug, and specific directions 4. Check label a second time for each of the previous items. 5. Before administering med to client, perform third safety check:  Check label with MAR to be sure correct drug and amount have been set up.  Replace cap if applicable.  Return medication container to storage area.  Secure medications: lock cart or med room before leaving. 6. Place medication inside client’s mouth, between gum and cheek. 7. Instruct client to keep medication in place until it dissolves.  No fluids until medication is completely dissolved. 8. Discard gloves, wash hands. 9. Document on the MAR (6th Right).


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Medication Assistant Training Demonstrative Skill Assessment Unit #10: Common Routes of Medication & Procedures – Topical Medications Employee Name: ______________________________________________

Date: ______________



Topical Medications Skill

□ Pass

□ Fail

1. Wash your hands and apply gloves. 2. Take medication from medication storage area, performing the first of 3 safety checks: Check label and MAR for 5 Rights: 1) Right client 2) Right medication 3) Right amount 4) Right time 5) Right route 3. Continue with safety checks, verifying: Allergies, expiration of drug, and specific directions 4. Check label a second time for each of the previous items. 5. Before applying topical medication, perform third safety check:  Check label with MAR to be sure correct drug and amount have been set up.  Replace cap if applicable.  Return medication container to storage area.  Secure medications: lock cart or med room before leaving. 6. Wash and dry area where topical medication is to be applied. 7. When removing the cap, place it upside down on the tray. 8. Apply thin layer of external medication to affected area, using cotton tipped applicator tip to touch skin. 9. Discard soiled gloves and wash hands. 10. Document on the MAR (6th Right).


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Medication Assistant Training Demonstrative Skill Assessment Unit #10: Common Routes of Medication & Procedures – Inhaled Medications Employee Name: ______________________________________________

Date: ______________



Inhaled Medications Skill

□ Pass

□ Fail

1. Wash your hands and apply gloves. 2. Take medication from medication storage area, performing the first of 3 safety checks: Check label and MAR for 5 Rights: 1) Right client 2) Right medication 3) Right amount 4) Right time 5) Right route 3. Continue with safety checks, verifying: Allergies, expiration of drug, and specific directions 4. Check label a second time for each of the previous items. 5. Before offering medication to client, perform third safety check:  Check label with MAR to be sure correct drug and amount have been set up.  Replace cap if applicable.  Return medication container to storage area.  Secure medications: lock cart or med room before leaving. 6. Assemble equipment needed. 7. Shake the MDI. 8. Instruct client to exhale completely. 9. Instruct client to inhale deeply at same time as puffing MDI.  Instruct client to hold breath for at least 10 seconds or as long as possible.  Instruct client to wait 1 minute between puffs. Supervising RN Signature _______________________________________________________________ Mirabelle Management, LLC ©2007

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10. If using 2 inhalers, give in proper sequence: Bronchodilators first, then steroids. 11. Assist to rinse mouth with water after steroid. 12. After each dose, rinse equipment with warm water and air dry on a paper towel. 13. Dispose of gloves; wash hands. 14. Document on the MAR (6th Right).


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Medication Assistant Training Demonstrative Skill Assessment Unit #10: Common Routes of Medication & Procedures – Nasal Spray Medications Employee Name: ______________________________________________

Date: ______________



Nasal Spray Medications Skill

□ Pass

□ Fail

1. Wash your hands and apply gloves. 2. Take medication from medication storage area, performing the first of 3 safety checks: Check label and MAR for 5 Rights: 1) Right client 2) Right medication 3) Right amount 4) Right time 5) Right route 3. Continue with safety checks, verifying: Allergies, expiration of drug, and specific directions 4. Check label a second time for each of the previous items. 5. Before assisting client, perform third safety check:  Check label with MAR to be sure correct drug and amount have been set up.  Replace cap if applicable. Set inhaler aside.  Return medication container to storage area: Lock cart or med room before leaving. 6. Request client to blow nose. 7. Shake the bottle. 8. Have client tilt their head slightly forward; hold one nostril closed. 9. Keep the bottle upright during the procedure. 10. Carefully insert the nasal applicator into the other nostril. 11. Advise client to start to breathe in through the nose. WHILE BREATHING IN, squeeze one time on the applicator to release the spray.


