Letting CNA pass your meds, bad idea? - page 3

I fill the cups and check for all interactions and whatnot, but anyone have any negative experiences or can think of any possible neg exp with this? Thanks... Read More

  1. by   NRSKarenRN
    delegation of medication administration to unlicensed assistive personal is done routinely by nurses working in outpatient settings such as school nursing, assisted living facilities, group homes for disabled + those w/mental illness and some home health settings in most states.

    issues to be looked at:
    a. what is permitted by state law/bon.
    b. is client stable?
    hospitals, extended care hospitals (ltac) and short term snf/rehab settings
    client often requires rn assessment and change in treatment plan so not prudent
    to delegate med administration in this setting.
    c. responsibility for assessing client regarding health status, medication interactions
    and side effects
    d. responsibility for delegation, instruction and supervision of uap/med techs
    e. documentation issues.

    allnurses posts:
    2006 north carolina bon:medication aides: public hearing may 19th
    medication aides


    appears new hampshire is licensing nursing assistants.

    boards of nursing policies:
    2003 nc: the interface of the licensed nurse with the medication aide


    2001 new hamphsire: medication nursing assistants (mna)
    question: what is a medication nursing assistant (mna)?
    answer: a medication nursing assistant (mna) is a licensed nursing assistant (lna) who has completed a board approved medication administration program conducted by a board approved registered nurse. board approved medication administration programs must offer a minimum of 30 hours of theoretical content and 30 hours of clinical content...certification as a mna allows the lna to administer medications under the supervision of a rn/lpn to "stable" clients.

    7/06 wisconson: medication administration by unlicensed personnel
    insulin and assisted living industry

    6/06 maryland board of nursing - new requirements for medication ...
    all rns who delegate medication administration to the medication technician must complete the board's new training program for rn case manager/delegating ... permitted out patient settings.



    washington state nurses association position statement:
    the rn may delegate medication administration to unlicensed assistive personnel. (uap) in settings having patients with stable and predictable conditions


    school nurses:
    national associaiton school nurses: medication administration
    guideline #4: delegation of medication administration by the lsn/rn

    s&cc 06-13: nurse delegation of medication administration to ...


    articles:
    state policies regarding nursing delegation and medication ...in child care settings
  2. by   mamason
    I have a friend who is a med tech. Certified in the state of Missouri. She works at a nursing home. I believe she took a special class to become certified for this. Also, there are stipulations on what type of meds she can legally administer. She also documents the administration of the meds she gives. I am a RN licensed in the state of Illinois. As far as I know, Illinois does not permit med techs to administer meds. I guess this practice varies state to state. My friend also lives in Illinois and chooses to work in the state of Missouri because of this. In Illinois, she would only be able to find a job as a CNA and not one passing meds. At least in this area.
  3. by   mamason
    Quote from Angie O'Plasty, RN
    I should also add that the CNA who gets certified to pass meds in some states is NOT licensed. It's a certification, like the CNA certification.

    Nurses are licensed.
    Yes.....I agree.
  4. by   Lacie
    And very much against most state nurse practice acts. Very quick way to lose your licensure. I for one of many have worked to hard to risk such an irresponsible act.
  5. by   Jolie
    Quote from Gompers
    I really don't think it's perfectly legal. I would like to know what state's nursing board allows CNAs to not only provide medication to patients, but to also be the ones to measure it out. No nurse involved at all?? If there were nurses working in this facility, medications were definitely their responsibility. Just because they delegated it to CNAs does not make it legal. Very scary situation.
    Just to clarify, it is not CNAs who pass meds, but CMAs (certified medication aides). They are certified by the state after completing a basic medication course (approximately 2-3 weeks in length), and passing a state-administered exam.

    If I remember correctly you are licensed in IL, which does not have CMAs at the present time, but there has been a push by nursing home administrators to establish this category of care-giver in IL. There was a commision established (by Gov. Blago) to study the issue and make recommendations to state lawmakers. The Illinois Nurses' Association and the IL Department of Professional Regulation participated in the process. I don't recall why the proposal was rejected, but I remember thinking at the time that the INA and IDPR seemed almost supportive of the idea, as neither did much to oppose it, which I would have expected. In my opinion, this proposal is dangerous to the health and safety of the public, and places nurses in legal jeopardy by requiring that they supervise these unlicensed care-givers who dispense medication without the knowledge base necessary to do so safely. So, IL was spared this (at least for the time being), but I'm sure the proposal will rear its ugly head again.

