Wisconsin Legislature: DHS 129.24(1)(b)2.

(c) After a medication aide program proposal is approved, medication aide course curriculum, course outline, instructor qualifications and other materials shall be submitted to and approved by the department before the training program can be implemented. The department will issue a decision on a completed course submittal within 90 calendar days.

(d) The department will limit the number of approved programs to a maximum of 10, subject to determined needs as submitted in program development proposals. If the department determines there is a geographical or consumer-based need, the department may approve additional programs.

(2) Post approval review and monitoring.

(a) The department shall conduct a post-approval review of a program every 2 years after the date on which the department formally approved the program. The department may conduct an on-site review of the program at any time to verify the program remains in compliance with the requirements of this chapter.

(b) The program designee shall submit a report at least every 2 years to the department on a form provided by the department and shall provide any additional information requested by the department during its review of the program. The program designee shall allow reasonable means for the department to examine records and gather requested information.

(c) The program designee shall report a substantial change in the program to the department in writing within 10 days of the change. A program may not operate without the department’s approval of any replacement or substantial change. Notwithstanding s. DHS 129.03 (51), in this subdivision, “substantial change” means any change in the instructor under s. DHS 129.22, or curriculum under s. DHS 129.24 (1).

(d) All approved courses are subject to inspection. If at any time the department determines that a program has failed to comply with a requirement of this chapter, the department may, after providing written notice, impose a plan of correction on the program, suspend or revoke approval of the program.

(e) The department may revoke approval of an instructor if the department determines the instructor failed to comply with any requirement of this subchapter.

Note: Current course proposal and course curriculum content requirements can be obtained from the Division of Quality Assurance, P.O. Box 2969, Madison, WI 53701-2969.

History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.

DHS 129.22 Standards for instructors of medication aide training programs. A medication aide program instructor shall be one of the following:

(1) A registered nurse, licensed in Wisconsin, with teaching experience in the principles of adult learning and training techniques and one or more years of experience in one of the following positions within the last 5 years immediately before the person will be a program instructor:

(a) An instructor in a school of nursing.

(b) A director of nursing in a nursing home or a hospital.

(d) A supervisory nurse in a nursing home.

(2) An approved primary instructor for nurse aide training under s. DHS 129.06.

(3) A pharmacist who is licensed in Wisconsin, with teaching experience in the principles of adult learning and training techniques, and who has at least one year of experience as a consultant to a nursing home.

History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.

DHS 129.23 Nursing home medication aide student qualifications.

(1) Student requirements. The student shall be at least 18 years of age, have a high school diploma or a high school equivalency diploma, and shall be listed on the registry as eligible to work in federally-certified health care settings.

(2) Work requirements. The student shall have at least 2,000 hours of experience as a nurse aide in direct patient care within the last 3 years and have worked a minimum of 40 hours as a nurse aide within the last 90 days, with the residents to whom the student will be administering medications during the clinical experience portion of the course.

(3) Written recommendation. The student shall have 4 written recommendations, 2 from licensed charge nurses, one from the director of nursing of the nursing home where the student will be working during the clinical experience, and one from the administrator of the nursing home where the student will be working during the clinical experience.

History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.

DHS 129.24 Standards for nursing home medication aide training programs.

(1) Curriculum.

(a) Minimum requirements. A training program shall include at least the following 6 areas, specified in pars. (b) to (h):

(b) Introduction.

1. To the course.

2. To the role of medication aides.

1. Federal and state nursing home standards, regulations, statutes, and administrative rules.

2. Standards of Practice for Registered Nurses and Licensed Practical Nurses, ch. N 6 specific to registered nurse delegation.

3. Professional and staff roles and liabilities.

4. Resident rights regarding administration of medications.

5. Confidentiality of information related to residents.

6. Facility policies and procedures for administration of medications.

(d) Overview of body systems related to routes of medication administration and the classes of medications.

1. Anatomy of body structures that pertain to medication administration, including structure of the eye, ear, nose, mouth, vagina, rectum, and skin, which are necessary to administer medication correctly via these routes.

2. Functions of these body structures that impact medication administration and effectiveness.

3. Diseases of these body structures that impact medication administration and medication effectiveness.

Note: Examples of anatomy, function and diseases are provided in the curriculum development guide.

