JCPSLP Vol 20 No 2 July 2018

Table 1. Competency attainment outline

Competency checklist

Element

Performance criteria

Competency (yes/no) (date and initials of medical supervisor)

1.1 Raise issues related to drug and poison administration with appropriate personnel (to be further discussed in mentor session) 1.2 Check for and identify common contraindications and adverse reactions of medications and refer to Medical Officer 1.3 Confirm client identity and check for any known allergies 1.4 Refer to drugs and poisons schedules and classifications as determined by law 1.5 Ensure infection control methods are applied correctly 1.6 Identify pharmacology and substance incompatibilities in relation to specific situations involving medication administration 1.7 Check expiry dates of medication prior to administration 2.1 Explain the process of medication administration to the client and ensure their readiness 2.2 Position the client appropriately prior to administration of medication 2.3 Correctly identify administration route for each medication to be administered, using appropriate terminology 2.4 Consider the effect of commonly used medications on the body prior to medication administration 2.5 Prepare medications in accordance with legislative requirements and organisation guidelines 2.6 Apply medication administration techniques and precautions specific to each client situation and as per medication orders 2.7 Ensure medication is stored and disposed of in accordance with medical instructions and organisation policy and procedures 3.1 Administer medications within scope of own role in line with the jurisdictional legislative requirements and organisation policy 3.2 Store medications in a safe manner according to legislative requirements and organisation policy 3.3 Apply quality management and risk assessment practices relating to administration of medication 3.4 Provide client information and education relating to medication requirements 4.1 Record administration of medications in accordance with relevant policy and procedures 4.2 Contribute to information provided to clients and carers on medication administration (including possible side effects) 4.3 Evaluate client understanding of information provided 4.4 Recognise acute and delayed adverse reactions to medications and act upon within role responsibility as appropriate 4.5 Implement emergency actions to address acute and delayed adverse reactions within role responsibility as appropriate 4.6 Record and report response to emergency strategies, where appropriate 4.7 Assess and manage a client experiencing pain using appropriate medication and non- medication therapies 4.8 Record and report effectiveness of pain relieving medication

1. Minimise potential

risk to safe administration of medications

2. Prepare for medication

administration

3. Administer

medications within legal parameters

4. Monitor and

evaluate client response to administered medication

Source: Adapted from Australian Government (2013) [Online Module]. HLTEN507C Administer and monitor medications in the work environment.

Schedule 2 classification under the Therapeutic Goods Act (1989) and Poisons Standard (2017). While Co-Phenylcaine Forte nasal spray is considered to be a “low-risk” medication as per Australian medication scheduling (Therapeutic Goods Act, 1989; Poisons Standard, 2017), it is important to note that stringent risk mitigation strategies were included in the service model to ensure safe administration by the SLP. These strategies included the completion of a thorough case history prior to administration, a review of clinical risk factors, completion of appropriate training and constant access to medical supervision and medical support as part of the services co- location with ENT specialist outpatients.

Unfortunately, the collection of pilot data did not include measures of improved efficiency such as reduced waiting time and reduced demands on medical officers. However, it is seems reasonable to assume that reduced reliance on medical officers to administer medication prior to nasendoscopy would improve service speed and efficiency; an assumption that warrants further exploration. Study limitation Although the sample size included 100 patients, adverse events in response to Co-Phenylcaine Forte nasal spray administration are rare (Georgalas, Sandhu, Frosh, & Xenellis, 2005; Myers & Iazzetta, 1982) and so tracking

73

JCPSLP Volume 20, Number 2 2018

www.speechpathologyaustralia.org.au