New LPN ~ are aides allowed to pass meds?

[ParadiseFound101]

I am a new LPN working in an upscale assisted living facility in Tennessee. Our administrator is an RN and has held a 6 hour class for several of our nursing aides to pass meds. They have begun passing meds on my 7 am to 7 pm shift. Am I responsible if they make an error??? Are they giving meds under my license or the RN Administrator??? This really makes me nervous.

Thank you for any information.

[Emerld2000]

I worked as a med passer for 3 years in a ALF. I know ALF rules allow you to pass meds even if your not a nurse as long as you have X amount of hours of training.

Im not sure who is liable in the event of a error. I never had one. Also in Texas we have a 4 month program that allows CNA's to become certified as a medication aide. In that case you work under the nurse but can have your certification revoked in the even errors are made.

[TheCommuter, BSN, RN]

In my state of residence (Texas), the CNAs are allowed to pass medications if they have completed a 4 to 6 month training program to become a CMA (certified medication aide).

Since I don't enjoy pushing pills, I love working with medication aides.

[bluegeegoo2, LPN]

In my LTC facility in IN, whoever passes meds is responsible for the med error, but as the nurse, I'm responsible for the well-being of my resident. So, I have to take every precaution to ensure that the res is suffering no ill effects from the error.

[ALF_LPN]

I have worked at 2 assisted living facilities in Iowa. One facility only allowed nurses to pass medications, the other facility allows the care attendants to pass the medications. I have read the state laws regarding this, and the aids are legally allowed to pass medications with training from the nurse. At the facility I currently work at, the RN and LPN are only scheduled 8 hours a day, otherwise the care attendants work without a nurse on staff. In the case of a med error, at the facility I work at, the RN is responsible. She chooses who can and cannot pass meds, and she trains them. If a mistake is made by the care attendant, it is the LPN or RN's responcibility to moniter the results of the error and insure the safety of the tenant.

[pagandeva2000, LPN]

I have no issues if the medication aide is responsible for their own errors, but if it were to be under my license, I would be deathly afraid. I can understand the situation with TheCommuter...those nurses that are responsible for 60+ patients need assistance. I really think it is better to have the assistance of another nurse, but, heck, who am I?

[Hospice Nurse LPN, BSN, RN]

I worked in a group home while in LPN school. I was the med-tech. I had to take a class (4 hours X 5 days). I was responsible for my own med errors. Thankfully I never made any!

[Valerie Salva, BSN, RN]

I worked as a med passer for 3 years in a ALF. I know ALF rules allow you to pass meds even if your not a nurse as long as you have X amount of hours of training.

Im not sure who is liable in the event of a error. I never had one. Also in Texas we have a 4 month program that allows CNA's to become certified as a medication aide. In that case you work under the nurse but can have your certification revoked in the even errors are made.

I just don't believe that.

Everyone who has ever passed meds has made an error.

Med aides in most states work under the license of the nurse who is directly over them. In most cases, it's an LPN. Sometimes, an RN.

When a med aide passes meds, it's considered to be delegated by and under the supervision of the licensed nurse immediately over the med aide, and the nurse is ultimately responsible for delegated tasks.

[Valerie Salva, BSN, RN]

MAC STANDARDS & PROTOCOLS:

(MAC= Medication Aide- Certified in Utah)

A nurse may refuse to delegate.

A nurse may delegate regularly scheduled, unit-dosed medications via approved routes.

MACs may only administer unit-dosed medications; MACs may not administer any

medication that requires a medication calculation to determine the appropriate

dose.

MACs may administer PRN medications if expressly instructed to by the nurse or the

medication is an over-the-counter drug.

MACs may assist in self administration.

MACs may not administer any medication which requires nursing assessment or

judgment prior to administration, evaluation, or follow-up.

MACs shall not administer meds to more than 40 residents per shift.

MACs shall not:

destroy medications;

receive written or verbal orders;

transcribe orders from the medical record;

conduct resident assessments or evaluations;

engage in resident teaching activities;

calculate drug doses;

administer the first dose of a new medication or a dosage change;

account for Controlled Substances, or witness wastage; and

administer Controlled Substances;

A licensed nurse shall not supervise more than two MACs per shift.

MACs can only work with adult residents.

Page 4

FORMULARY:

Under supervision by a licensed nurse, MAC may administer:

1. oral medications;

2. sublingual medications;

3. buccal medications;

4. eye medications, with the exception of eye medications to new post-operative eye

clients;

5. ear medications;

6. nasal medications;

7. rectal medications;

8. lady partsl medications;

9. skin ointments, topical medications including patches and transdermal

medications;

10. pre-measured medication delivered by aerosol/nebulizer;

11. medications delivered by metered hand-held inhalers;

12. oxygen, may turn oxygen on and off at predetermined, established flow rate; and

13. add fluid to established jejunostomy or gastrostomy tube feedings and change

established tube feeding bags.

MAC may not administer medications by the following routes:

1. central lines;

2. colostomy;

3. intramuscular;

4. subcutaneous;

5. intrathecal;

6. intravenous;

7. nasogastric;

8. nonmetered inhaler;

9. intradermal;

10. urethral;

11. epidural; and

12. endotracheal.

MAC may not administer the following kinds of medications:

1. barium and other diagnostic contrast media;

2. chemotherapeutic agents except oral maintenance chemotherapy;

3. medication pumps including client controlled analgesia;

4. nitroglycerin paste; and

5. controlled substances.

From the Utah BON:

http://64.233.169.104/search?q=cache:6G3w3cvfSIMJ:www.dopl.utah.gov/licensing/forms/nursing_MAC_pilot_program_protocols.pdf+medication+aide+under+supervision+of+nurse&hl=en&ct=clnk&cd=1&gl=us

[TheCommuter, BSN, RN]

Everyone who has ever passed meds has made an error.

You hit the nail on the head, Valerie. No nurse is infallible, and each and every one of us has made at least 1 medication error during the course of a career. However, most med errors are harmless to the patient and go undetected by the nurse.

The major med errors are the ones that receive the explosive attention. For example, a Florida patient died after receiving 8,000mg of Dilantin. The ordered dose was 800mg.