3 CCR 716-1.12 - RULES AND REGULATIONS FOR APPROVAL OF MEDICATION AIDE TRAINING PROGRAMS
Specific Authority sections 12-255-208, C.R.S.
A.
STATEMENT OF BASIS AND
PURPOSE
The Rules contained in this Rule 1.12 are adopted to specify the procedures relevant to the approval of Medication Aide Training Programs for Certified Nurse Aides whose graduates shall be eligible to take the Competency Evaluation.
B.
DEFINITIONS
1. Active Status:
The status in which an approved program is admitting or plans to admit and
graduate a class of students.
2.
Approved Clinical Resource: A facility that is approved by the Board for the
purpose of providing medication aide students with a suitable and compliant
Clinical experience.
3. Approval:
Recognition that a Medication Aide Training Program (herein after referred to
as "program") meets the standards established by the Board.
a. Interim Approval: Recognition by the Board
or the Board's Designee that a program may admit students and implement the
program pending Full Approval.
b.
Full Approval: Recognition by the Board that a program meets the standards and
requirements of this Rule.
4. Board: The State Board of
Nursing.
5. Client: The individual
receiving nursing care.
6.
Classroom: The portion of the approved training program in which medication
aide students receive instruction in the theory that comprises the basis for
safe and compliant medication administration.
7. Clinical: The portion of the approved
training program in which medication aide students, under the direct
supervision of qualified instructors, apply the knowledge and skills of a
medication aide in the direct care of Clients.
8. Clinical Preceptor: The qualified
registered or practical nurse or licensed psychiatric technician responsible
for the direct supervision and instruction of the student in the Approved
Clinical Resource.
9. Closed
Program: A program that no longer has the Board's Approval to
operate.
10. Certified Nurse Aide
(CNA): means a person who meets the qualifications specified in Colorado
Revised Statutes, Title 12, Article 255, Part II, and who is currently
certified by the Board as a nurse aide.
11. Competency Evaluation: The examination
approved by the Board that must be taken and passed as a condition for granting
Medication Aide Authority.
12.
Curriculum: The theory, Laboratory and Clinical education content that the
program is required to provide as a condition of program Approval.
13. Inactive Status: A status that allows a
program to retain its Approval when it has no plans to admit or graduate
students for an extended period of time.
14. Laboratory: The portion of the program
where students in a simulated care setting practice medication aide skills and
theory application under the direct supervision of qualified
instructors.
15. Medication Aide
Authority: The permission granted by the Board to perform the duties and
services of a medication aide.
16.
Medication Aide Training Program: A course of study that is approved by the
Board that meets the requirements of this Rule.
17. Practitioner: A person authorized by law
to prescribe treatment, medication or medical devices and acting within the
scope of such authority.
18.
Primary Instructor: The qualified registered nurse that is responsible for
delivering Classroom and Laboratory instruction and on-site supervision during
clinicals.
19. Program Coordinator:
The qualified registered nurse that is responsible for the program's compliance
with this Rule.
20. Unencumbered:
No pending disciplinary action or current restriction to practice in the state
of Colorado.
C.
INITIAL PROCEDURES FOR APPROVAL
1. Any institution, facility, agency or
individual desiring Approval of a program:
a.
Must submit an application and all attachments for such a program in the manner
required by the Board.
b. Must
designate a Program Coordinator who will be responsible for compliance with
this Rule.
c. May make inquiries of
the Board or the Board's designee for the purpose of clarifying the
requirements of this Rule.
2. The Board or the Board's designee is
responsible for:
a. Reviewing program
applications within ninety days of the date of receipt of the application by
the Board and advising the Program Coordinator whether or not the program has
met applicable standards for Approval.
b. Requesting any needed additional
information from the Program Coordinator.
c. Conducting site visit to determine if all
applicable standards have been met.
d. Notifying the Program Coordinator of the
recommendation to grant or not to grant Interim Approval based upon the
demonstrated compliance of the application and the site visit.
e. Providing the Program Coordinator with a
written description of any observed non-compliance.
3. Interim Approval to admit students may be
granted after the Board or the Board's designee determines the program to be in
substantial compliance with all applicable rules and regulations.
4. The program shall not enroll students
until Interim Approval is obtained. Students attending and graduating from a
non-approved program are not eligible to take the Competency
Evaluation.
5. Programs that are
granted Interim Approval must achieve Full Approval within twelve months of
being granted Interim Approval in order to continue operations.
D.
