MEDICATION ADMINISTRATION IN COMMUNITY SETTINGS. The Role of the Non-Nurse

Transcription

1 MEDICATION ADMINISTRATION IN COMMUNITY SETTINGS The Role of the Non-Nurse

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3 Resources Med Admin. & Delegation grid Self Administration Assessment Skills Checklists RN QA Instructions and Form Curriculums required for certification training classes

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5 Other Resou the Me Admin Page

6 DD Setting Certification

7 The 8 Specific Health Related Activities related to Certification Category 1: 1. Vital Signs-Temperature, Pulse, Blood Pressure, and Respirations 2. Ostomy Care-Changing and Emptying 3. Blood Glucose-Finger sticks 4. Basic Measurement of Intake and Output 5. Oral Suctioning-Oral ONLY 6. Clean Dressing-Basic first aid, no assessment 7. External Catheter Care-Cleaning around site of urinary catheter 8. Non-invasive Specimen Collection (ex. Urine collection)

8 Prescriptions are Always Required OAC 5123: (C) All prescribed medications administered pursuant to this chapter shall be administered according to the written direction of an appropriately licensed healthcare professional and according to the training received by MR/DD personnel pursuant to section of the Revised Code and rules 5123: and 5123: of the Administrative Code.

9 MAIS and Med Certification Overview DODD Certifies RN Instructors RN Instructors teach Train the Trainer for RNs to be certified to teach unlicensed DD Personnel RN Trainers present mandated DODD Curriculum to Unlicensed DD Personnel RN Trainers enter DDP training and skill requirements into MAIS Through MAIS, DODD issues Medication Administration Certification for unlicensed personnel to administer medications

10 General Requirements for Medication Administration Certification Certification Category 1 as the pre-requisite for Category 2 or 3 Certification Certification Category 1 (Oral, Topical, 8 HRA) is required for ALL Medication Administration by unlicensed personnel (except family delegation) Initial Certification Category 1 requires a minimum 14 hour course More than 14 hours is recommended for effective learning

11 Annual Certification Renewal Requirements for Medication Administration 2 hours of CE AND Skills verification annually CE can be any 2 hours accepted by the RN Trainer Skills only have to be verified by a nurse if the skill and/or setting require delegation RN Trainer may accept skills by non-nurse in non-delegated settings

12 MAIS and Med Certification Overview Cat 1 = Oral/Topical/8 Health Related Activities 5 bed or less only need Certification 6-16 Certification AND nurse Delegation 17+ Only by Delegation AND only on outings Cat 2 = G/J tube medications Medications always with Certification AND Delegation Food and Fluid may be done with Delegation only Cat 3 = Insulin Always with Certification AND Delegation Only allowed in 5 bed or less settings (Residential Settings)

13 RN Trainer vs. Delegation Only an RN Trainer can teach the initial 14 hour class Only an RN Trainer can verify re-certification requirements have been met; and enter re-certification into MAIS data base ****************************************** ANY Nurse can DELEGATE LPNs can only delegate at the direction of an RN An RN Assessment must be done for initial and on-going delegation (at least annually- or more often at nurses discretion) Ohio Board of Nursing OAC

14 Delegation is a Nursing action Parameters for delegation are specified in OBN law and rule: Chapter Delegation of Nursing Tasks Definitions. For the purposes of this chapter, the following definitions shall apply: (B) "Delegation" means the transfer of responsibility for the performance of a selected nursing task from a licensed nurse authorized to perform the task to an individual who does not otherwise have the authority to perform the task. (C) "Delegating nurse" means the nurse who delegates a nursing task or assumes responsibility for individuals who are receiving delegated nursing care.

15 Nursing problems belong to OBN Chapter Delegation of Nursing Tasks (2) Any complaints related to the scope of nursing practice shall be referred to the Ohio board of nursing, which regulates nursing practice in accordance with Chapter of the Revised Code.

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17 MAIS and Med Certification Overview Responsibility for oversight is shared by any and all: Certified Unlicensed DD Personnel Employer County (SSA) Delegating Nurse Quality Assurance Nurse

18 OAC 5123: (F) If the employer of MR/DD personnel believes or is notified by the county board, the department, a delegating licensed nurse or the registered nurse responsible for quality assessment pursuant to this rule that MR/DD personnel have not safely administered or will not safely administer prescribed medications, have not safely performed or will not safely perform health-related activities, have not safely administered or will not safely administer food or prescribed medication via stable labeled gastrostomy tube and stable labeled jejunostomy tube, or have not safely administered or will not safely administer subcutaneous insulin injections, the employer shall prohibit the action from continuing or commencing. MR/DD personnel shall not engage in the action or actions subject to an employer's prohibition.

19 OAC 5123: (1) When the employer prohibits the action from continuing or commencing, the employer shall do the following: (a) Notify the MR/DD personnel of the prohibition and immediately make other staffing arrangements so that administration of prescribed medication, performance of health-related activities, administration of food or prescribed medication via stable labeled gastrostomy tube and stable labeled jejunostomy tube, or administration of subcutaneous insulin injections are completed as prescribed, including compliance with the requirements of this chapter of the Administrative Code;

20 OAC 5123: (This is where MAIS Notations comes in) (b) Immediately notify the department; (c) If applicable, immediately notify the county board via the major unusual incident reporting system pursuant to rule 5123: of the Administrative Code; and the county board, as applicable, shall notify the registered nurse responsible for quality assessment oversight under paragraph (E) of this rule; (d) If applicable, immediately notify the delegating licensed nurse.

21 OAC 5123: (2) The employer shall ensure all corrective action is taken prior to allowing the MR/DD personnel to resume the administration of prescribed medication, performance of healthrelated activities, administration of food or prescribed medication via stable labeled gastrostomy tube and stable labeled jejunostomy tube, or administration of subcutaneous insulin injections.

22 OAC 5123: (MAIS Follow Up Notation) (3) The employer shall notify the department and, as applicable, the county board, the registered nurse responsible for quality assessment under paragraph (E) of this rule, or the delegating licensed nurse of the corrective action taken.

23 MAIS Notations Each Personnel record in MAIS has a Notation section Record of problems with medication administration training and performance Has pre-programed categories of the notation Demands upload of document(s) to enter notation Only DODD can see the uploaded Documents Documents are stored in UDS (MAIS-UDS)

24 MAIS Notations Employers gain Secretarial Association to access MAIS: Enter med pass deferrals (When staff are taken off of med pass duty for retraining or permanently) Enter corrective action taken when returning staff to med pass duty Enter patterns of med error UI s even if not taken off med pass duty DODD MUI enters substantiated med related MUI s

25 MAIS Notations Quantity of Notations triggers DODD Review mandated for renewal 4 Notations in 12 month span 6 Notations in 18 month span MUI notation is automatic DODD Review Rolling period of months relative to renewal date Each med pass deferral and end = 2 Notations

26 How to get Secretarial access Does not require being a nurse Relationship with RN Trainer Security Affidavit UN and PW obtained Enter MAIS, log off, notify RN Trainer RN Trainer creates association in MAIS Secretarial Access is now established MAIS training RN Trainer can train OR Attend day two

27 ? Q & A? Thank YOU!