4723-27-02 Standards of safe medication administration by a certified medication aide.

(A) A certified medication aide shall administer prescription medications only at the delegation of a nurse according to section 4723.67 of the Revised Code, Chapter 4723-13 of the Administrative Code, and this chapter, to residents of nursing homes and residential care facilities.

(B) Except as provided in paragraphs (C) and (D) of this rule, a certified medication aide to whom the task of medication administration is delegated, may administer the following types of prescription medications:

(1) Oral medications;

(2) Topical medications;

(3) Medications administered as nasal spray, or as drops, or ointment to a resident's eye, ear, or nose;

(4) Rectal and vaginal medications; or

(5) Inhalants delivered by inhalers, nebulizers, or aerosols, that allow for a single dose of a fixed, pre-measured amount of medication.

(C) A certified medication aide shall not administer medications in the following categories:

(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; or

(5) Oxygen.

(D) A certified medication aide shall not administer medications by any of the following methods:

(1) Injection;

(2) Intravenous therapy procedures;

(3) Splitting pills for purposes of changing the dose being given; or

(4) Through jejunostomy, gastrostomy, nasogastric, or oral gastric tubes.

(E) In addition to the prohibitions in paragraphs (C) and (D) of this rule, a certified medication aide shall not:

(1) Receive, transcribe or alter a medication order;

(2) Administer the initial dose of a medication ordered for a resident;

(3) Administer medications to a person other than a resident of a nursing home or residential care facility as provided in paragraph (A) of this rule;

(4) Administer any medication without the task having been delegated by a nurse;

(5) Administer medications to pediatric residents; or

(6) Access schedule II controlled substances.

(F) A certified medication aide shall maintain knowledge of the duties, responsibilities, and accountabilities of a certified medication aide and shall act in accordance with the laws pertaining to the administration of medication by a certified medication aide as set forth in Chapter 4723. of the Revised Code and the rules adopted under that chapter.

(G) A certified medication aide shall display the title "certified medication aide" at all times when administering medications to residents of a nursing home or residential care facility.

(H) A certified medication aide shall demonstrate competence and accountability in the task of medication administration, including appropriate recognition, referral, and consultation with the delegating nurse.

(I) Immediately after administering a medication, a certified medication aide shall accurately document in the resident's record, the following information:

(1) The name of the medication and the dosage administered;

(2) The route of administration;

(3) The date and time of administration;

(4) The name of the certified medication aide administering the medication; and

(5) Refusal by a resident to comply with medication administration.

(J) A certified medication aide shall implement measures to promote a safe environment for nursing home or residential care facility residents.

(K) A certified medication aide shall take measures to ensure the safety of the resident including but not limited to:

(1) Reporting to a nurse in a timely manner all of the following:

(a) The potential need of a resident for the administration of an as-needed medication, as evidenced by an expression of discomfort from the resident or other indication;

(b) Refusal by a resident to comply with medication administration;

(c) Any deviation from the delegated medication administration;

(d) Any unanticipated reaction by the resident to the medication administration; or

(e) Anything about the condition of a resident that should cause concern to the certified medication aide.

(2) Preparing and storing medications in accordance with instructions of the manufacturer or the pharmacist;

(3) Removing medications only from a dispensed and properly labeled container that includes all of the following:

(a) Medication name;

(b) Medication dose;

(c) Name of the resident to whom the medication is dispensed, unless:

(i) The medication is a contingency drug stored and supplied in accordance with Chapter 4729-17 of the Administrative Code and is supplied to the certified medication aide by the delegating nurse; or

(ii) Medication that is available over the counter and bears the original manufacturer's label and has been purchased and prescribed for the resident;

(d) Expiration date of the medication;

(4) Verifying the identity of the resident to whom the medication is to be administered;

(5) Witnessing the resident swallowing an oral medication that is to be ingested, or otherwise taking a medication in accordance with its prescribed route;

(6) Immediately documenting and reporting medication errors to a nurse;

(7) Utilizing only the medication delivery process currently in use in the nursing home or residential care facility; and

(8) Administering medications in accordance with standards set forth in the medication aide training curriculum established according to division (B)(6) of section 4723.69 of the Revised Code and this chapter.

(L) A certified medication aide shall not accept a resident care assignment that would interrupt or conflict with the administration of medications or the performance of other tasks and activities that are directly related to the administration of medications. A certified medication aide may perform other resident care activities during such times that the certified medication aide is not engaged in, or scheduled to be engaged in, the administration of medications.

(M) A certified medication aide shall maintain the confidentiality of resident information obtained in the course of the certified medication aide's duties and responsibilities, shall access resident information only for purposes of resident care or for otherwise fulfilling the aide's assigned job responsibilities, and shall not disseminate resident information for purposes other than resident care or for otherwise fulfilling the aide's assigned job responsibilities through social media, texting, emailing, or any other form of communication.

(N) A certified medication aide to whom the administration of medication has been delegated shall not delegate the task of medication administration to any other person.

(O) A certified medication aide shall not falsify any resident record or any other document prepared or utilized in the course of, or in conjunction with, the administration of medications.

(P) A certified medication aide shall delineate, establish, and maintain professional boundaries with each resident.

(Q) At all times when a certified medication aide is administering medications to residents in a nursing home or residential care facility the certified medication aide shall:

(1) Take reasonable measures to assure the privacy of the resident; and

(2) Treat each resident with courtesy, respect, and with full recognition of dignity and individuality.

(R) A certified medication aide shall not:

(1) Engage in behavior that causes or may cause physical, verbal, mental, or emotional abuse to a resident; or

(2) Engage in behavior toward a resident that may reasonably be interpreted as physical, verbal, mental, or emotional abuse.

(S) A certified medication aide shall not misappropriate a resident's property or:

(1) Engage in behavior to seek or obtain personal gain at the expense of a resident or that may reasonably be interpreted as behavior to seek or obtain personal gain at the expense of a resident; or

(2) Engage in behavior that constitutes inappropriate involvement in the personal relationships of a resident or that may reasonably be interpreted as inappropriate involvement in the personal relationships of a resident.

For purposes of this paragraph, the resident is always presumed incapable of giving free, full, or informed consent to the behaviors by the certified medication aide set forth in this paragraph.

(T) A certified medication aide shall not:

(1) Engage in sexual conduct with a resident or conduct that may reasonably be interpreted as sexual; or

(2) Engage in any verbal behavior that is seductive or sexually demeaning to a resident, or that may reasonably be interpreted as seductive, or sexually demeaning to a resident.

For purposes of this paragraph, the resident is always presumed incapable of giving free, full, or informed consent to sexual activity with a certified medication aide.

(U) A certified medication aide shall not make any false, misleading or deceptive statements, or submit or cause to be submitted any false, misleading, or deceptive information, or documentation to:

(1) The board or any representative of the board;

(2) Current employers;

(3) Prospective employers for positions requiring certification as a medication aide;

(4) Facilities in which, or organizations for whom, the medication aide is working a temporary or agency assignment;

(5) Other members of the client's health care team; or

(6) Law enforcement personnel.

(V) For purposes of paragraphs (P), (Q), (R), (S), and (T) of this rule, a certified medication aide shall not use social media, texting, emailing, or other forms of communication with, or about, a resident, for non-health care purposes or for purposes other than fulfilling the aide's assigned job responsibilities.

Effective: 02/01/2014
R.C. 119.032 review dates: 10/15/2016
Promulgated Under: 119.03
Statutory Authority: 4723.69
Rule Amplifies: 4723.61 to 4723.69
Prior Effective Dates: 02/01/2006 (Emer.), 05/01/2006, 02/01/2008, 02/01/2012