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Who should administer s.4 and s.8 medications in residential aged care?

Who should administer s.4 and s.8 medications in residential aged care?

During July 2022, ANMF members working in residential aged care, and their employers, may receive a consultation paper from the Victorian Department of Health regarding medication administration in residential aged care.

This follows the establishment of a working group to explore how medication management practices in residential aged care can be strengthened.

The focus is on residents who cannot self-administer medications (even with assistance), in particular those medications in Schedules 4 and 8.

Section 36E of the Victorian Drugs Poisons and Controlled Substances Act 1981 (the Act) requires that the approved provider of an aged care service must ensure a registered nurse is in place to manage the administration of Schedule 4, Schedule 8 and Schedule 9 medications supplied on prescription to high-level care residents.

These requirements apply to Victorian residential aged care services, regardless of whether they are operated by public, not-for-profit or private sector organisations.

The consultation paper will explore:

  • the roles and responsibilities of registered nurses, enrolled nurses (both with and without notation) and personal care workers within a residential aged care facility in administering medications or supporting residents, particularly those with cognitive deficits, who need their medications administered to them.
  • whether there are additional safeguards that should be included in Victorian legislation that could better support the administration of medications for residential aged care residents i.e. should the Act include requirements that limit who can administer medications for residents who need medications administered to them.

ANMF strongly encourages members to participate in this consultation phase.

For many years the expectation under the Act that a registered nurse ‘manage’ the administration of medications has too often been compromised by the lack of appropriately trained staff to delegate administration of medicines to.

Since that amendment to the Act, we have seen significant growth in Victoria of Diploma-qualified enrolled nurses to whom registered nurses can comfortably delegate administration of medications, but providers too often try to spread that responsibility to personal care staff who are already run off their feet, and for whom no accredited training exists to undertake that administration responsibility for residents with cognitive difficulties.

ANMF supports amending the Act to require medications that can be harmful if they are not carefully and accurately administered – i.e. those listed in Schedules 4, 8 and 9 – to be administered by a nurse if the resident cannot self-administer. With the improvements to staffing promised by the Albanese Government (i.e. the Aged Care Royal Commission recommendation of 215 care minutes per resident per day) it is an ideal opportunity to address this anomaly while also increasing staffing numbers and skill mix in residential aged care.