CRITERIA FOR EVALUATING
PROGRAM ADMINISTRATION
1. Program
Organization and Administration:
a. There
shall be a governing body that has the authority to conduct the program,
determine general policy and provide adequate financial support. Individuals
that comprise the governing body shall be disclosed in writing to the
Board.
b. There shall be an
organizational plan that demonstrates and describes the relationship of the
program to the governing body.
c.
There shall be a qualified Program Coordinator with the conferred authority and
responsibility to administer the program in accordance with the policies of the
governing body and in relation to the job duties specified in Section (G)(5)(1)
of Rule 1.12.
d. There shall be
sufficient qualified program instructors to provide effective assistance and
supervision to the students.
2. The program shall comply with all
applicable state and federal statutes, rules and policies including those in
this Rule 1.12.
3. The program must
ensure that students do not perform any services for which they have not been
trained and found proficient by the Clinical Preceptor.
4. The program must ensure that students who
are providing services to Clients are under the direct supervision of a
Clinical Preceptor.
E.
PROGRAM ADMISSIONS
1. All
applicants wishing to enroll in a training program to become a medication aide
shall meet all of the following pre-enrollment criterions:
a. Proof of High School Diploma or
GED.
b. Proof of being at least
eighteen years of age.
c. Proof of
completion of a state-approved nurse aide training program and certification as
a CNA by the board.
d. At least
1,000 hours of documented work experience as a CNA within the last twenty-four
months.
e. A written recommendation
from the CNA's supervising nurse, director of nursing or nursing home
administrator supporting the CNA's enrollment in the program.
f. Demonstrated ability, via enrollment
pre-test administered by the program, to read and write in English and the
ability to perform the four basic mathematical functions:
(1) Addition
(2) Subtraction
(3) Multiplication
(4) Division
F.
CURRICULUM
1. The Curriculum shall be developed,
implemented, managed and evaluated by the Program Coordinator and Primary
Instructor(s).
2. The Curriculum
content shall be developed from a Board-approved textbook that addresses the
required Curriculum content.
3. The
Curriculum shall include no less than 100 hours of training which shall include
no less than sixty hours of Classroom and Laboratory instruction and no less
than forty hours of Clinical experience.
4. Classroom and Laboratory training in the
required content must be completed before students proceed to Clinical
experience.
5. Classroom and
Laboratory training and general Clinical supervision are performed by a
qualified registered or practical nurse.
6. Clinical training and experience is
directly supervised by a qualified registered or practical nurse that ensures
that students demonstrate medication aide competencies and who documents the
student's success with the competencies on a state approved Clinical experience
checklist.
7. The Curriculum shall
include a review of the following:
a.
Communication and interpersonal skills including:
(1) Techniques for addressing the unique
needs and behaviors of individuals with dementia, Alzheimer's, and other
cognitively impaired residents.
(2)
Communicating with the cognitively impaired.
(3) Understanding the behavior of cognitively
impaired residents.
(4) Appropriate
responses to the behavior of cognitively impaired residents.
(5) Methods to reduce the effects of
cognitive impairments.
(6)
Appropriate responses to combative residents.
b. Infection control.
c. Safety/emergency procedures including the
Heimlich maneuver.
d. Client
Independence.
e. Resident
Rights.
f. Preventing and Reporting
abuse, neglect and misappropriation of Client property.
8. The program shall include
Classroom/Laboratory training and Clinical experience in:
a. Fundamentals of pharmacology.
b. Medication orders.
c. Care of long term care Clients and
monitoring the effects of medication usage.
d. Fundamentals of the following systems and
medications affecting each system:
(1)
Gastrointestinal.
(2)
Musculoskeletal.
(3) Skin and
sensory.
(4) Urinary.
(5) Cardiovascular.
(6) Respiratory.
(7) Endocrine.
(8) Male and female reproductive.
(9) Nervous.
e. Psychotherapeutic medications.
f. Inflammation, infection, immunity and
malignant disease.
g. Nutritional
deficiencies.
h. Principles of
administering medications.
(1) Six Rights of
Medication Administration.
(2)
Preparing or altering medication for administration in accordance with
manufacturer's instructions and Practitioner's orders.
(3) Count, administer and document controlled
substances.
i.
Documentation of medication administration.
j. Minimizing distractions and
interruptions.
k. Hand
washing/standard precautions.
l.
Positioning of Client in preparation for medication/treatment administration
including the following:
(1) Supine
position.
(2) Lateral
position.
(3) Sim's
position.
(4) Fowler's
position.
