While this course is directed to the Ohio registered nurses and licensed practical nurses the content may be applicable to other states that recognize the certified medication aide. This course meets the ONA criteria for a course on Ohio Board of Nursing Law and Rules Chapter 4723 of the Ohio Revised Code.
Beginning July 1, 2007 Ohio nursing homes and residential care facilities were approved to employ and use medication aides-certified (MA-Cs) to administer prescription medications to the residents of their facilities. The pilot program under which this training program was begun ended in March 2009 after an extension was granted in 2007. The purpose of this course is to inform registered nurses and licensed practical nurses about the role and training of MA-Cs and the RN/LPN?s responsibilities related to working with this new team member. Strict guidelines related to the training and supervision of MA-Cs have been established by the Ohio Board of Nursing so that patient safety and quality of care is assured. This course will describe the initial establishment and need for MA-Cs, the role of the registered nurse (RN) and licensed practical nurse (LPN) with regard to working with MA-Cs, the specific criteria established for becoming a MA-C, and the practice guidelines for the MA-C. This course meets the ONA criteria for a course on Ohio Board of Nursing Law and Rules Chapter 4723 of the Ohio Revised Code.
The need for the use of non-professional unlicensed health care providers has increased with the rise in the number of senior care residential facilities. The American Association of Homes and Services for the Aging (AAHSA) states that "among people turning 65 today, 69 percent will need some form of long-term care, whether in the community or in a residential care facility and in 2020, 12 million older Americans will need long-term care. " (AAHSA, 2007). The registered nurse population is also aging among those nurses who work in residential and nursing home facilities. Therefore a need was perceived for a means to assist the RNs and LPNs and help the nursing shortage by developing a program for preparing unlicensed nursing assistants to administer prescribed medications to the residents in these residential care and nursing home facilities.
As of 2005 there were 16 states that employ MA-Cs to dispense routine medications to residents in residential care facilities. While there is no current evidence available to determine the safety and benefit of MA-Cs, early data from Scott-Cawiezell (Nelson, 2005), who was conducting a study in Missouri, indicated that MA-Cs in three states "did not appear to make any more mistakes than nurses do." (Nelson, 2005). Scott-Cawiezell noted that MA-Cs appeared to be more focused with less interruptions and distractions than the nurses.
An advisory council was created by the Ohio Board of Nursing to develop a pilot project for the establishment of a medication aide program. The medication aide council was comprised of 16 members including RNs, LPNs, representatives from the nursing home industry, AARP (American Association for Retired People), nursing assistants and others. A pilot project was developed and begun in May 2006 ending June 2007 and was conducted in 13 nursing homes and 13 residential care facilities. (OBNa, 2007).
Medication Aide Certification
Applicants seeking certification as a MA-C must meet a number of criteria before applying for the medication aide training program. The following conditions must be met to apply. Applicant must :
- Submit to a criminal background and records check including a fingerprint impression;
- Be at least eighteen (18) years of age
- Have a high school diploma or high school equivalence diploma
- If applicant is to practice as a medication aide in a nursing home applicant meets the requirements for that division; if practice is to be in a residential care facility has at least one year of experience in that type of institution
MA-C Training program
At the beginning of the pilot program the Ohio Board of Nursing approved the establishment of training programs for MA-Cs at 21 facilities in the state of Ohio. (OBNc 2007). "As of the end of November 2008, 97 students completed the training program and passed the examination and 78 medication aide certificates were issued. Other students did not submit the required documentation for certification." (OBNf 2009).
With the completion of the pilot training program a list of approved medication aide training programs can be found on the OBN website. As of March 2009 facilities wishing to establish a training program for MA-Cs may apply through the Ohio Board of Nursing at http://www.nursing.ohio.gov/. A model core curriculum is also available at the OBN website.
The curriculum includes 80 hours of both didactic content and experiential laboratory content and 40 hours of supervised clinical experience. Successful completion of the training program is met by passing the written examination by a minimum of 80%, successful completion of both laboratory skills, and clinical rotation with skills check list. Certification is valid for two years.
Recertification of MA-C
In order to recertify the MA-C must obtain 15 approved contact hours of continuing education including one hour of Ohio Nursing Law and Rules, one hour related to professional boundaries, and ten hours related to medications or medication administration consistent with the function of the certified medication aide. (OAC, Chapt 47223-27) accessed on August 3, 2009 at: http://codes.ohio.gov/oac/4723-27-06.
Learning objectives for the applicant are:
(OBNb, 2006, Model training program)
- Describe the role and functions of a Medication Aide-Certified.
- Describe the six rights of medication administration and their application to safe medication administration.
- Relate the function of administering medications to the promotion of resident?s rights.
- Administer medications accurately, safely and document appropriately.
- Maintain the dignity of the residents.
- Successfully complete the written and clinical examinations approved by the Ohio Board of Nursing.
Students are taught their role as a MA-C will be primarily as that of one who delivers medications to the client. The MA-C will not have patient care responsibilities. However their major concern needs to be the patient?s well being and safety. Delegation of the MA-C?s role is entirely dependent upon the licensed nurse. The role of the MA-C is that of a team member and the MA-C must be able to communicate effectively with the nurse about any information pertinent to the patient?s well being and safety. The registered nurse?s role in delegation is discussed in a later section of this module.
Students receive significant didactic training about the importance of behavioral qualities