Jean B. Thompson Executive Director, OALA
September, 2008
Medication Aide Program
• Initial Pilot May 1, 2006 to June 30, 2007 • Report to be issued by Bd. Of Nursing, March 1,
2007 from input by pilot sites
• Pilot extended last budget due to small numbers of aides certified at the time
• New budget language called for report process to begin when 75thmedication aide certified
• Bd. Of Nursing to publish implementation date on their website – March 26, 2009
• Statewide implementation March 26, 2009
Medication Aide Program
• At statewide implementation, all RCFsmay use certified aides within limit of rules • Only “glitch” would be if thwarted by
report, or groups opposed
• MA-Cs will be able to administer law/rule defined medications using law/rule defined
routes/methods as a delegated nursing task • Nurse delegation already defined in Ohio law,
ORC 4723.67, OAC 4723-13-07
• RN/LPN (with medication authority, unrestricted license med adm) working in RCF/NH may delegate med admin to MA-C
Medication Aide Program
• On-site nursing supervision of MA-Csrequired in NHs
• On-site or off-site supervision of MA-Cs allowed RCFs. If off-site, nurse must be available via telecommunications, as permitted in delegation law, MA-C rules added “immediately & continuously”
Medication Aide Program
• Limitation in RCFs when nursingsupervision not on-site for PRN meds • RCF, nurse not on-site, only OTC meds by
MA-C, after telephonic consultation with nurse familiar with resident/their nursing regimen
• A RN, RCF/NH has done nursing assessment resident/whom PRN to be administered
• Nursing regimen established that contains PRN interventions
• Nurse determines need from sources: a) direct observation, b) nursing regimen c) resident record
• Nurse determines safe for MA-C admin.
Medication Aide Program
• Law/Rule prohibited medications: maynot be delegated to MA-Cs in RCFs/NHs
• Schedule II drugs containing controlled substances, medications requiring dosage calculation, including inhalants delivered by inhalers/nebulizers/aerosols,
medications that are not approved drugs, drugs administered as clinical research or oxygen
Medication Aide Program
• Permitted medications/routes fordelegation to MA-Cs
• Prohibited methods of administration:
may not be delegated to MA-Cs in RCFs/NHs
• Injectables, intravenous therapy
procedures, splitting of pills for purposes of changing dosage, feeding tubes
(jejunostomy, gastrostomy), nasogastric or oral gastric tubes.
Medication Aide Program
• Other prohibitions for MA-Cs • May not receive, transcribe, alter medorders or act without appropriate delegation, nor delegate to anyone else • Have access to Schedule II controlled
substances
• Accept care assignments that conflict with/interrupt adm. duties, other times yes
Medication Aide Program
• Administer initial dose of any medication • Administer meds to persons outside ofresidents of participating RCFs/NHs • Administer meds to pediatric residents
(NH)
• MA-Cs may not engage in any abusive physical, verbal, mental, emotional behavior. Misappropriate resident
property or engage in any sexual behavior or activity with residents
• MA-Cs may not submit false, misleading information to Board of Nursing or employers
Medication Aide Program
• MA-Cs shall act in accordance with rulesgoverning their certification • Display at all times their title when
administering (MA-C)
• Demonstrate competence for their tasks • Accurately document medication
administration
• Maintain resident confidentiality • Use/maintain professional boundaries
Medication Aide Program
• Promote resident safety by:• 1) Reporting to nurse appropriately, timely • 2) Preparing/storing meds with
manufacturer’s, pharmacists instructions • 3) Removing meds only from
• 5) Witnessing resident taking med
• 6) Immediately document/reporting errors to nurse
• 7) Utilizing med delivery process in use RCF/NH
• 8) Administering in accordance w/standards in med aide curriculum
Medication Aide Program
• Nurse responsibilities prior to delegation: Evaluate resident, their med needs, mental & physical stability, med. Timeframes, route or method of administration & ability of MA-C to safely administer
• Allows delegating nurse to decide if resident and/or MA-C appropriate for delegation. Can not be arbitrary/safety issue
Medication Aide Program
• Delegating nurse must communicate • Residents MA-C to administer to, meds tobe administered, timeframes for
administration and any special instructions • Nurses in RCF/NH utilizing MA-Cs remain
responsible for:
• 2) Accepting, transcribing, reviewing resident med orders
• 3) Monitoring residents to whom meds are adm., side effects, changes-health status • 4) Reviewing documentation of MA-Cs • Nurses who delegate according to
rule/laws not be liable damages persons, govt. entities in civil action for acts, omissions MA-Cs
