Topical Skin Medication Administration

1. Topical Skin Medication Administration Rachel Gallagher, RN, CPNP, NCSN DPI School Nursing Consultant Rachel.gallagher@dpi.wi.gov (608) 266-8857

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3. Training Knowledge training - webcast Competency checklists are available at: http://dpi.wi.gov/sspw/medtraining.html

4. Outline What is necessary prior to administration of topical medication? What are the medication safety guidelines in administering medications, or the 5 + 2 Rs? What are considerations when administering topical skin medications? How are topical skin medications administered?

5. What is necessary prior to administration of topical medication? Medication authorization form (log) Medical provider authorization form (orders) Parent authorization form Medication Sink with soap and water Gloves Applicator (optional for ointments) Dressing (optional for ointments)

6. What are the medication safety guidelines in administering medications, or the 5 + 2 Rs? Right student Right medication Right dosage Right time 5 + 2 Right route Right documentation Right reason

7. What are common types of topical skin medication administration? Medication is present in the ointment and applied to skin. Medication is present in a skin patch that is applied to the skin. Medication is present in a solution that is applied to the skin. Procedure and demonstration of ointment and patch topical medications.

8. What are some considerations for topical ointment medication? Cleansing site and noting condition of skin prior to medication administration can assist in later determining allergic or adverse reactions to the medication. Unless otherwise indicated, evenly apply a thin layer of ointment or solution. Excessive amounts of ointment can cause skin irritation.

9. What are some considerations for topical medication administration? Importance of washing hands before and after administration of the medication.

10. How are topical skin medications administered? 1. Wash hands and apply gloves as necessary. 2. Review the medication rights (student, medication, dosage, time, and route) at initiation of task. 3. Position and drape student. 4. Determine medication administration sites as indicated on the medication administration record.

11. Topical skin medication administration cont. 5. Recheck the medication rights 6. Cleansing site and noting condition of skin. 7. Cleanse site with mild, nondrying soap, rinse, and thoroughly dry. 8. Administration of a thin layer of ointment or solution with cotton applicator or gloved hand.

12. Topical skin medication administration cont. 9. Cover the application site if indicated on the medication administration record or authorization form. 10. Label medication patch with time, date, and initial of person administering the medication.

13. Topical skin medication administration cont. 11. Remove gloves and wash hands. 12. Document medication administration on the medication administration record.

14. Demonstration

15. What are some considerations for topical patch medication administration? Cleansing site and noting condition of skin prior to medication administration can assist in later determining allergic or adverse reactions to the medication. Generally, medication patches should not be administered to skin over boney prominence (such as the backbone or spine, shoulder blades, etc.), hairy, or scarred skin areas.

16. Considerations for topical patch medication cont. After administration of a medicated patch, write date, time, and initials of person administering the medication on the patch.

17. Considerations for topical patch medication cont. Rotation of sites may assist in maintaining the health of skin. Upon removal of a patch, fold the adhesive sides of the patch together to prevent contamination with other surfaces areas. Apply with firm pressure but do not massage applied patches. Massaging patch will increase rate of absorption of medication.

18. Demonstration

19. Questions School nurse Parent Medical provider

20. Any comments regarding this webcast? Any suggestions on future school nursing topics? Contact: Rachel Gallagher (608) 266-8857 E-mail: rachel.gallagher@dpi.wi.gov

21. To take required post-assessment: Close course window by clicking on the red X in the right hand corner. Go to the TRAIN home page by clicking on Home in the green ribbon. Look at My Learning Record in the right hand blue box. Click on My Learning. Select the M (Manage) to the right of the title. Select completed. Select assessment. You must answer 5 out of the 5 question correct to complete the course. To get a certificate: � Go to TRAIN home page. � Go to My Learning Record and click on certificate in right hand column and print.