REVISED MEDICATION ADMINISTRATION FOR UNLICENSED PERSONNEL CURRICULUM Presentation to the Tennessee Board of Nursing August 21, 2014 Tom Cheetham, MD Danny Ricker, RN

Timeline Exemption granted by the Tennessee Board of Nursing allowing unlicensed personnel to administer medications to persons served by DIDD 1999 – Curriculum completed and classes began 2010 – Legislation appointing a task force to review DIDD regulations for the purpose of relieving expensive and unnecessary regulations on provider agencies 2011 – Regulatory Relief Task Force assigned specific to medication administration 2013 – DIDD Nurse Educator group charged with review of subgroup recommendations and completion of medication administration program

Training Data FY 2013/2014 statewide data: 80 trainers 863 classes 9,674 people tested failure rate 13%

Regulatory Relief Task Force Goals and Recommendations Eliminate number of fails for class eligibility Expand or eliminate recertification period Decrease number of classroom hours Simplify curriculum Less time for lecture and more time for skills demonstration and practice

Goals of DIDD Nurse Educator Group Review of recommendations Propose rule changes Revise curriculum to focus on practical information and skills needed to safely administer medications Revise trainer forms and documents Revise agency medication policy to comply with ‘Medication Safety Policy’

Comparison Proposed Current 2 fails, no longer eligible to take test Recertification every 2 years Classroom instruction - 20 hours initial classes - 8 hours recertification classes 3 fails Recertification every 3 years 20 hours with test-out option following online review with comprehensive exam and skills testing by regional nursing

F R O M TO 178 pages

MEDICATION ADMINISTRATION FOR UNLICENSED PERSONNEL PowerPoint Presentation with Handouts Tennessee Department of Intellectual and Developmental Disabilities Training Curriculum Version 1.07.14 © Tennessee Department of Intellectual and Developmental Disabilities

Anatomy/Physiology and Pathology to From Anatomy/Physiology and Pathology to Common diagnoses and Associated medications

NERVOUS SYSTEM

© Tennessee Department of Intellectual and Developmental Disabilities Nervous System Consists of the brain, spinal cord and nerves to control and coordinate body activities. Version 1.07.14 © Tennessee Department of Intellectual and Developmental Disabilities

Associated medications Nervous System Common diagnoses Seizures Stroke Trauma (Concussion, Contusion) Dementia/Alzheimers Associated medications Anticonvulsants/antiepileptics Antiparkinsons Antipsychotics Antidepressants Antianxiety/Sedatives Version 1.07.14 © Tennessee Department of Intellectual and Developmental Disabilities

Training Sequence Body System Transcription of practitioner order to MAR Video demonstration of administration Practice of administration skills and documentation

Training Structure Transcription, documentation and skill practice progresses in difficulty with each body system to build on learning: daily dose – alternating dose routine documentation – PRN documentation oral administration – vaginal/rectal administration

Regulatory Relief Task Force Goals and Recommendations Eliminate number of fails for class eligibility Expand or eliminate recertification period Decrease number of classroom hours Simplify curriculum Less time for lecture and more time for skills demonstration and practice X

Goals of Nurse Educator Group Review of recommendations Propose rule changes Revise curriculum to focus on practical information and skills needed to administer medications safely Revise trainer forms and documents Revise agency medication policy to comply with ‘Medication Safety Policy’

SAFE MEDICATION ADMINISTATION for people served by DIDD Ongoing Goal SAFE MEDICATION ADMINISTATION for people served by DIDD Continuous quality improvement though data tracking, instructor and participant input Revisions as required to assure that participants receive adequate accurate information and demonstrate competency in administering medications