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12. Have client breathe gently inwards through the nostril and breathe out through pursed lips or through their nose. 13. Wipe the nasal applicator with a clean tissue and replace with dust cover. 14. Most nasal sprays should be stored upright. 15. Discard gloves, wash hands. 16. Return inhaler to proper storage location (part of third safety check). 17. Document on the MAR (6th Right).


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Medication Assistant Training Demonstrative Skill Assessment Unit #10: Common Routes of Medication & Procedures – Eye Drop Medications Employee Name: ______________________________________________

Date: ______________



Eye Drop Medications Skill

□ Pass

□ Fail

Verify knowledge  OD = Right Eye  OS = Left Eye  OU = Both Eyes 1. Wash your hands and apply gloves. 2. Take medication from medication storage area, performing the first of 3 safety checks: Check label and MAR for 5 Rights: 1) Right client 2) Right medication 3) Right amount 4) Right time 5) Right route 3. Continue with safety checks, verifying: Allergies, expiration of drug, and specific directions 4. Check label a second time for each of the previous items. 5. Before assisting client, perform third safety check:  Check label with MAR to be sure correct drug and amount have been set up.  Replace cap if applicable.  Return medication container, if applicable, to storage area.  Secure medications: lock cart or med room before leaving. 6. Administer in a private location. 7. Ask client to either sit or lie down. Supervising RN Signature _______________________________________________________________ Mirabelle Management, LLC ©2007

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8. If sitting, assist client to tilt chin up and ask him to look upward. 9. Gently remove any dry or crusted material with a clean, wet washcloth or moist cotton ball. 10. Gently pull lower lid down from eye to make a pouch. 11. Drop one drop at a time into the pouch, making sure that the medication bottle tip does not touch the skin or eye. 12. Occlude (apply slight pressure) the lacrimal sac for one minute to prevent systemic absorption of beta blocker eye drops (ex., Timoptic). 13. Instruct client to close eyes slowly. 14. Wait one minute before applying another drop of the same medication. Wait five minutes between drops if using two different eye drops. 15. Return eye medication to proper location. 16. Dispose of gloves; wash hands. 17. Document on the MAR (6th Right).


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Medication Assistant Training Demonstrative Skill Assessment Unit #10: Common Routes of Medication & Procedures – Eye Ointment Medications Employee Name: ______________________________________________

Date: ______________



Eye Ointment Medications Skill

□ Pass

□ Fail

Verify knowledge  OD = Right Eye  OS = Left Eye  OU = Both Eyes 1. Wash your hands and apply gloves. 2. Take medication from medication storage area, performing the first of 3 safety checks: Check label and MAR for 5 Rights: 1) Right client 2) Right medication 3) Right amount 4) Right time 5) Right route 3. Continue with safety checks, verifying: Allergies, expiration of drug, and specific directions 4. Check label a second time for each of the previous items: 5. Before administration of ointment, perform third safety check: Check label with MAR to be sure correct drug and amount have been set up. 6. Replace cap, if applicable. 7. Secure medications: lock cart or med room before leaving. 8. Assist client to tilt chin up and to look upward. 9. Gently pull lower lid away and down from the eye. 10. Apply thin ribbon of ointment along lower lid from inner corner of eye to outer area of eye. Supervising RN Signature _______________________________________________________________ Mirabelle Management, LLC ©2007

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11. Instruct client to close eyes slowly. 12. Advise client that their vision may be blurred up to one hour after administration of ointment. 13. Return eye ointment to proper storage location. 14. Dispose of gloves; wash your hands. 15. Document on the MAR (6th Right).


