5123:2-6-04 Qualifications, training, and certification of registered nurses to train MR/DD personnel in the administration of prescribed medications, performance of health-related activities, and performance of tube feedings.

(A) Qualifications of instructional personnel for the train the instructor program

(1) A registered nurse, who shall meet the following qualifications, may teach the train the instructor program, or any portion thereof, for a registered nurse:

(a) Current valid licensure in Ohio to practice as a registered nurse;

(b) At least sixty months experience in the practice of nursing, of which at least twenty-four months have been in the field of mental retardation and developmental disabilities;

(c) Knowledge of the laws and rules regulating the practice of nursing, and the laws and rules of the department that address delegation by a licensed nurse to MR/DD personnel and the training of MR/DD personnel pursuant to this chapter;

(d) Knowledge of and experience with the principles of adult education;

(e) Successful completion of the train the instructor program and maintenance of the train the instructor program certification pursuant to this rule; and

(f) Authorization from the department to teach the train the instructor program.

(2) The department's nurse consultant or other department registered nurse designee may teach the train the instructor program, or any portion thereof, for a registered nurse.

(B) Qualifications to plan, develop, and coordinate an MR/DD personnel program of instruction

(1) Only a registered nurse who meets the following requirements shall plan, develop, and coordinate a program of instruction that prepares MR/DD personnel to give or apply oral or topical medications, perform health-related activities, perform subcutaneous insulin injections, or administer food or prescribed medication via stable labeled gastrostomy tube or stable labeled jejunostomy tube:

(a) Current valid licensure in Ohio to practice nursing as a registered nurse;

(b) A minimum of eighteen months experience in the practice of nursing as a registered nurse;

(c) Previous experience caring for an individual with mental retardation and developmental disabilities;

(d) Successful completion of the train the instructor program as evidenced by a certificate from an approved department trainer who is an authorized Ohio board of nursing approver.

(2) The registered nurse certified instructor may utilize other licensed health care professionals to assist with conducting the training as long as the other health care professionals have received instruction on the material and are acting within the professional's scope of practice as outlined in the Revised Code. None of the other licensed health care professionals shall teach the class in its entirety, but may serve as a guest instructor at the direction of the registered nurse certified instructor.

(3) Licensed practical nurses may choose to participate in the train the instructor program. Upon completion, they will receive a certificate of participation offering them continuing education credits, but they may not become a certified instructor.

(C) Minimum curriculum for the train the instructor program

(1) A train the instructor program for registered nurses trained on or after the effective date of this rule, which prepares a registered nurse to teach MR/DD personnel to give oral or apply topical prescribed medication and perform health-related activities, administer food and prescribed medication via a stable labeled gastrostomy tube and a stable labeled jejunostomy tube, or perform subcutaneous insulin injections shall be at a minimum eight hours and include at a minimum the following:

(a) Review of section 4723.071 of the Revised Code and review of sections 5123.41 to 5123.47 of the Revised Code and rules adopted under this chapter and applicable Revised Code and Administrative Code relating to the functioning of a county board, nursing delegation and MR/DD personnel;

(b) Review of all components required when teaching MR/DD personnel to give oral or apply topical prescribed medications and perform health-related activities, administer food and prescribed medication via a stable labeled gastrostomy tube and a stable labeled jejunostomy tube, or perform subcutaneous insulin injections, including general principles of delegation by a licensed nurse to MR/DD personnel;

(c) Quality measures and quality assessment requirements pursuant to this chapter;

(d) MR/DD personnel and licensed nurse documentation requirements;

(e) Principles of nursing delegation supervision including direct and indirect supervision and determination of the appropriate type of supervision pursuant to this chapter;

(f) How to provide indirect supervision, including methods for remaining accessible, and training MR/DD personnel how and when to access help;

(g) How to evaluate the MR/DD personnel's skills including developing and using a skills check list for use in the program of instruction that teaches MR/DD personnel to give oral or apply topical prescribed medications and perform health-related activities, administer food and prescribed medication via a stable labeled gastrostomy tube and a stable labeled jejunostomy tube, or perform subcutaneous insulin injections;

(h) Liability issues pursuant to rule 5123:2-6-07 of the Administrative Code;

(i) General principles of adult basic education.

