A Guide to Medication Management Under the NDIS

Medications are substances given to prevent, treat, manage or cure disease. They can be prescription or non-prescription and include complementary medicines such as vitamins and herbal supplements (DoHaAC 2022).

Many medications are crucial in maintaining health and quality of life, preventing illness and treating health conditions. However, medications can cause serious harm if they are given incorrectly, stored unsafely or not monitored as required (DoHaAC 2022).

For this reason, workers employed by National Disability Insurance Scheme (NDIS) providers must be able to competently manage medications for participants who require them. Support workers do not prescribe, select, commence, cease, change or clinically review medicines. The decision to alter a dose, administration time, route or formulation remains with the qualified medical or health practitioner.

What is Medication Management?

Medication management occurs at both an individual level and a system level. It may include:

• The way in which people take medications or are assisted to take them, including independent self-administration, reminders or prompting, assistance with packaging or equipment or complete administration by a competent worker working within their scope of practice
• Recording medications, including documenting medication administration, refusals, missed doses, as well as a clinical review by a health practitioner or pharmacist
• Storing and disposing of medications, including secure storage, refrigeration when required, returning unwanted/expired medicines to the pharmacy and disposing of sharps safely
• Supporting, monitoring, and evaluating medication use, including observing for expected effects, side effects, or changes in health; reporting concerns; and reviewing whether the medication remains safe and effective.

(NDIS 2021; DoHaAC 2022)

Types of Medications

Medications come in a variety of forms. Workers may need to administer:

• Tablets
• Capsules
• Wafers or melts
• Pastilles or lozenges
• Liquids and suspensions
• Topical skin preparations
• Eye and ear drops
• Nasal drops or sprays
• Inhalants
• Transdermal patches
• Suppositories and pessaries.

(Ernstmeyer & Christman 2020)

A worker may only support a medication form or route that is recorded in the participant's current medication support plan, is supplied in appropriate labelled packaging, is within the worker's approved scope of practice and if they have been trained and assessed as competent to support.

Management of Medication in the NDIS Practice Standards

Management of medication is a requirement of the NDIS Practice Standards under Core Module: Provision of Supports Environment.

This Practice Standard aims to ensure that NDIS participants feel confident that their provider administers, stores and monitors the effects of the medications being administered, and that providers work to prevent errors and incidents (NDIS 2021).

Medication support must also uphold the participant's rights, privacy, informed choice and control, communication needs, independence and dignity of risk. For participants receiving Supported Independent Living Services (SIL), additional Practice Standards apply, including supported decision making and the use of evidence-based, person-centred practices within the participant's home (NDIS 2026a).

Medication Administration Under High Intensity Disability Support

Some medication administration falls under High Intensity Disability Support and requires additional safeguards and specialised training beyond standard medication management. These include:

• Subcutaneous injections
• Medication administered through an enteral (feeding) tube
• Bowel-care related medications
• Medications administered for epilepsy and seizure management
• Medications administered to support dysphagia
• Other medications administered as part of high-intensity support needs.

(NDIS 2022a)

Additional Requirements

When workers support participants requiring high-intensity medication administration, providers must ensure:

• The participant is involved in the assessment and development of their medication plan, which identifies how risks, incidents and emergencies will be managed, including required actions and escalation procedures
• Documented written or phone orders from the prescribing health practitioner authorise the medication to be administered
• Appropriate policies and procedures are in place, including a training plan for workers
• All workers have completed participant-specific training delivered by an appropriately qualified health practitioner, relating specifically to the participant's individual medication and health condition needs, the specific route or method of administration, the relevant high-intensity support skills descriptor, and how to manage any related incidents or emergencies
• Workers understand the participant's related health condition and can recognise changes that require escalation
• Regular and timely health reviews are conducted by an appropriately qualified health practitioner
• Ongoing training and competency reassessment occur as needed.

(NDIS 2022a)

Management of Medication Quality Indicators

• The provider's records clearly state the medications and dosages required by each participant, including all information required to correctly identify the participant and safely administer the medication.
• Workers responsible for administering medications understand the potential effects and side effects of medications and know what steps to take if a medication-related incident occurs.
• Medications are safely and securely stored, can be easily identified and differentiated, and can only be accessed by appropriately trained workers.

(NDIS 2021)

Medication Administration Records (MAR)

Medication Administration Records (MAR) monitor and document a person's medication information and administration (ACSQHC 2021b).

MARs are essential in reducing medication errors and incidents. They also:

• Support safe administration
• Improve communication between workers and health practitioners
• Ensure continuity of care across different support settings.

(ACSQHC 2021b)

A participant's MAR should be a current, accurate and reliable record of all their medications. All medication administration should be documented in the MAR, and the route of administration should be documented clearly using approved and safe terminology, abbreviations and symbols (ACSQHC 2021b).

Approved Abbreviations for Medication Administration

Table adapted from Recommendations for safe use of medicines terminology (ACSQHC 2024).

Safe Medication Administration

To safely administer medicines, all workers must know and adhere to the following checking process, known as the 6 Rights of Medication Administration. Depending on the organisation's policies and procedures, the number of rights may vary.

1. Right person: confirm you are giving medication to the correct participant without allergies to the medication
2. Right medication: the medication should match the prescription and MAR
3. Right dose: the correct amount
4. Right time: the correct time and frequency
5. Right route: the correct method (within your scope)
6. Right documentation: record accurately.

(WA DoH 2025)

Medication Effects and Side Effects

Before administering medication, a worker should understand and have access to information to safely support each participant, including:

• Their own scope and limitations
• The reason why the participant is taking each medication
• The participant's medication history, allergies and past adverse drug reactions
• How the medication should be administered and the expected effects
• Potential side effects, serious warning signs and interactions with other medicines
• Required observations or monitoring
• When and how to escalate concerns.

