With the exception of those aspects of medication
administration deemed outside the scope of practice of the certified nursing
assistant by Rule 64B9-15.0026, F.A.C., and subject to the approval of the home
health agency with whom the certified nursing assistant is employed or the
approval of the nursing home facility with whom the certified nursing assistant
is employed as a qualified medication aide, any certified nursing assistant who
meets the requirements of this rule is authorized to administer medications to
a patient of a home health agency or to a resident of a nursing home facility,
respectively, as delegated by a registered nurse and as further described in
this rule.
(1) A certified nursing
assistant shall complete an initial six-hour Board approved training course on
medication administration and be documented to be competent in the safe and
sanitary administration of medication by a registered nurse licensed under
Chapter 464, F.S., a physician licensed under Chapter 458, F.S., or an
osteopathic physician licensed under Chapter 459, F.S.
(2) The initial six-hour training course
curriculum shall include:
(a) A glossary of
common terminology for labeling of legend medications.
(b) Safe administration of oral, transdermal,
ophthalmic, otic, rectal, inhaled, enteral, and topical prescription and
over-the-counter medications.
(c)
Record keeping and documentation of medication administration.
(d) Safe storage and proper disposal of
medications.
(e) Prevention of
medication errors.
(f) Home health
care agency policies and procedures regarding medications.
(g) Recognizing, documenting and reporting
adverse reactions to medications.
(3) For a certified nursing assistant to be
eligible to administer medications to a patient of a home health agency, upon
completion of the initial six-hour training course, the certified nursing
assistant shall be assessed on both theoretical knowledge and practice, as well
as clinical practice and competence. The clinical practice assessment must be
witnessed by a registered nurse who shall validate the competency regarding the
certified nursing assistant's ability to safely administer
medications.
(4) For a certified
nursing assistant to be designated as a qualified medication aide and eligible
to administer medications and perform associated tasks to a resident of a
nursing home facility, the following is required:
(a) Holding a clear and active certification
as a nursing assistant from the state for a minimum of 1 year immediately
preceding delegation by a registered nurse;
(b) Completion of the initial six-hour
training course in subsection 64B9-15.0025(2), F.A.C., with the substitution of
training in nursing home facility policies and procedures for the training in
home health care agency policies and procedures in paragraph (2)(f);
(c) Completion of an additional 34-hour
training course curriculum which shall include:
1. An overview of the laws and regulations
governing medication administration in nursing home facilities.
2. Infection control practices related to
medication administration including application of principles to prevent spread
of infection, hand hygiene, standard precautions and use of personal protective
equipment, transmission-based precautions, bloodborne pathogens and diseases,
multi-drug resistant organisms, and antibiotic stewardship.
3. Anatomy and physiology in relation to
health and disease with commonly prescribed medications.
4. Additional information on safe
administration of oral, transdermal, opthalmic, otic, inhaled, and topical
prescription and over-the-counter medications including terminology and
abbreviations, measurement and dosage preparations, and the rights of
medication administration.
5.
Additional information on documentation and the legal aspects of record
keeping.
6. Controlled
substances.
7. Oxygen
administration, continuous positive airway pressure tasks, blood glucose
monitoring, and insulin administration.
(d) Upon completion of the initial six-hour
training course and the additional 34-hour training course, which may be
combined into a single 40-hour course, the certified nursing assistant shall be
assessed on both theoretical knowledge and practice, as well as clinical
practice and competence. The clinical practice assessment must be witnessed by
a registered nurse who shall validate the competency regarding the certified
nursing assistant's ability to safely administer medications and complete
associated tasks. Upon validation, the certified nursing assistant may be
designated as a qualified medication aide.
(e) Medication administration and performance
of associated tasks may only be performed by a qualified medication aide under
the direct supervision of a licensed registered nurse or a licensed practical
nurse. The licensed practical nurse must be qualified to supervise in
accordance with Rule Chapter 64B9-16, F.A.C.
(5) Education Providers: The certified
nursing assistant medication administration training courses in subsections
64B9-15.0025(2) and (4), F.A.C., must be sponsored by a provider of continuing
education courses approved by the Board pursuant to Rule
64B9-5.005, F.A.C. To
be qualified to teach any such course, the instructor must be a currently
licensed registered nurse in good standing in this state, have at least one
year of experience teaching adults, and at least one year of professional
nursing experience, including one year home health care or one year nursing
home facility experience, as appropriate, and the supervision of certified
nursing assistants. The education provider or course instructor is responsible
for issuing a certificate verifying completion of the requisite number of hours
and course content. In addition, all of the training under subsections
64B9-15.0025(2) and (4), F.A.C., must be through in-person
instruction.
(6) Nontraditional
Education. Continuing education providers may utilize nontraditional education
alternatives for teaching the theoretical content in subsection
64B9-15.0025(8), F.A.C. Nontraditional education alternatives include:
(a) Interactive videos,
(b) Self study,
(c) Other nontraditional education that may
be submitted to the Board for consideration and possible approval. Any
continuing education providers using nontraditional education must make
provisions for demonstration of and verification of knowledge.
(7) Clinical Competence. The
courses must be followed by supervised clinical practice in medication
administration as needed to demonstrate clinical competence. Initial and annual
verification of clinical competence shall be the responsibility of each
institution employing a certified nursing assistant based on institutional
protocol. Such verification shall be given through a signed statement of a
Florida licensed registered nurse with knowledge of the certified nursing
assistant's competence. Annual validation of clinical competency must be
completed on or before the anniversary date of the initial
validation.
(8) In addition to
other inservice training hours required under Rule
64B9-15.011, F.A.C.,
certified nursing assistants found to be competent to administer medications
shall annually and satisfactorily complete two (2) hours of inservice training
in medication administration and medication error prevention approved by the
Board. The initial two (2) hours annual inservice training shall be completed
within one year of verification of clinical competence.
Notes
Fla. Admin.
Code Ann. R. 64B9-15.0025
Rulemaking Authority
400.211(5),
464.2035(3) FS.
Law Implemented 400.211(5),
464.0156,
464.2035
FS.
Adopted by
Florida
Register Volume 47, Number 125, June 29, 2021 effective
7/15/2021, Amended
by
Florida
Register Volume 50, Number 040, February 27, 2024 effective
3/13/2024, Amended by
Florida
Register Volume 50, Number 133, July 9, 2024 effective
7/22/2024.
New 7-15-21, Amended
3-13-24.