Medication Aide Program
• Requirements to be a MA-C• 18 years old, HS diploma or GED • In RCF, have 1 year direct care
experience or be an STNA (if only direct care experience limited to RCF work) • In NH, must be an STNA
• MA-Cs change, RCF/NH if become STNA
Medication Aide Program
• Submit criminal record background check, certified copy within last 5 years, DC standards • Satisfactorily attend approved training, pass
• Approved training program fees will vary, set by individual programs
• Board of Nursing website will list approved training programs
• Once certified, MA-Cs will be on MA-C registry, Board of Nursing website, renewal every two years
• Certificates good for 2 years, but after pilot, for 1 year, interim certificate issued
• Interim certificate $15, Regular certificate $50
Medication Aide Program
• MA-C renewal will require 15 CEUs/2 years Interim certificate, 8 CEUs, 12 hours CEU content defined in rules • MA-Cs will receive certificates, wallet card • Certification by other states not recognized • MA-C certificates can be revoked or notgranted by Board as disciplinary action. Can lapse or be made “inactive” by MA-C
Medication Aide Program
• MA-C “standardized” testing will be done by D & S Diversified Technologies, contract with Board of Nursing, test fee $96, written multiple choice exam also testing reading, writing, math skills to safely administer, skills test/demonstration • 15-20 fixed sites, will come to training programs,
• Test results same day or next, up to 15 – 20 individuals can be tested, test ½ day • Testing company offer workshops for
training programs, share student results to improve training/pass rates, provide vocabulary lists, sample tests
• Students can pass both or one part of test – only re-take failed part, less cost
Medication Aide Program
• Training program: 80 hrs. classroom, lab (lab-simulated clinical) & 40 hrs. supervised clinical • Clinical “on the floor”, 1 on 1 direct RN/LPN
supervision/med administering
• During pilot, clinical must be in RCF/NH in pilot, classroom other locations
• After pilot, clinical still must be in RCF/NH without citations required for pilot facility sites
Medication Aide Program
• Model curriculum designed by Board of Nursing • Training programs can use model, or develop
own covering all subjects/time allocations in Board model, faster approval with Board model, Board model is minimum
• Training/class & clinical must be given in no less than 20 business days/more than 90
• Following the pilot, fee of $1000 to be a training program, good for 2 years with a $500 renewal fee, pilot program training programs can do $500 renewal
• Must not sign up applicants until approved
Medication Aide Program
• To be approved, submit name(s) 1 ormore nurses who meet following 1) RN 2 yr. unrestricted OH license who will administer program; 2) 1 yr. experience nursing RCF, NH; 3) Nurse with past experience adult education training; Nurse (RN/LPN) who will serve as clinical skills supervisor; 4) RN who will teach
classroom component
Medication Aide Program
• If classroom, clinical not same locations,must have agreement between qualified entities to provide both class/clinical • No online programs
• Non STNA candidates/class, clinical in NH • Agree to all rules, regulations established
• Apply on Board specified form, forms on-line
• Supply training program objectives and outcomes, teaching strategies, core competencies
• Needs to be consistent with law and rules, implemented as written, made available to students
• Must disclose policies to students/refunds
Medication Aide Program
• Clinical part of training program mustmaintain student skills checklist to record skill performance with dates skills successfully demonstrated, name/signature of supervisor nurse • Indicates if student did not have
opportunity to demonstrate skill in clinical component
Medication Aide Program
• Skills checklist given to student, to bepresented by MA-C to any employer • MA-C not to perform any skill not checked
until direct nurse supervision of skill, name, signature & date of nurse supervising
• Minimum Curriculum Training Programs • 1) Communication/interpersonal skills • 2) Resident rights related to med. adm. • 3) Six rights of med. adm.
• 4) Drug terminology, storage and disposal • 5) Fundamentals of body systems
• 6) Basic pharmacology, drug
classifications/med affects body systems
Medication Aide Program
• 7) Safe administration of medication • 8) Infection control, universal precautions • 9) Documentation meds clinical record • 10) MA-C reporting, consulting with nurse • 11) Medication errors• 12) Role of MA-Cs, delegation
Medication Aide Program
• Program important beginning, many statesalready offer (over 27) in AL, way to address nursing shortage, allow nurses in AL to do more “nursing”, keep AL
affordable for public