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Medication Assistant Training Demonstrative Skill Assessment Unit #10: Common Routes of Medication & Procedures – Ear Drop Medications Employee Name: ______________________________________________

Date: ______________



Ear Drop Medications Skill

□ Pass

□ Fail

1. Wash your hands and apply gloves. 2. 2. Take medication from medication storage area, performing the first of 3 safety checks: Check label and MAR for 5 Rights: 1) Right client 2) Right medication 3) Right amount 4) Right time 5) Right route 3. Continue with safety checks, verifying: Allergies, expiration of drug, and specific directions 4. Check label a second time for each of the previous items. 5. Before administration of ear drops, perform third safety check: Check label with MAR to verify correct drug and amount have been set up. 6. Replace cap, if applicable 7. Assist client to a comfortable position, on his side, his head supported on a pillow, with affected ear up. 8. Warm medication by holding bottle in palm 2-3 minutes. 9. Pull outer ear up, back, and out to straighten the ear canal. 10. Slowly drop ear drops into ear, wiping with a tissue any medication that escapes. 11. Encourage client to remain in this position 2-3 minutes. 12. Assist client to an upright position. Ear disturbances may cause client to feel unbalanced or dizzy. 13. Return ear drop medication to proper location. 14. Discard gloves, wash hands. 15. Document on the MAR. Supervising RN Signature _______________________________________________________________ Mirabelle Management, LLC ©2007

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Medication Assistant Training Demonstrative Skill Assessment Unit #10: Common Routes of Medication & Procedures – Transdermal Patch Removal Employee Name: ______________________________________________

Date: ______________



Transdermal Patch Removal Skill

□ Pass

□ Fail

1. 2. 3. 4.

Wash your hands and apply gloves. Remove old patch(s) before applying a new one. Depending on your company’s policy, you may need to document removal of old patch. Fold the patch in half; old patches may still contain remains of medication. Cut into two pieces and place in sharps container. 5. Document per company policy and procedure.


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Medication Assistant Training Demonstrative Skill Assessment Unit #10: Common Routes of Medication & Procedures – Transdermal Patch Application Employee Name: ______________________________________________

Date: ______________



Transdermal Patch Application Skill

□ Pass

□ Fail

1. Wash your hands and apply gloves. 2. Take medication from medication storage area, performing the first of 3 safety checks: Check label and MAR for 5 Rights: 1) Right client 2) Right medication 3) Right dose 4) Right route 5) Right time 3. Continue with safety checks, verifying: Allergies, expiration of drug (patch), and specific directions. 4. Check label a second time for each of the previous items. 5. Before administering a new patch, perform third safety check:  Check label with MAR to be sure correct patch and dose has been selected. 6. Rotate application sites to help prevent skin irritation. 7. Area should be clean, dry, and with little or no hair, usually the upper arm, back, or chest. Avoid any irritated skin area. (Location may be specified by the manufacturer). 8. Clean area with mild soap and water. Do not use alcohol. Rinse well and wipe dry. 9. Do not use soaps, cleansers, oils, or alcohol on medication patches. 10. Apply the patch to the cleaned skin when dry. 11. Firmly press the patch in place; hold for 20-30 seconds. 12. Date and initial the patch. 13. Remove gloves, wash hands. 14. Document on the MAR (6th Right). Supervising RN Signature _______________________________________________________________ Mirabelle Management, LLC ©2007

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Medication Assistant Training Demonstrative Skill Assessment Unit #10: Common Routes of Medication & Procedures – Vaginal Cream Medications Employee Name: ______________________________________________

