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Medication Administration in Nursing Homes

PDF Version of BQA 01-055 (PDF, 10 KB)

Date: December 28, 2001 -- DSL-BQA-01-055
Supersedes BQC-89-055

To: Nurse Aide Training Programs NATP 20, Nursing Homes NH 32

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

Via: Susan Schroeder, Director,  Bureau of Quality Assurance

This memorandum clarifies and updates the requirements that must be followed by unlicensed personnel who are allowed to administer medication to residents in nursing homes. It also supersedes BQC-89-055, a memorandum issued in 1989 by the Bureau of Quality Compliance.

The following administrative rule directly addresses medication administration in a nursing home.

Section DHS 132.60(5)(d)1. and 2., Wisconsin Administrative Code (exit DHS). Administration of medications.

  1. Personnel who may administer medications. In a nursing home, medication may be administered only by a nurse, a practitioner as defined in s. 450.07(1)(d), Stats., or a person who has completed training in a drug administration course approved by the department.

  2. Responsibility for administration. Policies and procedures designed to provide safe and accurate administration of medications shall be developed by the facility and shall be followed by personnel assigned to prepare and administer medications and to record their administration.

In addition, please refer to Bureau of Quality Assurance (BQA) memorandum BQA-01-021 relating to training and testing requirements for nurse aides, including "nurse technicians" and student nurses.

"Nurse technicians" who administer medications are subject to the following:

  1. "Nurse technicians" are nurse aides and must comply with the training and testing requirements for nurse aides who work in health care facilities. (BQA-01-021)

  2. A nurse aide who has graduated from an accredited nursing school but has been unsuccessful on the nursing license exam and does not hold a temporary permit may continue to administer medications for a period of one year after graduation. The person must become a licensed nurse or pass the medication aide challenge exam within that one-year period in order to continue administering medications.

  3. A nurse aide who is designated by a nursing home as a "nurse technician," because the person is currently enrolled in a nursing program, must be actively taking nursing courses. "Actively taking nursing courses" means there is no break of more than one year between nursing courses. This nurse aide must have passed the medication administration course of an accredited school of nursing in order to administer medications in the nursing home. The nursing home must have a record indicating this nurse aide has taken and passed a medication administration course. If this nurse aide is not actively taking nursing courses, the nurse aide must become a medication aide in order to continue to administer medications in a nursing home.

Medication Aide/Nurse Aide: Requirements to maintain status

BQA memorandum BQA-00-059 addressed and updated Medication Aide/Nurse Aide (MA/NA) status maintenance requirements. Please note the following in regard to those requirements:

  1. MA/NAs must maintain their status on the Wisconsin Nurse Aide Directory.

  2. MA/NAs must work a minimum of 100 hours annually as a medication aide to maintain MA/NA status. The MA/NA is responsible for keeping records of the annual number of medication administration hours for rolling 3–year- periods. This requirement takes effect January 1, 2002.

Medication Aide/Nurse Aide Supervision

Nursing homes and the registered nurses who work in nursing homes should be aware that MA/NAs are performing delegated nursing acts and must be supervised in accordance with the standards of section N 6.02, Wisconsin Administrative Code (exit DHFS).

Also, the BQA has received questions about the scope of duties for MA/NAs and what requirements apply to unlicensed persons administering medication in other settings. The BQA is developing a document to address these questions across health care settings and plans to provide it during the first quarter of 2002.

For questions about the medication aide program, please contact Doug Englebert at 608-266-5388.

For questions about nurse aide training, please contact Cindy Hintze at (608) 261-8328

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