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Nurse Aides and Topical Medication Administration

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 medications.

Background:

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.

Discussion:

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.

Results:

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) 243-2083.

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