Chapter DHS 129

DHS 129.24 Note 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.

DHS 129.24(1)(f)2. 2. Six “rights” of medication administration, including right patient, right drug, right dose, right route, right time, and right documentation.

DHS 129.24(1)(g) (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.

DHS 129.24(1)(h) (h) Medication safety.

DHS 129.24(1)(h)1. 1. Prevention of medication errors.

DHS 129.24(1)(h)2. 2. Causes and reporting of medication errors.

DHS 129.24(2) (2) Facility and class size.

DHS 129.24(2)(a) (a) The class facilities shall be of sufficient size and structure to allow adequate space and equipment to instruct the students.

DHS 129.24(2)(b) (b) The total number of students in any one class shall not exceed 24.

DHS 129.24(3) (3) Course structure.

DHS 129.24(3)(a) (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.

DHS 129.24(3)(b) (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.

DHS 129.24(4) (4) grading.

DHS 129.24(4)(a) (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.

DHS 129.24(4)(b) (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.

DHS 129.24(4)(c) (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.

DHS 129.24(4)(d) (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.

DHS 129.24(4)(e) (e) The curriculum shall contain a policy on quiz, final exam, and practicum exam retakes. The curriculum policy is subject to department approval.

DHS 129.24(5) (5) Record retention.

DHS 129.24(5)(a) (a) The records of the program shall be retained on file by the instructional entity for at least 3 years.

DHS 129.24(5)(b) (b) The records file for each class shall contain all of the following:

DHS 129.24(5)(b)1. 1. Records of each student’s attendance.

DHS 129.24(5)(b)2. 2. Each student’s quiz scores.

DHS 129.24(5)(b)3. 3. A copy of each final exam and the exam’s answer key.

DHS 129.24(5)(b)4. 4. Each student’s final exam answer sheets.

DHS 129.24(5)(b)5. 5. Each student’s practicum exam scores.

DHS 129.24(5)(b)6. 6. Each student’s clinical competency skills check list.

DHS 129.24(5)(b)7. 7. Copies of each student’s certificates of completion.

DHS 129.24(5)(b)8. 8. Copies of each student’s registry forms;

DHS 129.24(5)(b)9. 9. Forms evaluating each student’s performance.

DHS 129.24 History 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 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:

DHS 129.25(1) (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.

DHS 129.25(2) (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.

DHS 129.25 History History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.

DHS 129.26 DHS 129.26 Medication aide training program prohibitions.

DHS 129.26(1) (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.

DHS 129.26(2) (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.

DHS 129.26(3) (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.

DHS 129.26 History History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.

DHS 129.27 DHS 129.27 Hospice medication aide training program approval process.

DHS 129.27(1) (1) All medication aide training programs for hospice agencies shall be approved by the department.

DHS 129.27(2) (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.

DHS 129.27 History History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.

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

DHS 129.28(1) (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.

DHS 129.28(2) (2) A registered nurse, licensed in Wisconsin, with 2 or more years experience as a director of nursing.

DHS 129.28(3) (3) A registered nurse, licensed in Wisconsin, with one or more years experience as an in-service director in a health care provider.

DHS 129.28(4) (4) A pharmacist licensed in Wisconsin, with one or more years experience as a hospice consultant.

DHS 129.28(5) (5) An other health care professional the department approves.

DHS 129.28 History History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.

DHS 129.29 DHS 129.29 Hospice medication aide student qualifications.

DHS 129.29(1) (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.

DHS 129.29(2) (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.

DHS 129.29(3) (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.

DHS 129.29 History History: CR 08-042: cr. register November 2008 No. 635, eff. 12-1-08.

DHS 129.30 DHS 129.30 Standards for hospice medication aide training programs.

DHS 129.30(1) (1) Curriculum.

DHS 129.30(1)(a) (a) Minimum requirements. A training program shall include the following 6 areas specified in pars. (b) to (h).

DHS 129.30(1)(b) (b) Introduction.

DHS 129.30(1)(b)1. 1. To the course.

DHS 129.30(1)(b)2. 2. To the role of the medication aide.

DHS 129.30(1)(c) (c) Legal and ethical considerations.

DHS 129.30(1)(c)1. 1. Federal and state hospice standards, regulations, statutes, and administrative rules.

DHS 129.30(1)(c)2. 2. Standards of Practice for Registered Nurses and Licensed Practical Nurses, ch. N 6 specific to registered nurse delegation.

DHS 129.30(1)(c)3. 3. Professional and staff roles and liabilities.

DHS 129.30(1)(c)4. 4. Patient rights regarding administration of medications.

DHS 129.30(1)(c)5. 5. Confidentiality of information related to patients.

DHS 129.30(1)(c)6. 6. Facility policies and procedures for administration of medications.

DHS 129.30(1)(d) (d) Overview of body systems related to the routes of medication administration and the classes of medications.

DHS 129.30(1)(d)1. 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.

DHS 129.30(1)(d)2. 2. Functions of these body structures that impact medication administration and effectiveness.

DHS 129.30(1)(d)3. 3. Diseases of these body structures that impact medication administration and medication effectiveness.

DHS 129.30 Note Note: Examples of anatomy, function and diseases are provided in the curriculum development guide.

DHS 129.30(1)(e) (e) Medication fundamentals.

DHS 129.30(1)(e)1. 1. Medication orders.

DHS 129.30(1)(e)2. 2. Medication mathematics, weights and measures.

DHS 129.30(1)(e)3. 3. Dosage forms, including pills, capsules, ointments, patches, and suppositories.

DHS 129.30(1)(e)4. 4. Drug effects and actions.

DHS 129.30(1)(e)5. 5. Classes or types of commonly used medications in hospice settings.

DHS 129.30(1)(e)5.a. a. Use of the drug or drug indication.

DHS 129.30(1)(e)5.b. b. Side effects of the medications.

DHS 129.30(1)(e)5.c. c. Specific medication administration requirements.

DHS 129.30 Note Note: Chemotherapy is not part of the basic medication aide course.

DHS 129.30(1)(e)6. 6. Medication packaging systems.

DHS 129.30(1)(e)7. 7. Medication storage, destruction or return of medication.

DHS 129.30(1)(f) (f) Medication administration.

DHS 129.30(1)(f)1. 1. Techniques and procedures of various routes of medication administration.

DHS 129.30 Note Note: Injections, medications administered via a tube, nebulizers, and oxygen routes will not be evaluated as part of the basic hospice medication aide curriculum.