Supervision And Delegation

(1) A licensed nurse who provides care to nursing home, assisted care living facility or P.A.C.E. residents may delegate the task of medication administration to an MA in accordance with T.C.A. § 63-7-127(k) and these rules. (2) A licensed nurse who delegates medication administration to an MA shall supervise the MA by: (a) Reviewing the medication delivery process to assure that there have been no errors in stocking or preparing the medications; (b) Accepting, transcribing, and reviewing resident medication orders; (c) Monitoring residents to whom medications are administered for side effects or changes in health status; (d) Reviewing documentation completed by the MA, including, but not limited to the medication administration record; (e) Providing on-site supervision and availability for immediate direction while in a nursing home setting; (f) Providing on-site supervision or immediate and continuous availability through telecommunication while in an assisted care living facility or P.A.C.E. setting; and (g) Delegating the administration of medication for each resident in writing to the MA. (3) Prior to delegating medication administration to an MA, a licensed nurse shall evaluate the following upon admission, and after any change in status or acuity, or any change in medication: (a) The patient and the medication needs of the patient, including: 1. The patient’s mental and physical stability; 2. The medication to be administered; 3. The time frame during which the medication is to be administered; MEDICATION AIDES CHAPTER 1000-05 4. The route or method by which the medication is to be administered; and (b) The licensed nurse has determined that it is safe for the resident to receive medication from the MA. (4) When delegating the task of medication administration to an MA, the licensed nurse shall communicate, in writing, the following to the MA: (a) The patient to whom the MA shall administer medications; (b) The medications the MA shall administer; (c) The time frames during which the medications are to be administered; and (d) Any special instructions concerning the administration of medications to specific patients. (5) A licensed nurse may delegate the administration of as-needed medications to an MA provided the licensed nurse completes a nursing assessment of the resident to whom the as- needed medication is to be administered immediately prior to the medication being administered.