(5) Prone
position.
m. Measuring
and recording temperature via oral, axillary, otic, temporal or rectal route
using a thermometer (glass and electronic).
n. Measurement and recording of vital signs
including pulse, respiratory rate, and blood pressure, and reporting all
abnormalities to the practical or registered nurse that would prohibit
medication administration.
o. Scope
of Practice for the Medication Aide.
p. Reporting of observations to the practical
or registered nurse and documentation of those observations in the medical
record.
q. Clean technique in
handling medications and dressings.
r. Administration of oxygen per nasal canula
or non-sealing mask.
s. Obtaining
oxygen saturation utilizing an oximeter.
t. Administration of medications:
(1) Via oral, ophthalmic, otic, nasal,
topical, sublingual, buccal, vaginal, rectal and transdermal routes.
(2) Via G-tube, J-tube and NG tube.
(3) Via metered dose inhaler.
u. Finger stick blood glucose
testing and reporting of results to the practical or registered
nurse.
v. Administering insulin
subcutaneously via syringe, insulin pen, or insulin pump in accordance with
scope of practice.
v. Administering
pro renata (PRN) medications in accordance with scope of practice.
w. Hemoccult testing.
x. Applying dressing to minor skin
tear.
y. Applying dressing to a
healed G-tube or J-tube site.
z.
Emptying and changing colostomy bag (may not change apparatus).
aa. Instilling a commercially prepared
disposable enema.
bb. Administering
a sitz bath.
cc. Applying a cold
dry compress.
dd. Conducting
diabetic urine testing.
ee.Collecting fecal or urine
specimens.
9. The program
shall use an evaluation system that appropriately assesses the student's
ongoing progress. Documentation of the student's ongoing progress and
competency during the training program must be available for review by the
Board.
10. No individual class
session shall exceed eight clock hours.
11. The Clinical experience shall be
completed within three (3) months of the completion of the Classroom and
Laboratory instruction.
G.
INSTRUCTORS
1. In a long-term care facility based
program, the Director of Nursing may be the Program Coordinator, but not the
Primary Instructor.
2. Student to
qualified Primary Instructor ratios shall not exceed the following:
a. 20:1 in classroom.
b. 10:1 in Laboratory.
c. 5:1 in Clinical.
3. The ratio of students to qualified
Clinical Preceptors shall be 1:1.
4. Instructor Qualifications:
a. The program coordinator shall:
(1) Be a registered nurse with an active,
Unencumbered, registered nursing license valid to practice in the state of
Colorado.
(2) Have at least two
years of registered nursing experience in direct patient care.
(3) Have documented formal training in
teaching adult learners or one year of full-time documented experience in
teaching adult learners.
b. The primary instructor shall:
(1) Hold an active, Unencumbered, registered
nursing license valid to practice in the state of Colorado.
(2) Have at least two years of registered
nursing experience in direct patient care at least one of which is in a long
term care facility.
(3) Have
documented formal training in teaching adult learners or one year of full-time
documented experience in teaching adult learners.
c. The Clinical Preceptor shall:
(1) Hold an active unencumbered registered or
practical nursing license or psychiatric technician license valid for practice
in the state of Colorado.
(2) Have
at least two years of experience in medication administration at the level for
which they hold their license.
5. Instructor Responsibilities
a. The program coordinator shall:
(1) Serve as the program's primary point of
contact for the Board.
(2) Assist
with the development of the budget.
(3) Develop a student handbook that
demonstrates the program's written policies and notifications, including but
not limited to, policies for admission to, dismissal from and completion of the
program and written notification of program costs.
(4) Conduct initial and ongoing development,
implementation and evaluation of the program including planning for Classroom,
Laboratory and Clinical learning experiences.
(5) Secure and supervise an adequate number
of qualified instructors who will deliver Classroom, Laboratory and Clinical
instruction.
(6) Ensure Classroom
and Laboratory facilities meet established standards and ensure the program
maintains adequate stocks of supplies and equipment for training the enrolled
students.
(7) Secure written
agreements between the administration of the program and each Approved Clinical
Resource.
(8) Assure that each
student is clearly identified as a medication aide student in a manner easily
recognizable to Clients, family members, visitors and staff of the Approved
Clinical Resource.
(9) Ensure an
orientation of the medication aide students to each Approved Clinical Resource.
Such orientation may not be included as part of the minimum 100 hours training
program.
(10) Develop and implement
a systematic plan to evaluate the program which includes evaluation of the
following:
(a) Curriculum effectiveness. (e.g.
content, method of delivery, apportionment of hours)
(b) Primary Instructor
effectiveness.
