Medication Management
A procedure for the safe handling, storage, administration, and recording of medications in workplace settings where medication management is a component of service delivery.
Purpose
To ensure medications are managed safely and accurately, minimising the risk of medication errors and adverse events, and meeting regulatory and accreditation requirements for medication management.
Scope
Applies to all workplace settings where medications are stored, administered, or supervised, including aged care, disability services, childcare, and workplace first aid. Covers all personnel involved in any aspect of medication management.
Prerequisites
- Medication management policy approved and aligned with regulatory requirements
- Staff trained and assessed as competent in medication administration
- Secure medication storage with appropriate temperature and access controls
- Current medication charts or administration records for each person receiving medication
Step-by-Step Procedure
Receive and Check Medications
When medications are received — from a pharmacy, prescriber, or family — check and verify the details before accepting them into the workplace.
- 1.1Verify the person's name, medication name, strength, and quantity against the prescription or order
- 1.2Check the expiry date on all medications
- 1.3Confirm the medication is in its original packaging with the pharmacy label intact
- 1.4Sign the medication receipt register and note the date received
Store Medications Securely
Store medications in a secure, locked area with appropriate temperature control and access restricted to authorised personnel only.
- 2.1Store medications in a locked cupboard, trolley, or room
- 2.2Maintain room temperature medications between 15 and 25 degrees Celsius
- 2.3Store refrigerated medications between 2 and 8 degrees Celsius
- 2.4Separate Schedule 8 (controlled) medications in a separately locked compartment
- 2.5Record refrigerator temperatures daily
Prepare for Administration — The Six Rights
Before administering any medication, verify the six rights: right person, right medication, right dose, right route, right time, and right documentation.
- 3.1Right person — confirm the identity of the person receiving the medication
- 3.2Right medication — check the medication name matches the chart or order
- 3.3Right dose — verify the dose is correct per the prescription
- 3.4Right route — confirm the administration route (oral, topical, etc.)
- 3.5Right time — administer within the prescribed time window
- 3.6Right documentation — ensure the medication chart is current and valid
- Check the medication three times — when retrieving it from storage, when preparing it, and immediately before administering it
Administer the Medication
Administer the medication to the person as prescribed, observing their ability to take the medication and any immediate reactions.
- 4.1Provide the medication to the person with any required accompaniments (water, food)
- 4.2Observe the person taking the medication — confirm it has been swallowed if oral
- 4.3Do not leave medications unattended for self-administration unless authorised
- 4.4If the person refuses the medication, do not force it — document the refusal and notify the prescriber
Document the Administration
Immediately after administering the medication, record the administration on the medication chart. Document any refusals, errors, or adverse reactions.
- 5.1Sign the medication chart at the correct time and date slot
- 5.2Record any refusals with the reason and notification to the prescriber
- 5.3Document any observed adverse reactions and actions taken
- 5.4For Schedule 8 medications, complete the controlled drug register with a witness
Respond to Medication Errors or Adverse Events
If a medication error occurs or an adverse event is observed, respond immediately to minimise harm, report the incident, and document all actions taken.
- 6.1Assess the person for any adverse effects and provide first aid or emergency care as needed
- 6.2Contact the prescriber, pharmacist, or Poisons Information Centre (13 11 26) for advice
- 6.3Notify the supervisor and complete an incident report
- 6.4Document the error, the response, and the outcome
- 6.5Participate in the investigation and root cause analysis
- Report all medication errors, including near-misses — a culture of open reporting prevents future errors
Conduct Regular Medication Audits
Audit medication storage, records, and practices regularly to ensure compliance with the medication management policy and regulatory requirements.
- 7.1Audit medication storage conditions, temperatures, and security
- 7.2Review medication charts for accuracy, completeness, and prescriber authorisation
- 7.3Check for expired medications and arrange disposal
- 7.4Verify Schedule 8 register balances match physical stock
- 7.5Review incident reports for medication errors and trends
Dispose of Medications Safely
Dispose of expired, discontinued, or unwanted medications safely in accordance with regulatory requirements.
- 8.1Return expired or unwanted medications to the pharmacy for disposal
- 8.2For Schedule 8 medications, dispose of them in the presence of a witness and record the disposal in the controlled drug register
- 8.3Do not dispose of medications in general waste or down sinks
- 8.4Maintain a disposal record
Quality Checkpoints
Common Mistakes to Avoid
Expected Outcomes
Number of medication errors per 1,000 administrations, targeting zero errors
Percentage of medication charts found to be fully accurate and current during audits
Percentage of days where medication storage temperatures are within the required range
Frequently Asked Questions
What should I do if a person refuses their medication?
Respect the person's right to refuse. Document the refusal on the medication chart, including the reason if given. Notify the prescriber (doctor or nurse practitioner) as a missed dose may require medical review. Monitor the person for any adverse effects from the missed dose.
How should medication errors be reported?
All medication errors — including near-misses — should be reported immediately to the supervisor and documented using the organisation's incident report form. The focus should be on understanding what went wrong at a system level, not on individual blame. Regulatory reporting may be required depending on the severity and the sector.
Who can administer medications in a workplace setting?
This depends on the regulatory framework for the specific setting. In aged care, medication administration must be carried out by a registered nurse, enrolled nurse, or a trained and assessed care worker under delegation. In other settings, the employer must ensure the person is trained, competent, and authorised under the relevant legislation.
What are Schedule 8 medications and why are they managed differently?
Schedule 8 medications are controlled drugs — substances with a high potential for abuse or dependence, such as opioids and some sedatives. They require additional security (double-locked storage), a separate register, witness requirements for administration and disposal, and regular stock reconciliation due to the risk of diversion.
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