(e) Medication fundamentals, including:

1. Medication orders.

2. Medication mathematics, weights and measures.

3. Dosage forms, including pills, capsules, ointments, patches, and suppositories.

4. Drug effects and actions.

5. Classes or types of commonly used medications in nursing homes.

6. Use of the drug or drug indication.

7. Side effects of the medications.

8. Specific medication administration requirements.

Note: Chemotherapy is not part of the basic medication aide course.

9. Medication packaging systems.

10. Medication storage, destruction or return of medication.

(f) Medication administration.

1. Techniques and procedures of various routes of medication administration.

Note: Injections, and medications administered via a tube, a nebulizer, or an oxygen route will not be evaluated as part of the basic nursing home medication aide curriculum.

2. Six “rights” of medication administration, including right patient, right drug, right dose, right route, right time, and right documentation.

(g) Observations, communication, and reporting. Requirements for timely reporting and documenting the administration of all medication, including the need for PRN medications and the resident’s response, refusal to take medication, omission of medications, errors in the administration of medication and drug reactions and any change in the condition of a resident.

(h) Medication safety.

1. Prevention of medication errors.

2. Causes and reporting of medication errors.

(2) Facility and class size.

(a) The class facilities shall be of sufficient size and structure to allow adequate space and equipment to instruct the students.

(b) The total number of students in any one class shall not exceed 24.

(3) Course structure.

(a) Instruction. The program shall contain a minimum of 100 hours of instruction of which 60 hours shall be spent in classroom instruction and 40 hours of which shall be clinical experience in a nursing home. The department may not approve a program as a video-based program; however, videos, the internet, and other technology can be used to supplement the classroom instruction.

(b) Medication consultant. The program shall have a designated, qualified medication consultant who will act as a resource for medication issues, concerns, questions and assist in course updates.

(4) grading.

(a) The curriculum shall contain a minimum of 6 quizzes. Copies of examples of the quizzes shall be submitted to the department for approval as part of the curriculum. The curriculum shall require the student to achieve an average of 85 percent or better on the quizzes before being allowed to take the final written exam.

(b) The curriculum shall contain a final written exam. A copy of the final written exam or exams shall be submitted to the department for approval as a part of the curriculum. The curriculum shall require the student to achieve a grade of 85 percent or better on the final written exam before being allowed to take the practicum exam.

(c) The curriculum shall contain a practicum exam. Copies of the practicum exam shall be submitted to the department for approval as part of the curriculum. The curriculum shall require the student to achieve a grade of 85 percent or better on the practicum exam to be allowed to complete the clinical experience portion in a nursing home.

(d) The student shall complete the clinical experience portion in a nursing home under the direct supervision of a registered nurse preceptor. Each program shall submit to the department a clinical experience evaluation form for approval. The clinical experience evaluation form shall define the critical components of each type of medication administration skill as submitted at s. DHS 129.24 (1) (f). The nurse preceptor and program instructor shall use the approved clinical experience evaluation form to check each medication administration skill. To successfully complete the clinical experience the student shall obtain satisfactory scores as identified in the approved evaluation form. The nurse preceptor and program instructor shall sign the form if each medication administration skill has been successfully completed by the student.

(e) The curriculum shall contain a policy on quiz, final exam, and practicum exam retakes. The curriculum policy is subject to department approval.

(5) Record retention.

(a) The records of the program shall be retained on file by the instructional entity for at least 3 years.

(b) The records file for each class shall contain all of the following:

1. Records of each student’s attendance.

2. Each student’s quiz scores.

3. A copy of each final exam and the exam’s answer key.

4. Each student’s final exam answer sheets.

5. Each student’s practicum exam scores.

6. Each student’s clinical competency skills check list.

7. Copies of each student’s certificates of completion.

8. Copies of each student’s registry forms;

9. Forms evaluating each student’s performance.

History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08; correction in (1) (a) made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635.

DHS 129.25 Nursing home medication aide training program operation. Approved medication aide training programs shall submit all of the following information to the department:

(1) Any substantial changes in the program shall be reported to the department in writing within 10 calendar days. The program shall not implement the change until department approves the program’s proposed change in writing.