Wisconsin Legislature: DHS 129.24(5)(b)

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.

(2) The program shall submit to the department and to an entity designated by the department the required records for registry designation as a medication aide.

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

DHS 129.26 Medication aide training program prohibitions.

(1) The Department will review substandard quality of care citations made under 42 CFR 483 that result in a prohibition of a nurse aide training or competency evaluation program for a nursing home, in order to determine the appropriate action for a medication aide training program. Program decisions will be made on a case-by-case basis.

(2) Any nursing home citation that directly relates to a medication aide training program may result in termination by the department of the medication aide training program.

(3) A medication aide training program may request a waiver of the medication aide training program prohibition by submitting a request in writing to the department. The department will issue a written decision, either approving or denying the request, within 45 calendar days of receiving a complete waiver request.

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

DHS 129.27 Hospice medication aide training program approval process.

(1) All medication aide training programs for hospice agencies shall be approved by the department.

(2) Entities wishing to operate a hospice medication aide training program shall submit a course syllabus, course curriculum, text book, list of students, proof of all student qualifications and course instructors’ names and qualifications to the department for approval.

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

DHS 129.28 Standards for instructors of hospice medication aide training programs. A hospice medication aide program instructor shall be one of the following:

(1) A registered nurse, licensed in Wisconsin, with one or more years experience as an instructor in a school of nursing or other educational institution.

(2) A registered nurse, licensed in Wisconsin, with 2 or more years experience as a director of nursing.

(3) A registered nurse, licensed in Wisconsin, with one or more years experience as an in-service director in a health care provider.

(4) A pharmacist licensed in Wisconsin, with one or more years experience as a hospice consultant.

(5) An other health care professional the department approves.

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

DHS 129.29 Hospice medication aide student qualifications.

(1) Student requirements. The student shall be at least 18 years of age at the completion of the course, have a high school diploma or high school equivalency diploma, be listed on the registry, and be eligible to work in a federally-certified facility. Nurse aides who have completed the 100-hour nursing home medication aide program are deemed to meet the hospice medication aide program requirements.

(2) Work experience. The student shall be employed as a nurse aide by a hospice agency and shall complete 2,000 hours in direct patient care within the 3 years immediately preceding the start of the course or by the end of the course.

(3) Written recommendation. The student shall be recommended in writing by the hospice administrator, and by a registered nurse who is working with the nurse aide.

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

DHS 129.30 Standards for hospice medication aide training programs.

(1) Curriculum.

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

(b) Introduction.

1. To the course.

2. To the role of the medication aide.

1. Federal and state hospice 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. Patient rights regarding administration of medications.

5. Confidentiality of information related to patients.

6. Facility policies and procedures for administration of medications.

(d) Overview of body systems related to the 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.

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 hospice settings.