Wisconsin Legislature: DHS 129.30(1)(b)2.

(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.

a. Use of the drug or drug indication.

b. Side effects of the medications.

c. Specific medication administration requirements.

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

6. Medication packaging systems.

7. Medication storage, destruction or return of medication.

(f) Medication administration.

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

Note: Injections, medications administered via a tube, nebulizers, and oxygen routes will not be evaluated as part of the basic hospice 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 and reporting. Requirements for timely reporting and documenting the administration of all medication, including the need for PRN medications and the patient’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 patient.

(h) Medication safety.

1. Prevention of medication errors.

2. Causes of medication errors.

3. Reporting of medication errors.

(2) Facility and class size.

(a) The class facilities shall be of sufficient size and structure so as 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. The program shall have a minimum of 40 hours of instruction of which 32 hours is lecture and 8 hours of which is quizzes, final examination and practicum. The 32 hours of lecture shall contain hands-on and demonstrations of the appropriate techniques of medication administration. The program will not be approved as a prerecorded video-based program; however, videos internet and other technology can be used to supplement the classroom instruction.

(4) Grading.

(a) The program shall have a minimum of 6 quizzes. The student shall achieve an average of 85 percent on the quizzes in order to take the final written examination.

(b) The student shall achieve a grade of 85 percent or better on the final written examination to take the practicum. A student may be permitted one retake of the final written examination. Any retake shall occur at least 3 months after the student first took the final written examination.

Note: The final written examination is a state-generated examination and is administered by the department or its designee.

(c) The practicum examination shall be administered after the final written examination and the student shall achieve a grade of 85 percent or better on the practicum examination to pass the course. Retakes of the practicum examination shall not be permitted.

(d) If the student does not successfully pass either the final written examination or the practicum exam, the student shall retake the entire course.

(5) Certification. The department or designee shall issue a certificate to each student who satisfactorily completes the course. The department or designee shall maintain a database of hospice nurse aides who complete this course.

Note: The nurse aide should retain his or her hospice medication aide certificate of completion.

(6) Record retention.

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

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

1. The student’s qualifications.

2. The student’s record of attendance.

3. The student’s quiz scores.

4. A copy of the practicum requirements.

5. A copy of the student’s certificate of completion.

6. Program evaluation forms.

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

DHS 129.31 Hospice medication aide training program operation.

(1) Approved hospice medication aide training programs shall complete all of the following before conducting a course:

(a) Submit a sample of the practicum questions or scenarios to the department at least 2 weeks before the practicum examination.

(b) Establish a date for the state-generated final examination with the department.