    I currently live in Nebraska where CMAs exist, and are utilized in virtually every nursing home. They independently dispense medications that are given orally and topically. They do not give IV or IM meds. I don't know whether or not they are allowed to give controlled substances.

    Scary, huh!
  6. by   mamason
    Quote from Jolie
    Just to clarify, it is not CNAs who pass meds, but CMAs (certified medication aides). They are certified by the state after completing a basic medication course (approximately 2-3 weeks in length), and passing a state-administered exam.

    If I remember correctly you are licensed in IL, which does not have CMAs at the present time, but there has been a push by nursing home administrators to establish this category of care-giver in IL. There was a commision established (by Gov. Blago) to study the issue and make recommendations to state lawmakers. The Illinois Nurses' Association and the IL Department of Professional Regulation participated in the process. I don't recall why the proposal was rejected, but I remember thinking at the time that the INA and IDPR seemed almost supportive of the idea, as neither did much to oppose it, which I would have expected. In my opinion, this proposal is dangerous to the health and safety of the public, and places nurses in legal jeopardy by requiring that they supervise these unlicensed care-givers who dispense medication without the knowledge base necessary to do so safely. So, IL was spared this (at least for the time being), but I'm sure the proposal will rear its ugly head again.

    I currently live in Nebraska where CMAs exist, and are utilized in virtually every nursing home. They independently dispense medications that are given orally and topically. They do not give IV or IM meds. I don't know whether or not they are allowed to give controlled substances.

    Scary, huh!
    Yes, as a Licensed RN in the state of Illinois, I find this very scary. I don't think I would feel comfortable with it. Just my opinion.
  7. by   Gompers
    Quote from Jolie
    Just to clarify, it is not CNAs who pass meds, but CMAs (certified medication aides). They are certified by the state after completing a basic medication course (approximately 2-3 weeks in length), and passing a state-administered exam.
    Oh, I understand that there are CMAs out there now that are certified to pass meds. I was responding to the posts at the beginning where they are specifically referring to regular CNAs passing meds who have not been certified to do so.
  8. by   gwenith
    It may be different in the States but I know here that the drug administration act was written and SPECIFICALLY worded so that unregistered personel could ASSIST someone in taking medications i.e. open the bottle or give a glass of water but they cannot ADMINISTER medications.
  9. by   Always Smiling
    In my 2 1/2 years as a CNA for a skilled nursing facility, I have never had a nurse ask me to administer meds. If asked, I would not do it. Besides the fact that it would be illegal in my area and unethical, I simply do not have the knowledge to administer medication! My training program was 4 weeks long and didn't even begin to cover anything like this. I would be putting patient safety at risk.
  10. by   salandry54
    Are you absolutely out of your mind???? You must not value your license at all!! In my state (Louisiana) this would be grounds for losing your license!! I can think of a 100 reasons why this is a BAD, BAD idea!!! They are so obvious, I am not even going to go into it. Just don't do it!

    BTW, this person sounds exactly like the nurses who make you question why they are nurses in the first place!!!
  11. by   rn/writer
    I wouldn't set up meds for another NURSE to give. Nor would I give meds someone else had set up for me. It isn't ONLY the lack of training of the unlicensed personnel but also the messy issue of divided responsibility.

    If one of my patients needs a pain med while I am busy, one of my co-workers will get that med from the ADU, give it, and sign it off herself. That's okay because she is the responsible party from start to finish.

    In the case of setting up meds for someone else to give, there are too many pitfalls. And heaven help you if a narc goes missing.
  12. by   sloppy_joe
    I work as a CNA in a private run Assisted Living facility. Our DON lets us pass meds (i believe it's her license on the line) We do a like 3 or 4 day training (i haven't gotten passed yet b/c i got hired at the end of the summer before i went back to college in another state) We're not certified by the state or anything but from what i understand, we can do it at our place b/c it's private run. I think our DON does it so she doesn't have to hire more nurses and cut costs, but i have other CNA friends that work in assisted living private run facilities that pass meds. I'm a student now working my butt of, and i know when i'm a nurse i wouldn't want to take that risk
  13. by   rktele
    Don't do it. You can't confirm that the pt took all of the pills, besides, it's illegal!

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