Current through all regulations passed and filed through September 16, 2024
(A) A registered
nurse or a licensed practical nurse acting at the direction of a registered
nurse, who provides nursing care to residents in nursing homes or residential
care facilities, may delegate the task of medication administration to a
certified medication aide according to section
4723.67 of the Revised Code,
Chapter 4723-13 of the Administrative Code, and this chapter.
(B) A registered nurse may delegate the
administration of medications to a certified medication aide only if the
registered nurse holds a current, valid license issued under Chapter 4723. of
the Revised Code that is not subject to restrictions relating to the
administration of medications imposed under section
4723.28 of the Revised Code, or
imposed by agreement entered under section
4723.282 or
4723.35 of the Revised Code.
(C) A licensed practical nurse,
acting at the direction of a registered nurse, may delegate the administration
of medications to a certified medication aide only if all of the following
apply:
(1) The registered nurse at whose
direction the licensed practical nurse is delegating the administration of
medications is authorized to delegate the administration of medications to a
certified medication aide according to paragraph (B) of this
rule;
(2) The licensed practical
nurse is authorized to administer medications according to division
(F)(3) of section 4723.01 of the Revised Code; and
(3) The licensed practical nurse
holds a current, valid license issued under Chapter 4723. of the Revised Code
that is not subject to restrictions relating to the administration of
medications imposed under section
4723.28 of the Revised Code, or
imposed by agreement entered under to section
4723.282 or
4723.35 of the Revised Code.
(D) A nurse who
delegates to a certified medication aide responsibility for the administration
of prescription medications to residents in nursing homes or residential care
facilities shall not withdraw the delegation on an arbitrary basis or for any
purpose not related to resident safety.
(E) Prior to delegating the task of
medication administration to a certified medication aide, a nurse shall
evaluate the following:
(1) The resident and
the medication needs of the resident, including:
(a) The resident's mental and physical
stability;
(b) The medication to
be administered;
(c) The timeframe
during which the medication is to be administered;
(d) The route or method by which the
medication is to be administered; and
(2) The ability of the certified medication
aide to safely administer the medication being delegated.
(F) When delegating the task of medication
administration to a certified medication aide, the nurse shall communicate the
following:
(1) The residents to whom the
certified medication aide shall administer medications;
(2) The medications the certified medication
aide shall administer;
(3) The
timeframes during which the medications are to be administered; and
(4) Any special instructions concerning the
administration of medications to specific residents.
(G) A nurse who is on site may delegate the
administration of as-needed medications to a certified medication aide
if
:
(1) A
registered nurse has completed a nursing assessment of the resident to whom the
as-needed medication is to be administered;
(2) A nursing regimen based on the nursing
assessment is established that contains interventions including the
administration of the as-needed medication according to the
medication order;
(3) The nurse
determines the resident's need for the medication based on information
collected from sources that include but are not limited to:
(a) Direct observation of the resident;
(b) The nursing regimen
established for the resident;
(c)
The resident's record; and
(4) The nurse determines the as-needed
medication may be safely administered by the certified medication aide.
(H) If a nurse is not
on site, the nurse may delegate the administration of as-needed medications to
a certified medication aide if
:
(1) A registered nurse has completed a
nursing assessment of the resident to whom the as-needed medication is to be
administered;
(2) A nursing
regimen based on the nursing assessment is established that contains
interventions including the administration of the as-needed medication
according to the medication order;
(3) A nurse is immediately available by
telecommunication and determines the resident's need for the medication based
on but not limited to the following:
(a)
Current knowledge of the resident's health status and the resident's nursing
regimen;
(b) The resident's
record; and
(c) Data conveyed by
the certified medication aide who is directly engaged in the administration of
medications to the resident.
(4) The as-needed medication is available for
over the counter purchase; and
(5) The nurse determines the as-needed
medication may be safely administered by the certified medication aide.
(I) In a nursing home
or residential care facility that utilizes certified medication aides, a nurse
remains responsible for all of the following:
(1) Reviewing the medication delivery process
to assure there have been no errors in stocking or preparing the medications;
(2) Accepting, transcribing, and
reviewing resident medication orders;
(3) Monitoring residents to whom medications
are administered for side effects or changes in health status; and
(4) Reviewing documentation completed by a
certified medication aide, including the medication administration record.
(J) A nurse shall
supervise the certified medication aides as
follows:
(1) In a nursing home, a
nurse shall provide on-site supervision of a certified medication aide.
(2) In a residential care facility,
supervision of a certified medication aide shall be provided by a nurse who is
either on-site or is immediately and continuously available through some form
of telecommunication.
(K) A nurse may not delegate the
administration of prescription medications in the following categories, by the
following routes, or under the following circumstances, to a certified
medication aide:
(1) Medications containing a
schedule II controlled substance, as defined in section
3719.01 of the Revised Code;
(2) Medications, including
inhalants delivered by inhalers, nebulizers, or aerosols, requiring dosage
calculations;
(3) Medications that
are not approved drugs;
(4)
Medications being administered as part of clinical research;
(5) Administration of medications via
injection;
(6) Administration of
medications via intravenous therapy procedures;
(7) Administration of medications via
splitting pills for purposes of changing the dose being given;
(8) Administration of medications through
jejunostomy, gastrostomy, nasogastric, or oral gastric tubes;
(9) Administration of medications to
pediatric residents;
(10)
Administration of the initial dose of any medication ordered for a resident;
(11) Administration of oxygen.
(L) A registered nurse
or a licensed practical nurse acting at the direction of a registered nurse,
who delegates the administration of medications to a certified medication aide
according to section
4723.67 of the Revised Code and
this chapter, shall not be liable in damages to any person or government entity
in a civil action for injury, death, or loss to person or property that
allegedly arises from an action or omission of the certified medication aide in
the administration of the medications.
Five Year Review (FYR) Dates:
12/19/2016 and
12/19/2021
Promulgated
Under: 119.03
Statutory Authority: 4723.69
Rule
Amplifies: 4723.61, 4723.64, 4723.65, 4723.651, 4723.652, 4723.653, 4723.66,
4723.67, 4723.68, 4723.69
Prior Effective Dates: 2/1/06 (Emer.),
5/1/06, 2/1/12
