1000-05-.11
Standards Of Practice
Cite as Tenn. Comp. R. & Regs. 1000-05-.11
(1)
A medication aide shall maintain knowledge of the duties, responsibilities, and
accountabilities of a medication aide and shall act in accordance with the statutes and rules
pertaining to the administration of medication by a medication aide.
(2)
A medication aide shall display the title “medication aide” at all times when administering
medications to residents of a nursing home, assisted care living facility, or P.A.C.E.
(3)
An MA shall demonstrate competence and responsibility in the task of medication
administration including any observation about the condition of a resident that should cause
concern to a medication aide and reporting to the delegating nurse.
(4)
An MA shall ensure and promote a safe environment for nursing home, assisted care living
facility, or P.A.C.E. residents.
(5)
An MA shall accurately document in the patient’s or resident’s record the following
information immediately after the administration of a medication:
(a)
The name of the medication and the dosage administered;
(b)
The route of the administration;
(c)
The date and time of the administration;
(d)
The name and credentials of the MA who administered the medication;
(e)
The name of the licensed nurse who delegated the administration of the medication;
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(f)
The resident’s refusal or inability to ingest the medication or comply with the
administration of the medication; and
(g)
Any complaints by the resident about the medication administration or medication
administered.
(6)
An MA shall document in the medical record and report the following to the delegating nurse
or the delegating nurse’s supervisor in a timely manner:
(a)
The resident’s request for an as-needed medication;
(b)
The resident’s refusal or inability to ingest the medication or comply with the
administration of the medication;
(c)
Any deviation from the delegated medication administration; and
(d)
Any observations or information about the resident’s condition that causes concern.
(7)
An MA shall document contact with the supervising nurse in the medical record.
(8)
An MA shall store drugs in accordance with the pharmacist’s instructions.
(9)
An MA shall remove drugs only from a properly labeled container or packaging that has been
dispensed by a licensed pharmacist that contains the drug name; dosage; strength; name of
the resident to whom it is to be dispensed; and drug expiration date.
(10) An MA shall complete all necessary tasks to ensure safe medication administration to a
resident, including, but not limited to the following:
(a)
Verifying the identity of the resident to whom the medication is to be administered;
(b)
Ensuring that medication administration for the resident has been delegated and
documented by the delegating licensed nurse prior to the administration of the
medication;
(c)
Ensuring that the medication is being administered to the resident in accordance with
the delegation and prescriber instructions;
(d)
Ensuring that the correct medication in the correct dosage and route is administered to
the resident;
(e)
Documenting and reporting a medication error to the delegating licensed nurse who is
on-site at the nursing home, assisted care living facility, or P.A.C.E. or via a two-way
telephone conversation.
(11) An MA shall maintain the confidentiality of protected health information obtained in the course
of the MA’s duties and responsibilities.
(12) An MA shall not delegate the task of medication administration to any other person.
(13) An MA shall not falsify any resident record or any other document prepared or utilized in the
course of, or in conjunction with, the administration of medication.
(14) An MA shall maintain professional boundaries with each resident.
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(15) An MA shall not:
(a)
Administer medication when such administration would require a dosage decision or
calculation including splitting medications, by the medication aide;
(b)
Directly receive orders from a physician or other medication prescriber;
(c)
Administer barium or other contrast media;
(d)
Administer chemotherapeutic agents;
(e)
Administer rectal and vaginal medications;
(f)
Administer medications delivered by metered hand-held inhalers without a spacer;
(g)
Administer medications delivered by aerosol/nebulizer;
(h)
Apply topical medications ordered for the treatment of pressure ulcers or skin grafts;
(i)
Change a dosage amount to adhere to a change in a physician’s/prescriber’s order; or
(j)
Administer the initial dose of a medication ordered for a resident until after a new
evaluation has been performed by a licensed nurse.
(16) An MA shall not, under any circumstances, administer medications by certain methods or
routes, or both. These include, but are not necessarily limited to, the following:
(a)
Injection;
(b)
Intravenous;
(c)
Central lines;
(d)
Intrathecal;
(e)
Colostomy;
(f)
A surgically placed feeding tube, e.g., gastrostomy, jejunostomy;
(g)
Nasogastric;
(h)
Non-metered inhaler;
(i)
Intradermal;
(j)
Urethral;
(k)
Epidural
(l)
Endotracheal;
(m)
Intramuscular; or
(n)
Subcutaneous.
(17) An MA shall not:
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(a)
Engage in sexual conduct with a resident or conduct that may reasonably be
interpreted as sexual; or
(b)
Engage in any verbal behavior that is seductive or sexually demeaning to a resident, or
that may reasonably be interpreted as seductive, or sexually demeaning to a resident.
(For purposes of this paragraph, the resident is always presumed incapable of giving
free, full, or informed consent to sexual activity with a medication aide); or
(c)
Make any false, misleading or deceptive statements, or submit or cause to be
submitted any false, misleading, or deceptive information or documentation to the
board or any representative of the board; or
(d)
Use social media, texting, emailing, or other forms of communication with, or about, a
resident, for non-health care purposes or for purposes other than fulfilling the aide’s
assigned job responsibilities.