Date: ______________



Vaginal Cream Medications Skill

□ Pass

□ Fail

1. Wash your hands and apply gloves. 2. Take medication from medication storage area, performing the first of 3 safety checks: Check label and MAR for 5 Rights: 1) Right client 2) Right medication 3) Right dose 4) Right route 5) Right time 3. Continue with safety checks, verifying: Allergies, expiration of drug, and specific directions. 4. Check label a second time for each of the previous items. 5. Fill applicator with prescribed amount of medication. If prefilled, check dosage. 6. Before administering vaginal cream, perform third safety check:  Check label with MAR to be sure correct drug and amount have been set up. 7. Provide privacy. 8. Encourage client to breathe deeply to help relax. 9. Gently insert applicator into vagina as far as it will comfortably go. 10. Push plunger to release medication. 11. Remove applicator from vagina. 12. Wash applicator with soap and hot water; rinse thoroughly and allow to dry on paper towel. 13. Discard gloves, wash hands. 14. Document on the MAR (6th Right).


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Medication Assistant Training Demonstrative Skill Assessment Unit #10: Common Routes of Medication & Procedures – Rectal Medications Employee Name: ______________________________________________

Date: ______________



Rectal Medications Skill

□ Pass

□ Fail

1. Wash your hands and apply gloves. 2. Take medication from medication storage area, performing the first of 3 safety checks: Check label and MAR for 5 Rights: 1) Right client 2) Right medication 3) Right dose 4) Right route 5) Right time 3. Continue with safety checks, verifying: Allergies, expiration of drug, and specific directions 4. Check label a second time for each of the previous items. 5. Before administration of rectal med, perform third safety check:  Check label with MAR to be sure correct drug and amount have been set up.  Replace cap, if applicable.  Return package of medications to storage area.  Secure medications: lock cart or med room before leaving. 6. Provide privacy. Remember, this procedure can be stressful for anyone. 7. Assist client to a comfortable position on his/her side in bed.  If you are right-handed, client on his/her left side.  If you are left-handed, client on his/her right side. 8. Undergarments should be down or removed. 9. Remove suppository from foil wrap as appropriate. 10. Lubricate suppository or applicator with KY Jelly (or similar product). Supervising RN Signature _______________________________________________________________ Mirabelle Management, LLC ©2007

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11. Slowly and gently insert suppository into anal opening, past rectal sphincter muscle, along rectal wall.  Generally angle suppository toward the belly button.  Encourage client to take several deep breaths. 12. Gently wipe excess lubricant from rectal area. 13. Instruct client to retain suppository medication per instruction or package directions. 14. Discard gloves, wash hands. 15. Document on the MAR (6th Right).


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Medication Assistant Training Demonstrative Skill Assessment Unit #10: Common Routes of Medication & Procedures – Nasal Cannula Application Employee Name: ______________________________________________

Date: ______________



Nasal Cannula Application Skill

□ Pass

□ Fail

1. Wash your hands and apply gloves. 2. Check MAR for 5 Rights (First safety check): 1) Right client 2) Right medication (oxygen) 3) Right dose (flow rate) 4) Right route (inhalation) 5) Right time 3. Continue with safety checks, verifying:  Allergies  Specific directions or any contraindications to nasal cannula application  Dosage (flow rat) per MAR 4. Gather needed supplies and equipment per physician order. Supplies and equipment include the oxygen source (cylinder, concentrator), flow meter, tubing, catheter, nasal cannula, humidifier attachment, and sterile water. 5. Before applying nasal cannula, perform second safety check:  Check MAR to verify correct oxygen flow rate and that each of previous steps are completed. 6. Third safety check: Verify previous 2 checks. 7. Place nasal prongs in nose; fit cannula tubing around ears and adjust tubing slide under chin. 8. Monitor for pressure around ears and pad cannula tubing for comfort if indicated. 9 Encourage nasal passage care regularly in addition to oral hydration – oxygen is a dry gas. 10. Dispose of gloves; wash hands. 11. Document on the MAR (6th Right). Supervising RN Signature _______________________________________________________________ Mirabelle Management, LLC ©2007

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Medication Assistant Training Demonstrative Skill Assessment Unit #10: Common Routes of Medication & Procedures – Simple Face Mask Application Employee Name: ______________________________________________

