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Hospice Aides and Medication Administration

PDF Version of BQA 06-018 (PDF, 24 KB)

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Date: August 9, 2006 BQA Memo 06-018

To: Hospices HSPCE 05

From: Jan Eakins, Section Chief
Provider Regulation and Quality Improvement Section

Via: Otis Woods, Director

The following memorandum addresses the administration of topical and certain other medications by hospice aides.


Under s. HFS 131.43(4)(f), Wis. Admin. Code, if hospice aide services are provided, they must be given in accordance with the patient's plan of care and be assigned by a registered nurse through a written document that is updated consistent with the plan of care and with service provisions supervised by a registered nurse. A hospice aide may administer medications to patients if the aide has completed a state-approved medications administration course, and a registered nurse has delegated this responsibility, in writing, for the specific patient.


Currently, there are Department-approved medication administration courses that hospice aides can take to be recognized as a medication aide, which allows them to administer medications in a hospice. Information about medication aides, including approved courses, can be accessed at

Hospice providers have asked the Bureau of Quality Assurance, however, if hospice aides may administer topical medications, oral mouthwashes, and nonprescription rectal suppositories without having taken a medication aide course.

Most, if not all, nurse aide training programs do teach aides how to apply topical ointments and creams as part of their daily care training. Nurse aide training programs also teach oral mouth care, including teeth brushing. In addition, some nurse aide programs teach administration of rectal suppositories.

Response to question:

The Bureau of Quality Assurance will allow hospice aides to administer prescription and nonprescription topical creams and ointments to unbroken skin during daily care, administer prescription and nonprescription oral mouthwashes used for daily oral care, and administer nonprescription rectal suppositories if the aides have had training in these administration areas during their nurse aide training course. These are delegated nursing activities. They are authorized only if the delegating registered nurse has verified and determined that the hospice aide is competent to administer topical creams and ointments, oral mouthwash, and rectal suppositories. The registered nurse must follow the appropriate requirements for delegation, including training, competency verification, and providing direct or general supervision as part of that delegation.

Please direct all questions on medication administration practice to Douglas Englebert, RPh, at (608) 266-5388. All questions regarding nurse aide training programs should be directed to Cynthia Hintze at (608) 243-2083.

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