Untrained HCA's giving meds

loriangel14, RN · Jul 5, 2012

What kind of facility? A friend of mine worked in a retirement home as an untrained HCA and she passed meds.It isn't regulated in some types of facilities.I know staff in group homes give meds with no formal training.

lemur00, BSN, RN · Jul 5, 2012

Medication administration by unlicensed staff is usually covered in provincial law by personal care home or home health regulations. Provinces differ, but usually there will be regulations about keeping the meds in original containers and administering strictly according to physician's orders. With meds like insulin, pre-filled doses are usually recommended. Here (SK) it is also part of the law to only administer meds if the person is unable to self-administer.

RDNurse · Jul 5, 2012

This is a private facility which is partially funded by AHS. According to the Government Organization Act HCA's are restricted in dispensing Schedule 1 and 2 medications which are of course narcotics. The HCA's have been told they can now do this if the narcotics are in blister packs or pouches. They have also been told they can now take doctors orders.

I've emailed my licensing body to find out if I will be responsible for any situations that arise.

Thanks for your replies.

itsmejuli · Jul 5, 2012

I'm in Alberta and have just started working in a lodge as an HCA supervisor. Our HCAs must go through a 6 week med course before passing meds from blister packs. One of our client's is receiving scheduled narc from a blister pack kept in a lockbox. I should add that the facility is private and I am working for a homehealth company.

I don't get how or why an HCA would take doctor's orders.

Daisy_08, BSN, RN · Jul 6, 2012

Here in Ontario that is legal in retirement homes and group homes ect. My first job was retirement. We had an nurse and UCP (unregulated health care provider) both giving meds. The nurse did all injectable nacs and sliding scale insulin. As well this company only had people with previous medical knowledge, like foreign trained nurses and nursing students. UCPs had to take a medication course, write a test and be supervised for a few med passes. I felt safe that the residents were safe with the UCPs.

However, A friend of mine recently was hired at a retirement home as charge nurse and is shocked by the knowledge of those they allow to give meds. They require no previous medical knowledge, not even personal support worker experience. She said they do not know what they are giving therefore don't make the necessary assessments. They play a guessing game with PRN meds, pt has a mild headache, they give dilaudid over ibuprofen because its the first one they see and snow the pt. I think it is pretty scary.

itsmejuli · Jul 11, 2012

Turns out I was wrong, our HCAs are not required to go thru a med class.

I will be spending time making sure they do it right and that our careplans and doctor's orders are up to date.

The HCAs are only allowed to give meds from blisterpacks, they are not allowed to give any PRNs.

Fiona59 · Jul 11, 2012

Home support workers routinely did this and gave insulin that was premeasured in syringes after taking their sugars.

I don't see it as being any different from family members doing the same. They follow the same charts, no insulin if sugar below xy and call it in.

lemur00, BSN, RN · Jul 16, 2012

Yeah that's exactly the logic behind it. If this person were able, they'd be giving the same meds per self. If with family, family would do it. Many unlicensed people give meds everyday.