Date: ______________



Simple Face Mask Application Skill

□ Pass

□ Fail

1. Wash your hands and apply gloves. 2. Check MAR for 5 Rights (First safety check): 1) Right client 2) Right medication (oxygen) 3) Right dose (flow rate) 4) Right route (inhalation) 5) Right time 3. Continue with safety checks, verifying:  Allergies  Specific directions or contraindications to face mask  Dosage (flow rate) per MAR 4. Gather needed supplies and equipment per physician order. Supplies and equipment include the oxygen source (cylinder, concentrator), flow meter, tubing, catheter, face mask, humidifier attachment, and sterile water. 5. Before applying face mask, perform second safety check.  Check MAR to verify correct oxygen flow rate and that each of previous steps are completed. 6. Third safety check: Verify previous 2 checks. 7. Place the mask over the nose; fit the mask straps around the head. 8. Ensure that the mask is secure and comfortable. 9. Encourage nasal passage care regularly in addition to oral hydration – oxygen is a dry gas. 10. Dispose of gloves; wash your hands. 11. Document on the MAR (6th Right). Supervising RN Signature _______________________________________________________________ Mirabelle Management, LLC ©2007

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Medication Assistant Training Demonstrative Skill Assessment Unit #10: Common Routes of Medication & Procedures – Oxygen Saturation Procedure Employee Name: ______________________________________________

Date: ______________



Oxygen Saturation Procedure

□ Pass

□ Fail

1. 2. 3. 4. 5. 6.

Check doctor’s order for frequency of O2 SATS Wash your hands Check battery strength on portable probe Place probe on client’s finger, not thumb When reading appears, make note of information before removing probe. Able to state “normal” reading and procedure to follow if reading is 85% or lower.  Normal= 95-100%  Below 85% = inform supervisor immediately (% will be defined by your company) 6. Record/Document O2 SATS in proper location. 7. Return equipment to storage location 8. Wash hands


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Medication Assistant Training Demonstrative Skill Assessment Unit #10: Common Routes of Medication & Procedures – E Tank Filling Employee Name: ______________________________________________

Date: ______________



E Tank Filling Skill

□ Pass

□ Fail

1. 2. 3. 4.

Wash your hands (gloves are not necessary). Wipe the filling connectors on both the stationary unit and the E tank with a clean, lint free cloth. Turn the flow control knob on the E tank to OFF. Attach the E tank unit to the stationary reservoir at the filling connectors.  Center the E tank unit connector over the reservoir connector.  Lower the unit into the shaped recess or onto the connector.  Once the unit is resting on the connector, hold down firmly until the filling process is complete. 5. Open the fill valve. This valve is found on the E tank.  Press the fill button.  This will start the filling process. As the unit is filling, you will hear a hissing noise. When the unit is full, hissing noise will change and you will see a small cloud of white vapor at the connection.  Always remain with the units while filling. Fill time is approximately 2 minutes. 6. When unit is full, slowly close the fill valve. 7. Disengage the E tank unit from the stationary reservoir.  If the unit does not separate easily, do not force it. The units may be frozen together. Wait until the units warm up and they will separate easily. 8. DO NOT TOUCH any of the frosted parts of the connectors. Liquid oxygen can cause skin frostbite  Reattach the oxygen tubing to the oxygen outlet on the E tank.  Remember to turn the oxygen back on for the client at the correct liter flow; check with the nurse if you have any questions. 9. Wash hands. 10. Document as appropriate (6th Right). Supervising RN Signature _______________________________________________________________ Mirabelle Management, LLC ©2007

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Medication Assistant Training Demonstrative Skill Assessment Unit #10: Common Routes of Medication & Procedures – Portable Oxygen Tank Filling Employee Name: ______________________________________________

