REVISED MEDICATION ADMINISTRATION FOR UNLICENSED PERSONNEL

CURRICULUM

Presentation to the Tennessee Board of Nursing

August 21, 2014

Tom Cheetham, MD

Danny Ricker, RN

Timeline

Exemption granted by the Tennessee Board of Nursing allowing unlicensed personnel to administer medications to persons served by DIDD• 1999 – Curriculum completed and classes began

• 2010 – Legislation appointing a task force to review DIDD

regulations for the purpose of relieving expensive and unnecessary

regulations on provider agencies

• 2011 – Regulatory Relief Task Force assigned specific to medication

administration

• 2013 – DIDD Nurse Educator group charged with review of

subgroup recommendations and completion of medication

administration program

Training Data

FY 2013/2014 statewide data:

80 trainers

863 classes

9,674 people tested

failure rate 13%

Regulatory Relief Task Force Goals and Recommendations

• Eliminate number of fails for class eligibility• Expand or eliminate recertification period• Decrease number of classroom hours• Simplify curriculum• Less time for lecture and more time for skills

demonstration and practice

Goals of DIDD Nurse Educator Group

• Review of recommendations• Propose rule changes • Revise curriculum to focus on practical

information and skills needed to safely administer medications

• Revise trainer forms and documents• Revise agency medication policy to comply with

‘Medication Safety Policy’

Comparison

Current• 2 fails, no longer eligible

to take test• Recertification every 2

years

• Classroom instruction

- 20 hours initial classes

- 8 hours recertification classes

Proposed• 3 fails

• Recertification every 3 years

• 20 hours with test-out option following online review with comprehensive exam and skills testing by regional nursing

178 pages

FROM

TO

MEDICATIONADMINISTRATION FOR UNLICENSED

PERSONNELTennessee

Department of Intellectual and Developmental Disabilities

Training Curriculum

Version 1.07.14 © Tennessee Department of Intellectual and Developmental Disabilities 8

PowerPoint Presentation with Handouts

FromAnatomy/Physiology and

Pathologyto

Common diagnoses and Associated medications

NERVOUS SYSTEM

Nervous System

Consists of the brain, spinal cord and nerves to control and coordinate

body activities.

Version 1.07.14 © Tennessee Department of Intellectual and Developmental Disabilities 11

Nervous SystemCommon diagnoses

• Seizures• Stroke• Trauma (Concussion, Contusion)• Dementia/Alzheimers

Associated medications• Anticonvulsants/antiepileptics• Antiparkinsons• Antipsychotics• Antidepressants• Antianxiety/Sedatives

Version 1.07.14 © Tennessee Department of Intellectual and Developmental Disabilities 12

Training Sequence

• Body System

• Transcription of practitioner order to MAR

• Video demonstration of administration• Practice of administration skills and

documentation

Training Structure

Transcription, documentation and skill practice

progresses in difficulty with each body system to

build on learning: • daily dose – alternating dose• routine documentation – PRN documentation• oral administration – vaginal/rectal

administration

Regulatory Relief Task Force Goals and Recommendations

• Eliminate number of fails for class eligibility

• Expand or eliminate recertification period

• Decrease number of classroom hours

• Simplify curriculum

• Less time for lecture and more time for

skills demonstration and practice

X

Goals of Nurse Educator Group

• Review of recommendations• Propose rule changes • Revise curriculum to focus on practical

information and skills needed to administer medications safely

• Revise trainer forms and documents• Revise agency medication policy to comply

with ‘Medication Safety Policy’

Ongoing Goal

SAFE MEDICATION ADMINISTATION for people served by DIDD

• Continuous quality improvement though data tracking, instructor and participant input

• Revisions as required to assure that participants receive adequate accurate information and demonstrate competency in administering medications