DOI: 10.1097/NAN.0b013e3181cffe3d

,  

,  

PMID: 20228644

Issn Print: 1533-1458

Publication Date: 2010/03/01


Print

Medication Technicians' Contribution to Long-term Care Remains Controversial: Craven & Ober Policy Strategists, LLC

Stacey Ober; Gloria Craven

    loading  Checking for direct PDF access through Ovid

Excerpt

The beginning of a new year is often the beginning of a new state legislative session. On average, state legislative sessions formally run from 3 to 6 months, starting in January, unless you reside in a state with a full-time legislature that operates a formal 18-month session, such as Massachusetts. According to the National Council of State Boards of Nursing's July 2009 final survey, 19 states currently have “medication technicians or aides” that work in long-term care settings.1 The issue of authorizing medication technicians to administer medication in long-term care facilities has generated much interest and controversy with conflicting results. Be on the lookout for whether such state legislation may be filed in your state for consideration in 2010.
There have been a variety of legislative proposals with a variety of different provisions. Back in 2005, the Illinois Nurses Association called for the defeat of HB 822, which would have specifically authorized unlicensed medication technicians to administer all medications to patients in assisted living and long-term care sites without on-site supervision and delegation of a registered nurse.2 Last year, the use of medication technicians under the general supervision of a registered nurse or a licensed practical nurse to administer oral medications; topical medications; eye, ear, or nose drips; rectal and vaginal medications; and medications in metered inhalers or nebulizers was debated in Tennessee. Despite opposition from licensed nurses there, HB 1607/SB 9 was signed into law as Pub Ch 403 on June 23, 2009, with significant political support.3 The Tennessee General Assembly estimated that in 2007, there were 1881 newly licensed practical nurses and that there will be an increase of twice this amount, or 3762, in new “certified medical technicians” due to a shorter training period of 6 months and nursing homes wanting to employ this level of practitioner. As part of the plan, a public health nursing consultant will be provided to supervise staff, provide a liaison to the Board of Nursing, test and service the nursing home industry, survey the training programs, respond to inquiries, and educate the public. Additional staff resources will be necessary to process certification applications and criminal background checks; anticipated disciplinary actions were estimated at $516,000 in recurring costs, and setting up office operations will cost $47,000, a one-time expenditure. Certification fees are expected to offset the estimated fiscal impact to the state of the new law.
Arizona has taken a slower, more methodical approach with mixed results. In 2004, legislation was enacted for a pilot program to be overseen by the Board of Nursing (Laws 2004 [2nd Reg Session] Ch 121) that could determine the impact on patient health and safety of allowing nursing assistants acting under a pilot program as “medication technicians” to administer medications under educational requirements and conditions prescribed by the Board. With funding from nongovernmental sources, a pilot study involving 6 long-term care facilities implemented the program with a very small number of participants. The Board of Nursing adopted recommendations that certain medications and tasks associated with medications could not be delegated because they required the skill of a licensed nurse or because the task had increased potential for harm to residents. Tasks that could not be delegated included the first dose of a medication, a medication requiring complex mathematical conversion, inhalant medications, skin patches, vaginal medications, sublingual medications, and PRN (or “as needed”) medications with some exceptions.4
The Board's subcommittee designed a 100-hour medication technician course that included 45 hours of didactic instruction, 15 hours of skills laboratory, and 40 hours of supervised medication administration.
    loading  Loading Related Articles