Date: ______________



Portable Oxygen Tank Filling Skill

□ Pass

□ Fail

1. Wash your hands (gloves are not necessary). 2. Wipe the filling connectors on both the portable unit and the stationary reservoir with a clean, lint-free cloth. These fittings must be dry. Moisture could cause the units to freeze together. 3. Turn the flow control knob on the portable unit OFF. 4. Attach the portable unit to the stationary reservoir at the filling connectors.  Center the portable unit connector over the reservoir connector.  Lower the unit into the shaped recess or onto the connector.  Once the unit is resting on the connector, hold down firmly until the filling process is complete. 5. Open the fill valve. This valve is found on the portable unit.  Press the fill button.  This will start the filling process. As the unit is filling you will hear a hissing noise. When the unit is full, hissing noise will change and you will see a small cloud of white vapor at the connection.  Always remain with the units while filling. Fill time is approximately 2 minutes. 6. When the unit is full, slowly close the fill valve. 7. Disengage the portable unit from the stationary reservoir.  If the unit does not separate easily, do not force it. The units may be frozen together. Wait until the units warm up and they will separate easily.  DO NOT TOUCH any of the frosted parts of the connectors. Liquid oxygen can cause skin frostbite. 8. Reattach the oxygen tubing to the oxygen outlet on the portable unit.  Remember to turn the oxygen back on for the client at the correct liter flow. 9. Wash hands when finished handling equipment. Supervising RN Signature _______________________________________________________________ Mirabelle Management, LLC ©2007

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Medication Assistant Training Demonstrative Skill Assessment Unit #10: Common Routes of Medication & Procedures – Nebulizer Medications Employee Name: ______________________________________________

Date: ______________



Nebulizer Medications Skill

□ Pass

□ Fail

1. Wash your hands and apply gloves. 2. Take medication from medication storage area, performing the first of 3 safety checks: Check label and MAR for 5 Rights: 1) Right client 2) Right medication 3) Right dose 4) Right route 5) Right time 3. Continue with safety checks, verifying: Allergies, expiration of drug, and specific directions. 4. Check label a second time for each of the previous items. 5. Before assisting with nebulizer, perform third safety check:  Check label with MAR to be sure correct drug and amount have been set up.  Replace cap if applicable.  Return medication container to storage area.  Secure medications: lock cart or med room before leaving. 6. Pour dose of medication into small plastic med cup. Seal cup securely. 7. Attach the filled cup onto the tubing that is connected to the machine. 8. Assist the client putting the mouth piece/mask in place. Be sure mask fits comfortably and securely. 9. Ask client if he is comfortable. 10. Turn the machine on. Note the time. 11. Take off your gloves and wash your hands. 12. Document after treatment is completed (6th Right). Supervising RN Signature _______________________________________________________________ Mirabelle Management, LLC ©2007

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Medication Assistant Training Demonstrative Skill Assessment Unit #10: Common Routes of Medication & Procedures – After Using a Nebulizer Employee Name: ______________________________________________

Date: ______________



After Using a Nebulizer Skill 1. 2. 3. 4. 5.

□ Pass

□ Fail

Wash your hands and put on your gloves. Empty any remaining solution from the med cup. Rinse the mouth piece, connectors & cup with warm tap water. Let air dry on clean paper towel. Remove gloves; wash hands. Document treatment on the MAR.


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Medication Assistant Training Demonstrative Skill Assessment Unit #10: Common Routes of Medication & Procedures – Nightly Nebulizer Equip. Care Employee Name: ______________________________________________

Date: ______________



Nightly Nebulizer Equipment Care Skill

□ Pass

□ Fail

1. Wash hands; apply gloves. 2. Soak the mouth piece or mask in a 50/50 solution of vinegar and water for 30 minutes or per company’s policy and procedure. 3. Rinse thoroughly with cool water. 4. Let dry on paper towel. 5. Remove gloves; wash hands.


