Nurse Aides and Topical Medication
PDF Version of
BQA 05-009 (PDF, 33 KB)
DATE: August 22, 2005 DSL-BQA-05-009
To: Nursing Homes, NH 006
From: Cris Ros-Dukler, Director, Bureau of Quality Assurance
The following memo addresses nurse aides and administration of topical
Current state nursing home regulations related to the issue of who can
administer medications are as follows:
HFS 132.60 (5) (d) 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. 450.01 (17), Stats., or a person who has completed training in a drug
administration course approved by the department.
Currently, there are medication administration courses that are
approved by the Department that nurse aides can take to become recognized
as a medication aide, permitting them administer medications in a nursing
home. Information about medication aides, including approved courses, can
be accessed at http://www.dhs.wisconsin.gov/rl_DSL/NHs/MedAides.htm.
Questions have come up, however, related to nurse aides who apply
topical medications when providing daily cares. In addition, some nurse
aides have been administering nonprescription rectal suppositories as
well. Facilities have asked if nurse aides can administer topical
medications, oral mouthwashes, and nonprescription rectal suppositories
without having taken a medication aide course.
Most, if not all, nurse aide training programs teach nurse aides how to
apply topical ointments and creams as part of the daily care training.
Nurse aide training programs teach oral mouth care, including teeth
brushing. In addition, some nurse aide programs also teach the
administration of rectal suppositories.
The Bureau of Quality Assurance will now allow nurse aides to
administer prescription and nonprescription topical creams and ointments
to unbroken skin during daily care, oral mouthwashes used for daily oral
care, and nonprescription rectal suppositories. Nurse aides who administer
topicals, mouthwashes and rectal suppositories must have had training in
these areas. The delegating RN must verify and determine that the nurse
aide is competent to perform the task for topical creams and ointments,
oral mouthwashes, 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 Geist at (608)
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