(2) A train the instructor program for registered nurses trained prior to the effective date of this rule, and already certified under the delegation train the instructor program (DTTI) pursuant to requirements in effect prior to the effective date of this rule, which prepares a registered nurse to teach MR/DD personnel to give or apply oral or topical prescribed medication and perform delegable nursing tasks or administer food and prescribed medication via gastrostomy tube and jejunostomy tube shall be at a minimum two and one half hours and include at a minimum the following:

(a) Review of sections 5123.42 to 5123.47 of the Revised Code and rules adopted under this chapter;

(b) Update on MR/DD personnel administration of oral and topical prescribed medication, performance of health-related activities, administration of food or prescribed medication via stable labeled gastrostomy tube or stable labeled jejunostomy tube, or performance subcutaneous insulin injections;

(c) Quality measures and quality assessment requirements;

(d) MR/DD personnel and nurse documentation requirements;

(e) Prescription receiving and transcription by MR/DD personnel requirements;

(f) Introduction to internet accessible database for certified registered nurses and certified MR/DD personnel.

(3) The registered nurse coordinator of the train the instructor program shall ensure that the train the instructor program for a registered nurse shall be planned, developed and taught in accordance with requirements set forth in this rule.

(4) The training of nursing task delegation shall be completed as described in rules adopted by the Ohio board of nursing under Chapter 4723-13 of the Administrative Code.

(5) The department must approve a train the instructor program course not developed by the department prior to use in the train the instructor program.

(D) Certificate of training

Successful completion of the train the instructor program provided to prepare the registered nurse to train MR/DD personnel to give oral or apply topical prescribed medications, perform health-related activities, administer food or prescribed medication via stabled labeled gastrostomy tube or stable labeled jejunostomy tube, or administer subcutaneous insulin injection is required to receive a certificate of training. To receive certification, the registered nurse must submit to the course instructor the required application, attend the entire program of required training, participate in class discussions and activities, and complete and submit the evaluation of the train the instructor program.

(E) Renewing certification and maintaining qualifications to teach MR/DD personnel

To maintain the certification to teach MR/DD personnel to give oral or apply topical prescribed medications, perform health-related activities, administer food or prescribed medication via stabled labeled gastrostomy tube or stable labeled jejunostomy tube, or administer subcutaneous insulin injection, the registered nurse shall complete, at a minimum, four contact hours of continuing education per licensure renewal period that relate to the information taught in the train the instructor program or that will enhance the role of the registered nurse who has completed the train the instructor program. Cardiopulmonary resuscitation (CPR), first aid or universal precautions training shall not make up any part of the four contact hours. These contact hours may be a part of the twenty-four hours required by the Ohio board of nursing during each licensure renewal period.

(F) The requirements for registered nurses who will be teaching MR/DD personnel in the administration of prescribed medications and the performance of tube feedings for individuals of a residential facility with seventeen or more beds who are on a field trip from the facility as specified in paragraph (A)(9) of rule 5123:2-6-03 of the Administrative Code are established under rule 5123:2-6-05 of the Administrative Code.

R.C. 119.032 review dates: 07/05/2012 and 07/05/2015
Promulgated Under: 119.03
Statutory Authority: 5123.04 , 5123.44 , 5123.45 , 5123.46
Rule Amplifies: 5123.04 , 5123.41 to 5123.47
Prior Effective Dates: 09/30/1993 (Emer.), 12/29/1993, 05/16/1994 (Emer.), 08/06/1994, 06/30/1995, 02/14/2000, 10/22/2003 (Emer.), 01/08/2004