[CharlieTN]

Okay, the state of Tennessee has just passed a law granting properly trained staff permission to pass medications. I know there are plenty of other states out there that have been doing this for years, but this is new to us. Was wondering if anyone can share training material on properly training direct care staff to pass medications safely? I work in an ICF/MR facility, so it is not Supported Living. All ideas, thoughts and trainings are welcome.

Thanks, Charlie

[boulergirl]

First and foremost, make sure that the people you train as med techs are conscientious employees, the type who will be paying attention to the medication record if anything changes with a resident's meds.

Secondly, make sure that all med techs are trained in taking vital signs. They will need to know how to take a blood pressure and pulse. (Some residents might be on BP medication and the doctor needs to know if it's working, or a certain med might stop a resident's heart if their pulse or BP is too low).

Third, all med techs will need to know how to do a narcotics count. Very important!!! If an employee (med tech or not) is pilfering narcotics, no one will know if the pills aren't counted at the end of every shift. At my facility, the on-coming MT and off-going MT count each narcotic together so you have two witnesses that the count is correct.

I'm sure I can think of more ideas, but I hope this helps for now. Good luck!

[boulergirl]

What is an ICF/MR? I work in an ALF (assisted-living facility). I'm guessing that's the same thing as Supported Living in Tennessee.

[CharlieTN]

Originally Posted by boulergirl

What is an ICF/MR? I work in an ALF (assisted-living facility). I'm guessing that's the same thing as Supported Living in Tennessee.

ICF/MR stands for Intermediate Care Facility - Mental Retardation. Basically the ICF is nursing home standard and the MR means it is only for the mentally retarded. The difference is that a nursing home is strictly a health care facility and an ICF/MR is based on Active Treatment (Programming) to teach independence skills. Hope that helps, and thanks for your input, it is helpful! Do you have any training material from Colorado???

[Wawaloam]

Charlie,

I can't imagine that the state would have passed this without actually having guidelines for what kind of training needed to be provided. Most states that have passed waivers to their Nurse Practice Acts have had to submit how they will train their Direct Support Staff. When we did this in RI in the DD field, it was a tedious process but it was well worth it. The training packet that was ultimately produced is really good and has reduced the number of medication errors significantly in our agency (I don't have access to statewide numbers, but I know overall as nurses we feel much more confident about the ability of our support staff). For you personally, it will be essential to retain the decision to delegate, that is, that your agency can't determine if a particular staff can administer medications--it needs to be your decision, and a decision that is respected.

Sandy

[HeatherLPN]

I worked in the same kind of facility before I got my nursing license and I took the class to be delegated for med pass. You just have to be careful who is doing it. I still work there PRN as a medpass nurse and I cannot believe some of the people they are letting pass meds now. And our new supervisor is one of the worst for med errors and leaving the medrooms a mess. It works out nicely, but only if you have very conscientious employees doing it--not ones in it just for the extra money, or to be able to say they can do it.

[rdnkmom]

Originally Posted by boulergirl

First and foremost, make sure that the people you train as med techs are conscientious employees, the type who will be paying attention to the medication record if anything changes with a resident's meds.

Secondly, make sure that all med techs are trained in taking vital signs. They will need to know how to take a blood pressure and pulse. (Some residents might be on BP medication and the doctor needs to know if it's working, or a certain med might stop a resident's heart if their pulse or BP is too low).

Third, all med techs will need to know how to do a narcotics count. Very important!!! If an employee (med tech or not) is pilfering narcotics, no one will know if the pills aren't counted at the end of every shift. At my facility, the on-coming MT and off-going MT count each narcotic together so you have two witnesses that the count is correct.

I'm sure I can think of more ideas, but I hope this helps for now. Good luck!

carry a drug reference book with them too...

[Aussie19]

In Ohio we give a 14 hour course on Med Administration that was created by ODMRDD. The direct care staff must take the course, pass the test with 80 % or better and do successful return demonstrations on med pass and basic skills to recieve their basic certification. We also offer certificates for g and/or j tubes med admin and also for insulin administration.

I am the Nursing Coordinator for a 12 bed ICF/MR and a certified trainer for Medication Administration. I have trained most of the direct care staff to do med admin. I personally preferred it when only RN's and LPN's passed meds. However, I will be the first to admit that it was getting difficult to find nurses to do the med passes.

[lindseylpn]

I also live in tennessee and I work in a 8 home facility and only 2 of the homes have nurses because the clients in these homes have g-tubes. In the other homes the direct support staff give meds. I know the supervisors are always having to fill out med error forms and having MAR refreshment courses at some of the houses. At our facility the direct care staff take an 8 hour med training class and then have to pass a test and then they are legally allowed to give meds. 8 hours is nothing, how much can u really learn in one day, they have no idea what meds they are giving, what they do or what the side effects are. I believe that if the state wants to allow uncertified people to hand out meds then the should make them take a more intensive med class.

[Markthemalenurse]

Originally Posted by lindseylpn

At our facility the direct care staff take an 8 hour med training class and then have to pass a test and then they are legally allowed to give meds. 8 hours is nothing, how much can u really learn in one day, they have no idea what meds they are giving, what they do or what the side effects are. I believe that if the state wants to allow uncertified people to hand out meds then the should make them take a more intensive med class.

I agree with you Lindsey - here in PA it is the same. An 8 hour med class - then an hour long practicum where someone (who is usually not a medical professional) observes staff giving meds, then signs a sheet of paper staing that the staff is able to give meds. Fortunatly, PA is re-vamping its Medication Adminsitration program to where it will be a two day class and instead of one practicum - staff will need to be oserved for more than one (the total amount of practicums escapes me know).