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Elements and Performance Criteria

1. Elements define the essential outcomes
2. Minimise potential risk to ensure safe administration of medications.
   • Refer to drugs and poisons schedules and classifications as determined by law.
   • Identify the purpose and function of prescribed medicine and intravenous (IV) therapy.
   • Identify pharmacology and substance incompatibilities in relation to specific situations involving medication administration, blood and blood products.
3. Prepare for medication administration and infusion of IV fluids.
   • Explain the process of medication administration or IV fluid infusion to the person, and ensure their readiness and understanding.
   • Identify correct administration route or site for each medication or IV fluid to be administered, and position the person appropriately.
   • Consider the effect of commonly used medications and IV fluids on the body before medication administration and IV infusion.
   • Calculate accurate dosages and IV infusion rates for administration of drugs.
   • Prepare medications in accordance with legislative and jurisdictional requirements and organisation policy and procedures.
   • Identify medication administration techniques and precautions specific to the person’s situation and as per medication orders.
   • Prepare blood and blood products for blood transfusions according to organisation policy and procedures.
4. Administer and store medication.
   • Administer medication or IV fluid to the person applying the ‘Rights of Medication’ concept and in accordance with the jurisdictional and legislative requirements and organisation policy and procedures.
   • Secure medications in a safe manner during medication administration.
   • Apply quality practices in management and use of medications, and undertake risk assessment practices that relate to medication administration.
   • Report to the registered nurse a person’s refusal of medication or IV therapy or suspected incomplete medication ingestion.
   • Ensure medication and blood and blood products are stored, handled and disposed of according to organisation policy and procedures and manufacturers’ instructions.
5. Monitor and evaluate a person’s response to administered medication, IV fluids and blood and blood products.
   • Document and monitor observations of the person’s response and whether intended outcome of administered medications, IV fluids and blood and blood products is achieved.
   • Recognise, record and report acute and delayed adverse reactions of the person to medications, and implement emergency actions within own role responsibility.
   • Record, report and evaluate fluid and electrolyte imbalances, and monitor the effect on the person of medicines commonly administered with IV fluids.
   • Remove IV cannula according to organisation policy and procedures
   • Provide educative information to the person, their family or carer concerning the administration of medicines including possible side effects.
6. Assess effectiveness of pain-relieving therapy.
   • Observe and question the person to identify signs of pain or discomfort.
   • Clarify the location and nature of pain or discomfort, taking into account factors that may influence the person’s perception of pain.
   • Ensure consistency in interpreting observations and evaluating the person’s pain using the pain assessment scale.
   • Identify a range of prescribed medications and complementary strategies that may assist in alleviating pain and discomfort.
   • Assess and manage effectiveness of pain-relieving medication and non-medication therapies for the person experiencing pain.
   • Record observations of the person and own evaluation the effectiveness of pain management strategies.
7. Monitor and evaluate a person’s response to administered medication, IV fluids and blood and blood products.
   • Document and monitor observations of the person’s response and whether intended outcome of administered medications, IV fluids and blood and blood products is achieved.
   • Recognise, record and report acute and delayed adverse reactions of the person to medications, and implement emergency actions within own role responsibility.
   • Record, report and evaluate fluid and electrolyte imbalances, and monitor the effect on the person of medicines commonly administered with IV fluids.
   • Remove IV cannula according to organisation policy and procedures
   • Provide educative information to the person, their family or carer concerning the administration of medicines including possible side effects.

Performance Evidence

The candidate must show evidence of the ability to complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the job role. There must be evidence that the candidate has:

undertaken nursing work in accordance with Nursing and Midwifery Board of Australia professional practice standards, codes and guidelines

calculated medications with 100% accuracy and used the ‘Rights of Medication’ to administer medication to at least 2 people in simulation and at least 3 people in the workplace, and which must include the following routes:

oral

sub-cutaneous injection

calculated medications with 100% accuracy and used the ‘Rights of Medication’ to administer medication in the workplace or in a simulation environment to at least 2 people, and which must include the following routes:

intramuscular injections

peripheral IV injection

safely prepared equipment for IV therapy and blood and blood products administration, and monitored IV therapy and blood and blood products administration in the workplace or in simulated environment to at least 2 people including assessing cannula site.

