Texas Administrative Code
Title 26 - HEALTH AND HUMAN SERVICES
Part 1 - HEALTH AND HUMAN SERVICES COMMISSION
Chapter 557 - MEDICATION AIDES-PROGRAM REQUIREMENTS
Section 557.105 - Allowable and Prohibited Practices of a Medication Aide

Universal Citation: 26 TX Admin Code ยง 557.105

Current through Reg. 49, No. 38; September 20, 2024

(a) A medication aide permitted under this chapter:

(1) must observe and report to the facility's or home health agency's licensed nurse on duty or on call any reactions or side effects to medication shown by a resident or client, and document such side effects to the medication in the resident's or client's clinical or equivalent record;

(2) must take and record vital signs before the administration of medication that could affect or change vital signs;

(3) may administer regularly prescribed medication to a resident or client if the medication aide:
(A) is trained to administer the medication;

(B) personally prepares the medication or sets up the medication to be administered; and

(C) documents the administration of the medication in the resident's or client's clinical or equivalent record;

(4) may administer oxygen per nasal cannula or a non-sealing mask only in an emergency, after which the medication aide must verbally notify the licensed nurse on duty or on call and appropriately document the action and notification;

(5) may apply specifically ordered ophthalmic, otic, nasal, vaginal, and rectal medication unless prohibited by subsection (b)(10) of this section;

(6) may administer medications only from the manufacturer's original container or the original container in which the medication had been dispensed and labeled by the pharmacy with all information mandated by the Texas State Board of Pharmacy;

(7) may administer previously ordered PRN medication, if:
(A) the facility's or home health agency's licensed nurse on duty or on call authorizes the medication;

(B) the medication aide documents in the resident's or client's records the symptoms indicating the need for the medication and the time the symptoms occurred;

(C) the medication aide documents in the resident's or client's records that the facility's or home health agency's licensed nurse on duty or on call was contacted, symptoms were described, and the licensed nurse granted permission to administer the medication, including the time of contact;

(D) the medication aide obtains authorization to administer the medication from the facility's or home health agency's licensed nurse on duty or on call each time the symptoms occur;

(E) except as required by subparagraph (F) of this paragraph, the medication aide ensures that the resident's or client's record is co-signed by the licensed nurse who provided authorization by the end of the nurse's shift or, if the nurse was on call, by the end of the nurse's next on duty shift; and

(F) must, if a home health medication aide, ensure that the client's clinical record is co-signed by the RN who provided authorization within seven days after the notes are incorporated into the clinical record;

(8) may measure a prescribed amount of a liquid medication to be administered to a resident or client;

(9) may break a tablet to be administered to a resident or client, if:
(A) the resident's or client's medication card or its equivalent accurately documents how the tablet must be broken before administration; and

(B) the licensed nurse on duty or on call has calculated the dosage;

(10) may crush medication, if:
(A) authorization has been given in the original physician's order or the medication aide obtains authorization to crush the medication from the licensed nurse on duty or on call; and

(B) the medication aide documents the authorization on the resident or client's medication card or its equivalent; and

(11) may, except as prohibited by subsection (d) of this section, electronically order a refill of medication from a pharmacy, if the refill request is signed by the licensed nurse on duty or on call.

(b) A medication aide permitted under this chapter may not:

(1) administer medication by the injection route including the:
(A) intramuscular route;

(B) intravenous route;

(C) subcutaneous route;

(D) intradermal route; and

(E) hypodermoclysis route;

(2) administer medication used for intermittent positive pressure breathing treatments or any form of medication inhalation treatments;

(3) administer previously ordered PRN medication, except in accordance with subsection (a)(7) of this section;

(4) administer medication that, according to the resident's or client's clinical records, has not been previously administered to the resident or client;

(5) calculate resident's or client's medication doses for administration;

(6) crush medication, except in accordance with subsection (a)(10) of this section;

(7) administer medications or feedings by way of a tube inserted in a cavity of the body, except as specified for home health medication aides in § 558.404(h) of this title (relating to Standards Specific to Agencies Licensed to Provide Personal Assistance Services);

(8) receive or assume responsibility for reducing to writing a verbal or telephone order from a healthcare professional including a physician, dentist, podiatrist or advanced practice nurse;

(9) order a resident's or client's medications from a pharmacy, except in accordance with subsection (a)(11) of this section;

(10) apply topical medications that involve the treatment of skin that is broken or blistered or when a specified aseptic technique is ordered by the attending physician;

(11) steal, divert, or otherwise misuse medication;

(12) violate any provision of the Texas Health and Safety Code, Texas Human Resources Code, or this chapter;

(13) fraudulently procure or attempt to procure a permit;

(14) neglect to administer appropriate medications, as prescribed, in a responsible manner; or

(15) administer medications if the person is unable to do so with reasonable skill and safety to residents or clients by reason of drunkenness or excessive use of drugs, narcotics, chemicals, or any other type of material.

(c) If a practice is not described in subsection (a) of this section the practice is prohibited for a medication aide permitted under this chapter.

(d) A home health medication aide may not order a client's medication from a pharmacy.

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