Correctly identifies the person to be assisted by:
• Checking their name and their photograph on their medication forms and on their medication

Correctly identifies the person to be assisted by:
• Checking the QF 5301.02 Current Medication Summary Form matches the medication named on the medication packaging.

Does the staff member position the person appropriately to take or apply their medication. E.g. Sitting, standing?

Does the staff member assist one person at a time – for example, each person is given all of their medication before moving onto the next person?

Staff member checks the 6 Rights of Medication Provision listed below:

Right Person - Correctly re-identifying the person (Name and Photograph).

Right Time - Correctly identifies the time medications to be taken / applied from the (QF 5301.02) Current Medication Summary Form.

Right Drug - Checks the QF 5301.02 Current Medication Summary Form with the name of the drug on the medication pack. Checks the expiry date.

Right Route - Checks the QF 5301.02 Current Medication Summary Form to determine the correct route (for example taken to be taken orally, applied to skin, eyes, etc).

Right Dose - Checks the QF 5301.02 Current Medication Summary Form to determine correct dose to be given and correct dose is provided in medication packaging. Note- Drug dosage refers to the amount to be taken at one time.

Staff member thoroughly washes and dries hands or uses hand sanitizer and puts medication into a clean medicine cup.

Staff member hands the person a glass of water and asks them to take a sip. Hands the medication cup to the person and observes them placing all of their medication into their mouth and swallowing the medication.

Staff member washes up or disposes of used items and then washes and dries hands again.

Right Documentation - Records the assistance of medication on the correct medication record forms (QF 5301.04 and / or QF 5301.05) for Regular, Short Term or PRN medication.

Staff member records any medication incidences in the Incident & Risk Reporting System (if a medication incident occurs).

Staff member continues to observe the person for any adverse reaction.

Staff member requests a work colleague to double check document accuracy after completion of assisting the person with medication

Staff member is able to properly demonstrate how to record a medication incident into Riskman


Assessed as compliant with Medication Management Procedure


I declare that I have observed the employee named on this form assist with medication/s. This person has demonstrated competence in all aspects and requires no further training to safely assist a person to take or apply their medication.

Site Manager
Manager Service Delivery
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.