24 Del. Admin. Code §§ 1900-5.0

Current through Register Vol. 27, No. 12, June 1, 2024
Section 1900-5.0 - Limited Lay Administration of Medications (LLAM)
5.1 The following words and phrases, as used in this rule, shall be defined as follows:

"Core Curriculum" means the educational course of study developed and approved by the Board of Nursing.

"Eligible Programs" means those programs specified under Title 24, Chapter 19 that may utilize LLAM.

"LLAM Trained UAP" means unlicensed assistive personnel who have completed a Board of Nursing approved Limited Lay Administration of Medications curriculum.

"Medication Error" means engaging in any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the UAP.

"Module" means a Board of Nursing approved educational training unit that is eligible program specific and used in addition to the core curriculum.

5.2 LLAM Training
5.2.1 Eligible programs utilizing LLAM must ensure all unlicensed assistive personnel have completed a core curriculum given by a qualified instructor before giving a prescribed medication to a client, patient, resident, or student. Eligible program specific modules may be required by the program. Both the core curriculum and any module must be completed by all unlicensed assistive personnel as approved with no deviations.
5.2.2 Eligible programs must keep a current list of all LLAM Trained UAPs, including supporting documentation. Eligible programs must also maintain a current list of all qualified instructors. The list of qualified instructors shall be submitted annually to the Board on or before August 1.
5.2.3 Unlicensed assistive personnel who complete a core curriculum and any eligible program specific module, obtain at least an 85% on the written examination, and successfully demonstrate medication administration, will be provided a completion letter, indicating the recipient is a LLAM Trained UAP. No certificates will be issued.
5.2.4 A core curriculum or module may be presented in a class size limited to a 1:20 student ratio. The Board of Nursing may waive this ratio limit upon good cause shown.
5.3 LLAM Instructor Qualifications
5.3.1 Qualified instructors must initially meet the following criteria:
5.3.1.1 Active Delaware or compact state RN license in good standing;
5.3.1.2 One year of clinical nursing experience, including experience in medication administration;
5.3.1.3 At a minimum observation of the presentation and successful completion of the core curriculum and any eligible program specific module to be taught;
5.3.1.4 Presentation of at least one component of the core curriculum and any eligible program specific module to be taught with observation by a qualified instructor. Documentation of observation must be provided to the eligible program.
5.3.2 Qualified instructors must present a minimum of one core curricula and eligible program specific module per year. If an instructor fails to present in a single year, that instructor must again complete the core curriculum and any eligible program specific module before s/he will be deemed a qualified instructor.
5.3.3 All instructors of courses related to "Assistance with Self-Administration of Medications" approved by the Board as of July 1, 2015 will qualify as LLAM instructors pursuant to regulation 5.3 without being required to satisfy regulations 5.3.1.3-5.3.1.4.
5.4 LLAM Trained UAP Qualifications
5.4.1 All LLAM Trained UAPs must meet the following criteria:
5.4.1.1 Ability to read, speak and write English and demonstrate competency in basic math skills.
5.4.1.2 Minimum age 18 years or older.
5.4.1.3 Current CPR certification.
5.4.1.4 Successful completion of a core curriculum and any applicable eligible program specific module.
5.4.2 LLAM trained UAPs are required to renew their status annually by successfully demonstrating competency in the LLAM process with no errors and by achieving a minimum score of 85% on the annual review exam. A letter of completion will be issued after successful renewal of competencies each year.
5.4.3 LLAM Trained UAPs may:
5.4.3.1 Participate solely within the confines of the core curriculum and any applicable program eligible module.
5.4.3.2 Administer medication without assessing the appropriateness and/or effectiveness of the prescribing practitioner's medication order.
5.4.3.3 Administer injectable emergency medications pursuant to the core curriculum.
5.4.3.4 Only administer approved medications with a licensed prescriber's order.
5.4.4 LLAM Trained UAPs may not:
5.4.4.1 Administer medications through a feeding tube, including nasogastric, gastrostomy, or jejunostomy tubes.
5.4.4.2 Be held responsible for assessing pharmacy accuracy either by identifying the appearance of the medication or assessing proper medication dosing for medications released by the pharmacy.
5.5 Medication Errors
5.5.1 All eligible programs must maintain a monthly LLAM error report, retained on site and readily available for inspection at all times.
5.5.2 If a LLAM Trained UAP commits two medication errors within a six month timeframe, he/she must repeat the entire LLAM training program before resuming LLAM duties.

24 Del. Admin. Code §§ 1900-5.0

3 DE Reg. 1373 (04/01/00)
19 DE Reg. 432 (11/1/2015)
24 DE Reg. 379 (10/1/2020)
27 DE Reg. 61 (7/1/2023) (Final)