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Knowledge Evidence

The candidate must be able to demonstrate essential knowledge required to effectively complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the work role. This includes knowledge of:

legal requirements for practice parameters of enrolled nurse in relation to the administration and documentation of medications, including legal requirements for each route of administration

legal and regulatory framework including

health (drugs and poisons) regulations

State/Territory drugs and poisons Acts

State/Territory nurse regulatory authority codes and guidelines

National Safety and Quality Health Standard (NSQHS) ‘Preventing and Controlling Health Care Associated Infections’

Visual Infusion Phlebitis Score (VIPS)

scheduled medications and interpretation of scheduling of medications - Schedule 2, Schedule 3, Schedule 4, Schedule 8

forms of medication and how they are handled, calculated, administered and stored, including:

capsules

drops

inhalants

liquid

lotions and creams

ointments

patches

powders

tablets

wafers

suppositories

pharmacology of medications, including:

pharmacodynamics

pharmacokinetics

pharmacotherapeutics

toxicology

anaphylactic reactions

adverse reactions

contraindications

precautions

side effects

potential complications of blood transfusion including:

pain at IV site and arm

loin pain

urticaria (hives)

nausea and vomiting

headache

flushing, chills or fever

anxiety

tachycardia

wheezing, progressing to cyanosis

haematuria

anaphylactic reaction or shock

cardiac arrest

death

how to transport, store, handle, check and dispose blood and blood products safely

‘Rights of medication’ - the right medication (drug, medication, medicines), right dose, right prescription (documentation), right route, right time, right person, right expiration date, right to refuse

how medication is administered via the following routes or methods:

oral

sublingual, buccal

dry powder inhalers

metered dose, spacer inhalers

nebulisers

oxygen therapy

subcutaneous injection

intramuscular injections

IV injections

Z-track injections

peripheral IV infusion, cannulation fluid

enteral administration - Percutaneous Gastrostomy (PEG) as well as nasogastric tubes

intranasal, including nebulised medications

ocular

rectal

subcutaneous, intramuscular routes

sub-cutaneous injection using pre-loaded syringes or pens

topical, including transdermal

vaginal

ventrogluteal injection technique

IV medication administration methods including:

bolus

gravity

electronic pump infusion

via burette

IV piggyback, tandem

syringe driver

sub-cut lines

pathophysiology related to medicine groups including but not limited to:

Anaesthetics Analgesia Antacids Antianginals antianxiety Antiarrhythmics Antibiotics Anticholinergics Anticoagulants	Anticonvulsants Antidepressants Antidiarrhoeals Antiemetics Antifungals Antihistamines Antihypertentives Anti-inflammatory
Antineoplastics Antiparkinsonion Antipruritic Antipsychotics Antiseptics Antiulcer Antivirals Anxiolytics	Hormones Hypnotics, sedatives Hypoglycaemics Insulin
Beta-blockers Bronchodilators	Electrolyte solutions
Laxatives/aperients	Ophthalmic, otic nasal medications
Contraceptives Corticosteroids	Diuretics
Narcotic analgesia Neuroleptics	Vitamins

factors to consider when calculating medication dosages including:

calculation formulae

calculation of dosages of injectable drugs including liquid, solid unit dosages

flow rate drops per minute

flow rate millilitres per hour

paediatric dosage calculations - considering body weight, surface area and age-related dose reduction

geriatric dosage calculations - considering body weight, surface area and age

dose administration aids (DAAs) where dose is already calculated

organisation policy and procedure for addressing medication errors

drugs commonly used for fluid and electrolyte imbalance:

acidifiers, alkalisers

diuretics

electrolytes

replacement solutions.

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