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Medication Assistant Training Demonstrative Skill Assessment Unit #10: Common Routes of Medication & Procedures – Insulin Pen Verification Employee Name: ______________________________________________

Date: ______________



Insulin Pen/Syringe Verification Skill

□ Pass

□ Fail

1. Communicate with the client what you are going to do. 2. Gather supplies.  Gloves  Alcohol wipe  Insulin pen  Sharps container 3. Wash your hands and apply gloves. 4. Take insulin pen or prefilled syringe and perform the first of 3 safety checks: Check label and MAR for 5 Rights: 1) Right client 2) Right medication 3) Right dose 4) Right route 5) Right time 5. Continue with safety checks, verifying: Allergies, expiration of drug, and specific directions 6. Check label a second time for each of the previous items. 7. Perform third safety check:  Check label with MAR to be sure correct insulin and amount have been set up.  Replace cap, if applicable.  Return medication container to storage area, if applicable.  Secure medications: lock cart or med room before leaving. Supervising RN Signature _______________________________________________________________ Mirabelle Management, LLC ©2007

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8. Verify dose of insulin to be administered with the client. 9. Assist with alcohol wipe at site to be injected, or allow client to swab area. 10. Client will self inject prescribed insulin dosage from insulin pen or syringe. 11. Dispose of gloves; wash hands. 12. Document (6th Right).


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Medication Assistant Training Demonstrative Skill Assessment Unit #10: Common Routes of Medication & Procedures – Blood Sugar Testing Employee Name: ______________________________________________

Date: ______________



Blood Sugar Testing Skill

□ Pass

□ Fail

1. Communicate with the client what you are going to do. 2. Gather all supplies.  Gloves  Penlet/Lancet  Glucometer and test strips  Moist cotton ball, tissue, or cloth  Dry cotton ball or tissue  Sharps container 3. Wash hands; put on gloves. 4. Cleanse client’s finger tip. 5. Load test strip into Glucometer. 6. Gently massage or ‘milk’ finger toward tip. 7. Prick on side of finger tip. 8. Squeeze gently and draw a drop of blood onto the test strip. 9. Have client apply pressure to puncture site with dry cotton ball or tissue. 10. Eject lancet from Glucometer into sharp’s container. 11. Read results when time. 12. Document results in proper location.


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Medication Assistant Training Demonstrative Skill Assessment Unit #11: Controlled Substances – Counting Controlled Substances Employee Name: ______________________________________________

Date: ______________



Counting Controlled Substances Skill

□ Pass

□ Fail

1. Staff can state principle: Staff person going-off duty counts narcotics with staff person coming-on duty. 2. Staff person going off-duty counts number of pills remaining in bubble pack or medication bottle, keeping number to him/herself. 3. Med container (bubble pack or med bottle) is passed to staff coming-on duty; he/she counts separately and keeps count to him/herself. 4. Both staff verifies correct count. 5. If count is verified, document on appropriate Narcotic Count Sheet the number of pills remaining. 6. Both staff sign name on Narcotic Count Sheet. 7. Medication keys are passed from going-off staff to coming-on staff. 8. Staff can state procedure if count is not accurate:  Both staff remain in building  Nurse is notified and will provide instructions before anyone may leave.


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Medication Assistant Training Demonstrative Skill Assessment Unit #13: Documentation – Procedure for PRN Medications Employee Name: ______________________________________________

Date: ______________



Procedure for PRN Medications

□ Pass

□ Fail

1. Review the documentation for when the medication was last given. 2. Review the documentation for the reason for the last medication. 3. Review the documentation for the name of the person who last administered the medication. 4. Review the possible reasons for using the PRN medication 5. Wash your hands and apply gloves. 6. Complete the first safety check, verify 5 rights. 7. Complete the second safety check. 8. Pour or dispense correct dose. 9. Complete the third safety check 10. Return med to storage. 11. Secure the medications. 12. Remove gloves; dispose and wash your hands. 13. Document.


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Medication Assistant Training Demonstrative Skill

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