4.7.25. Medication Administration: Buprenorphine Group

Preview

Stepworks reserves the right to administer the medication buprenorphine to a group of clients in order to facilitate education and group learning to high-risk individuals. These groups are scheduled and managed by the Facility Administrator or an individual assigned by the Facility Administrator.

PROCEDURE:

To conduct a Medication Administration: Buprenorphine Group, please abide by the following procedures: Preparing the Medications, Preparing the Room, and Medication Administration.

Preparing the Medications

Because the medications shall be dispensed outside of standard protocols, special care and instruction must be performed to ensure proper medication administration. The following steps must be completed in the Recovery Coach’s office:

  • For each client participating in the Buprenorphine Group, staff shall prepare one quart-size ziplock bag with the client’s first name written on it.
  • Each bag shall contain the following items:
    • Medication cup (with lid) labeled “C” for controlled medication
    • Medication cup (with lid) labeled “PO” for non-controlled medications
  • Staff shall arrange each bag in a carrying case or tray for transportation.

Preparing the Room

The Medication Administration: Buprenorphine Group must be conducted in a private location specified by the Facility Administrator. This location should be prepared prior to admittance by any client, according to the following procedure:

  1. Clear room of all clients and staff.
  2. Set up a table with chairs and a piece of paper marking each client’s place (first name).
  3. Each client’s place should also have a paper cup containing water.
  4. With clients restricted from room, staff shall bring in ziplock bags containing the medication cups and distribute the medication cups to each client’s place at the table.
  5. The door shall be locked once preparation is complete.

Medication Administration

Staff shall direct the clients to gather outside the specified room at a designated time. Once all clients have arrived, the Facility Administrator shall invite the clients into the room and conduct the following procedure:

  • Clients will be asked to take their seat at their designated place and to follow standard medication administration procedures, which include the following:
    • All personal items (books, coats, drinks, etc.) must be left outside the room.
    • Sleeves must be pushed up to the elbows.
    • Clients should place their hands flat on the table.
  • Administration of PO Medications
    • Clients with PO medications will be asked to remove those medications from the medication cup marked “PO” and self administer while staff monitors.
    • Staff will complete a mouth check on all PO medications.
  • Administration of Controlled Medications
    • Clients will be asked to remove their controlled medications from the medication cups marked “C” and place the buprenorphine medication under their tongue.
    • Staff shall perform mouth checks on all clients to verify the medication is under the tongue.
    • Staff will instruct clients to perform the following steps:
      • Remain seated without speaking.
      • Keep heads tilted down.
      • Swallow normally as needed.
      • Notify staff when they feel their medication has dissolved.
    • Once a client notifies staff that their medication has dissolved, the staff shall perform a mouth check. If dissolved, the client will be asked to place their medication cup back into their ziplock bag and leave the room.
  • Once all clients have left the room, staff shall:
    • Sanitize the table tops.
    • Return ziplock bags to clients’ individual medication bags in the Recovery Coach’s office.
    • Document the self administration of medications for each client.

Additional Notes

The Medication Administration: Buprenorphine Group is an opportunity for Facility Administrators (or other staff members) to engage and connect with this group of clients. Stepworks encourages Facility Administrators to utilize this time period for creative activities, such as:

  • Decorative construction paper placemats for each client
  • Asking clients to write at least one thing they really like about themselves on their placemat every day. Allow them to take their place mat with them at discharge so they can remember everything good about themselves.
  • Providing reading material for the client to read during the med time (daily readings, inspirational quotes, song lyrics that are inspiring). These materials must stay in the room.
  • Providing sticky notes and giving clients the opportunity to write a “shout-out” to one or more staff members who have helped them out during their stay. Stick these notes on the wall in that room.
  • Have the clients draw a picture on their place mat that represents happiness to them.