N.J. Admin. Code § 8:36-11.5

Current through Register Vol. 57, No. 1, January 6, 2025

Section 8:36-11.5 - Certified Medication Aide Program

(a) The administration of medications is within the scope of practice and remains the responsibility of the registered professional nurse.

(b) The registered professional nurse may choose to delegate the task of administering medications in accordance with N.J.A.C. 13:37-6.2 to certified medication aides, as defined in this chapter.

1. A unit-of-use/unit dose drug distribution system shall be developed and implemented whenever the administration of medication is delegated by the registered professional nurse to a certified medication aide;

i. Over-the-counter (OTC) solid and liquid dosage forms may be dispensed in a non unit-of-use or non unit-dose medication distribution system.

ii. Prescription liquid medications (that is, conventional bottles, concentrates) may be dispensed in a non unit-of-use, non unit dose, or conventional medication distribution system.

2. If an appropriate delegation is made, and in accordance with the facility's policies and procedures and all applicable State and Federal laws and regulations, the certified medication aide may:

i. Administer medications through the routes of oral, ophthalmic, otic, inhalant, nasal, rectal, vaginal, topical, and by the percutaneous endoscopic gastrostomy (PEG) tube route of administration;

ii. Administer any prescription or OTC medications as described in (b)1 above;

iii. Administer regularly scheduled medications, including prescription, OTC, and Schedule II-V medications;

iv. Administer "prn" or as-needed prescription, OTC and Schedule II-V medications except that residents receiving the following medications shall be assessed by the registered professional nurse at least once every seven days:

(1) Residents receiving prn Schedule II narcotic analgesics;

(2) Residents receiving Schedule III-IV narcotic analgesics; and

(3) Residents receiving Schedule III-IV central nervous system agents;

v. Administer medications that have been dispensed by a pharmacy, in accordance with N.J.S.A. 45:14 et seq., N.J.S.A. 24:21 et seq., N.J.A.C. 13:39, and the requirements of this chapter; or

vi. Administer experimental and/or research medications in accordance with 45 CFR Part 46, Protection of Human Subjects, incorporated herein by reference, as amended and supplemented.

3. The certified medication aide shall not:

i. Administer any injection other than pre-drawn properly packaged and labeled insulin as described in (b)1 above;

ii. Calculate a medication dosage;

iii. Pre-pour medications for more than one resident at a time;

iv. Contact prescribers for changes in medication, to clarify an order, or contact the pharmacist for questions regarding a dispensed medication; or

v. Administer bolus doses of enteral feedings, or stop and/or start an existing enteral feeding pump or gravity-fed system.

4. The certified medication aide shall contact the registered professional nurse for any questions or clarification regarding medication administration.

5. The delegating nurse shall review with the certified medication aide medication actions and untoward effects for each drug to be administered. Pertinent information about medications' adverse effects, side effects, contraindications, and potential interactions shall be incorporated into the plan of care for each resident, with interventions to be implemented by the personal care assistant and other caregiving staff, and documented on the medication administration record (MAR).

6. At least weekly, a registered professional nurse shall review and sign off on any modifications or additions to the MAR that were made by the certified medication aide under the registered professional nurse's delegation.

7. Registered professional nurses who participate in certified medication aide training shall attend a Department offered one-day Train-the-Trainer Medication Aide Workshop prior to providing such training to certified medication aides.

8. Registered pharmacists, who participate in certified medication aide training, shall attend a Department offered one-day Train-the-Trainer Medication Aide Workshop prior to providing such training to certified medication aides.

9. The fee charged by the Department for a two-year approval of a medication aide training program shall be $ 100.00 and is non-refundable.

10. The facility shall keep a record of all prescription and non-prescription medications administered to each resident.

(c) Each resident shall be identified prior to medication administration.

(d) Medication prescribed for one resident shall not be administered to another resident. Borrowing shall not occur.

(e) The registered professional nurse shall report medication errors and adverse drug reactions immediately to the prescriber, to the provider pharmacist and/or consultant pharmacist, and shall document the incident in the resident's record.

(f) Medications shall be accurately administered and documented by properly authorized individuals, in accordance with prescribed orders.

N.J. Admin. Code § 8:36-11.5