Hospice Aides and Medication Administration
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Date: August 9, 2006 BQA Memo 06-018
To: Hospices HSPCE 05
From: Jan Eakins, Section Chief
Provider Regulation and Quality Improvement Section
Via: Otis Woods, Director
The following memorandum addresses the administration of topical and
certain other medications by hospice aides.
Background:
Under s. HFS 131.43(4)(f), Wis. Admin. Code, if hospice aide services
are provided, they must be given in accordance with the patient's plan of
care and be assigned by a registered nurse through a written document that
is updated consistent with the plan of care and with service provisions
supervised by a registered nurse. A hospice aide may administer
medications to patients if the aide has completed a state-approved
medications administration course, and a registered nurse has delegated
this responsibility, in writing, for the specific patient.
Discussion:
Currently, there are Department-approved medication administration
courses that hospice aides can take to be recognized as a medication aide,
which allows them to administer medications in a hospice. Information
about medication aides, including approved courses, can be accessed at http://dhs.wisconsin.gov/rl_DSL/NHs/MedAides.htm.
Hospice providers have asked the Bureau of Quality Assurance, however,
if hospice aides may administer topical medications, oral mouthwashes, and
nonprescription rectal suppositories without having taken a medication
aide course.
Most, if not all, nurse aide training programs do teach aides how to
apply topical ointments and creams as part of their daily care training.
Nurse aide training programs also teach oral mouth care, including teeth
brushing. In addition, some nurse aide programs teach administration of
rectal suppositories.
Response to question:
The Bureau of Quality Assurance will allow hospice aides to administer
prescription and nonprescription topical creams and ointments to unbroken
skin during daily care, administer prescription and nonprescription oral
mouthwashes used for daily oral care, and administer nonprescription
rectal suppositories if the aides have had training in these
administration areas during their nurse aide training course. These are
delegated nursing activities. They are authorized only if the delegating
registered nurse has verified and determined that the hospice aide is
competent to administer topical creams and ointments, oral mouthwash, and
rectal suppositories. The registered nurse must follow the appropriate
requirements for delegation, including training, competency verification,
and providing direct or general supervision as part of that delegation.
Please direct all questions on medication administration practice to
Douglas Englebert, RPh, at (608) 266-5388. All questions regarding nurse
aide training programs should be directed to Cynthia Hintze at (608)
243-2083.
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