(ACSQHC 2026)

This information can be provided directly by the participant's pharmacist or through written material, such as a consumer medicine information (CMI) leaflet (TGA 2024).

CMI leaflets contain general information on the safe and effective use of prescription and pharmacist-only medications. They provide information aimed at improving health outcomes, but do not replace the participant's medication support plan or advice from the participant's pharmacist or prescriber (TGA 2024).

Chemical Restraint and Restrictive Practices

It is important for workers to recognise when medication may be considered a chemical restraint. This occurs when medication is used primarily to influence a person's behaviour, rather than to treat a diagnosed health condition (NDIS 2020).

When chemical restraints are used, registered NDIS providers must meet specific behaviour support, authorisation and reporting requirements, with a focus on reducing and eliminating restrictive practices (NDIS 2020).

Workers should understand why a medication is being given and recognise its potential impact on the person's dignity, rights and autonomy (NDIS 2020).

PRN Medications

A PRN (as-needed) medication may be administered when the documented criteria for use are met and in accordance with the worker's training and organisational procedures. The medication plan should clearly state when it can be given, the dose, the minimum interval, the maximum dose, when to escalate, and whether approval is required before administering. If the instructions are unclear, the criteria are not met, or the worker is unsure, do not administer and seek advice (ACSQHC 2021a; DoHaAC 2022; NDIS 2020).

If a PRN medication is being used as a chemical restraint, it comes under the NDIS restrictive-practice framework. This means that each use of a PRN restrictive practice must be reported (NDIS 2020).

Medication Incidents

A medication incident is any event where the expected course of events in the administration of medications is not followed (Tariq et al. 2024).

Medication incidents include:

• Giving medication to the wrong person
• Giving the wrong medication
• Giving the wrong dose
• Giving medication at the wrong time
• Giving medication via the wrong route
• Missing a dose or giving an incomplete dose
• Spilling or dropping medication
• Losing a medication
• Medication being out-of-date
• Medication not actively prescribed
• Drug-drug interactions
• The participant refuses medication or requests not to be given medication
• A near miss.

(Tariq et al. 2024; ACSQHC 2019)

All providers must have an incident management system in place to address incidents that occur (NDIS 2026b). Workers should call for help immediately by dialling 000 if the person requires medical assistance.

The incident must be reported and documented in accordance with the organisation's policies and procedures. Depending on the circumstances of the incident, it may be required to report the incident to the NDIS Commission (NDIS 2026b).

Storage of Medications

All medications must be safely and securely stored to maintain their quality and protect those who live in, work in, or visit the service environment (NDIS 2021).

Wherever possible, dispensed medications should be kept in their original packaging. Workers must not administer loose, unlabeled or unidentified medication.

In some cases, a dosage administration aid (DAA) might be deemed more appropriate for safely storing a medication.

A DAA is a pharmacy-prepared aid that divides solid oral medications into sealed individual doses. The medications are arranged according to the dosing schedule throughout the day (PSA 2017).

Medications, including those in a DAA, should be stored:

• According to the pharmacy label, manufacturer's instructions and participant's plan
• In accordance with legislative requirements
• In a way that protects from heat, light, moisture, contamination and unauthorised access
• Separately and clearly identified for each participant
• In their original packaging or a pharmacy-issued SDAA
• In an area accessed only by appropriately trained workers.

(DoHaAC 2022; PSA 2017)

In most cases, medications should be stored in a cool, dark, dry and secure place. However, certain medications may require special conditions, such as refrigeration. Any unwanted, ceased, or expired medication should be separated from current medication and returned to the community pharmacy or as per organisational policy. Needles and other sharps must be placed immediately into an approved sharps container (DoHaAC 2022).

Medications should always be under the control of a specified worker. At the end of each shift, this worker should be responsible for checking the participant's MAR to ensure that no medication administrations have been missed and that an accurate record has been kept.

Medication access and storage arrangements must reflect the participant's needs, self-managed capacity and risks. Keys and codes must be securely managed and limited to authorised people. Requirements for storing and administering scheduled drugs, specifically schedule 4 and schedule 8 medications, vary by jurisdiction. Check your state or territory legislation and organisational policies.

Identification and Differentiation of Medications

Before administering a medicine, check the label against the participant's MAR, including the name, active ingredient, strength and formulation. If anything is missing, unclear or does not match, do not administer and escalate according to your organisation's procedures.

Use the active ingredient name where possible. Medicines with the same active ingredient may not always be interchangeable, so substitutions require appropriate advice or authorisation.

Medicines should remain in their original labelled packaging or pharmacy-prepared packaging, such as a secure dosage administration aid (SDAA). Never identify a medicine by its colour, size or shape.

Appropriate Training of Workers

Disability service providers must ensure the workers they employ are competent to provide appropriate and safe medication management support to people living with disabilities (NDIS 2021). Workers should not administer medications until they have completed the required training and are deemed competent by their organisation.

Completion of a medication administration training course does not mean a worker is competent to administer medications to all participants or via all routes. Medication management under High Intensity Disability Support will require additional competency.

Conclusion

Competent medication management is essential for maintaining the health, safety and wellbeing of NDIS participants. Workers must understand the different forms medications take, the importance of proper storage, accurate administration, and thorough documentation. Recognising medication incidents and knowing when to escalate is critical to preventing harm.

To learn more about medication administration for NDIS support workers, see Ausmed's training module on Medication Prompting, Assistance and Administration Under the NDIS.