Job aids

Medication words, orders and routes: the steps to remember

The short step lists from each lesson of Medication words, orders, labels and routes for medication helpers, on one page. Print it for the station or the break room. Each list points back to its lesson, where the sources are linked.

Open the course Print a poster with a QR code

Decision guide

May I help with this medication now?

Is the resident saying no to the medication?

Yes
Do not force, hide or trick. Follow your facility's refusal procedure and tell your supervisor.
No
Is it an injection, enema, suppository or oxygen that she cannot manage on her own?
- Yes
  Do not do it yourself. Tell your supervisor: an appropriately skilled professional, such as a nurse, gives it.
- No
  Do the name, drug and directions on the label match this resident and her order?
  - Yes
    Is it a PRN medication, taken as needed, whether prescription or store-bought?
    Yes
    Do the signed order and the label both show the symptoms, exact dose, minimum hours and maximum doses in 24 hours?
    Yes
    Check the physician's written statement. If she can judge and tell her need, assist within the order. If she can do neither, call the physician before each dose.
    No
    Do not assist from an incomplete order. Report the missing item to your supervisor so the physician can complete it.
    No
    Assist her to take her own medication as the order and label direct, and record it the way your facility does.
  - No
    Stop. Do not help, and do not change the label. Tell your supervisor; only the dispensing pharmacist may alter a label.

A job aid, not a rule book. It does not replace the physician's orders or your facility's procedures. A resident who can describe her symptoms but cannot judge her need for a nonprescription PRN medication has its own rule, section 87465(c): ask your supervisor. Call 911 for an imminent threat to health.

Step through it one question at a time: alwbeta.com/training/courses/medication-orders-and-routes#decision-guide

Lesson 1

Medication words the rules define

Medication papers use short words with exact meanings: assist, administer, PRN, OTC. Read one wrong and you may help in a way the rules do not allow. This lesson gives you the words the rules define, so you can tell what each one asks of you on shift.

Assist: she takes it herself. Administer: someone gives it to her
PRN: taken as needed, prescription or not
OTC: sold without a prescription; taken as needed, it is PRN
Skilled professional (RN, LVN, PT, OT, RT): does what staff may not
A short form you do not know: ask, do not guess

Lesson: alwbeta.com/training/courses/medication-orders-and-routes#lesson-medord-words

Lesson 2

Reading a prescription label and a Drug Facts label

Before you help with any medication, you read its label. A pharmacy label and a store-bought medicine's label look different. This lesson shows what each one carries, so you can decide whether the medication in your hand is the right one for the resident in front of you.

Resident's name and the prescribing physician
Drug name, strength and quantity; date filled
Prescription number, pharmacy, expiration date, refills
Does it match the resident and the order? If not, stop and tell your supervisor
Never alter a label: only the dispensing pharmacist may
OTC: read Uses, Warnings and Directions

Lesson: alwbeta.com/training/courses/medication-orders-and-routes#lesson-medord-labels

Lesson 3

Orders for PRN and over-the-counter medications

A resident asks for her as-needed medicine. Or a family member brings a bottle from the store. Before you help, you check the order. This lesson shows what a PRN order must carry, why a store-bought medicine needs one too, and what the physician must say about the resident.

Signed, dated physician order on a prescription blank, in her file
Four items on order and label: symptoms, exact dose, minimum hours, maximum in 24 hours
Store-bought PRN: same order and label
An item is missing: report it, never fill it in
Can judge and tell her need: assist within the order
Can do neither: call the physician before each dose

Lesson: alwbeta.com/training/courses/medication-orders-and-routes#lesson-medord-orders

Lesson 4

Routes: what staff may help with and what goes to a skilled professional

A route is the way a medication gets into the body. A pill goes by mouth. Some residents also use shots, suppositories or oxygen. This lesson shows which routes you may help with, and which ones stay with the resident herself or an appropriately skilled professional.

By mouth: assist her to take her own dose, as ordered
Injections: the resident herself or a skilled professional
Enemas and suppositories: the resident or a skilled professional, with privacy
Oxygen: she runs it herself, or a skilled professional helps
A route you were not trained for: ask your supervisor first

Lesson: alwbeta.com/training/courses/medication-orders-and-routes#lesson-medord-routes

Lesson 5

When to stop and ask: supervisor, physician, pharmacist or 911

Many medication questions are not yours to answer alone. Some go to the physician, some to the pharmacist and some to your supervisor. An emergency goes to 911. This lesson shows the signs that mean stop and ask, and who answers each kind of question.

Physician's name, address and phone: kept ready for staff
Imminent threat to health: 911 first
Order and label disagree: stop, report, do not pick one
Refusal: never force, hide or trick; follow the refusal procedure
Ordering, refills and deliveries: your home's trained steps

Lesson: alwbeta.com/training/courses/medication-orders-and-routes#lesson-medord-when-to-ask