(c) Testing and
evaluation effectiveness.
(d)
Student performance on the Competency Evaluation.
(11) Provide for the safe keeping of a system
of permanent records and reports essential to the operation of the program and
verification of graduate's preparation for a minimum of two years, which shall
include but not be limited to, the following:
(a) Student Attendance.
(b) Student Test Scores.
(c) Laboratory skills checklist that
demonstrates satisfactory performance of all required skills for each
student.
(d) Clinical experience
checklist that demonstrates a satisfactory and compliant Clinical experience
for each student.
(e) Student
records such as applicable education verification, scored entrance exams,
health screenings, criminal background screenings, program application, letters
of recommendation, etc.
(f)
Instructor records such as license verification, qualifications, and
training.
(g) Annual report
submitted to the Board in the manner established by the Board.
(12) Report to the Board, in the
manner established by the Board, the names of all individuals who have
satisfactorily completed the training program within thirty days of course
completion.
b. The
primary instructor shall:
(1) Maintain
communication with the Program Coordinator related to student issues.
(2) Prepare and deliver theoretical content
as required by the Board and this Rule.
(3) Provide Laboratory instruction in and
evaluation of the practical skills that comprise the medication aide's scope of
practice.
(4) Provide general,
on-site supervision of students at the Clinical site.
(5) Prepare, administer and evaluate each
student's course examinations.
(6)
Counsel students about academic performance.
(7) Provide the Program Coordinator with the
names of all students who complete the program for submittal to the
Board.
c. The Clinical
Preceptor shall:
(1) Provide direct
instruction to and supervision of students at the Clinical site.
(2) Provide evaluation and feedback on the
student's performance and competence.
H.
EDUCATIONAL FACILITIES
1. Classrooms, laboratories and instructor
offices shall be adequate in size, number and type.
2. Classrooms and laboratories shall be in a
clean and safe condition, at a comfortable temperature and with adequate
lighting.
3. Instructional
materials shall be provided and be available to students and
instructors.
4. Equipment must be
kept clean and in good working order.
5. Supplies and equipment must be sufficient
in number to meet the learning needs of the students enrolled in the
program.
I.
CLINICAL RESOURCES
1. Facilities
selected for Clinical experience shall provide adequate learning experiences in
medication administration as determined by the Board or the Board's
designee.
2. Programs that utilize
outside providers of Clinical resources must have a signed written agreement
with each outside provider of Clinical resources.
3. Those Clinical resources requiring
licensure shall be licensed in accordance with state and federal
regulations.
4. Other
considerations in the evaluation of a facility as an Approved Clinical Resource
for students are:
a. Clinical resource's
compliance with applicable state and federal regulations.
b. Amount and type of administrative
support.
c. Numbers and types of
other programs and students using the Clinical resource.
d. Average daily census.
J.
CONTINUING
APPROVAL
1. Annual reports, which
approved programs shall provide timely to the Board in the manner established
by the Board, will be used for evaluating continuing Approval.
2. In all reviews other than initial
application reviews, the Board of the Board's designee will conduct an onsite
survey of the program. At minimum, programs will receive an onsite survey every
two years. All surveys will evaluate a program's compliance with the
requirements set forth by state and federal regulation and this Rule. All
surveys may also utilize:
a. The quality of
care provided by medication aide students that are monitored during any state
inspection or certification survey.
b. Record of complaints received about the
program.
c. Medication Aide
Competency Evaluation pass rates.
3. Onsite surveys may be conducted in
conjunction with visits by other state survey agencies and may be conducted in
conjunction with reviews for other Board-regulated education
programs.
4. A report of the
Board's survey findings will be sent to the Program Coordinator with any
requirements for the correction of any non-compliance identified during the
survey.
5. Approval of the program
will be continued by the Board, provided that the program is compliant with
state and federal regulations and the requirements of this Rule.
6. The program may be visited at times other
than the regularly scheduled survey visit, if deemed necessary by the Board or
the Board's designee.
7.
Significant changes in the program shall be reported to the Board prior to
implementation. Significant changes shall be defined to include, but not be
limited to, changes in:
a. Program
Coordinator.
b. Primary
Instructor.
c. The number of
program hours required for completion of the program.
d. Curriculum content.
e. Status of the program (e.g., inactive,
closing).
f. Clinical Site or
Clinical Resource.
g. Program
contact information.
8.
Any change in the governing body must be reported to the Board prior to the
change's implementation. Such change may necessitate an onsite survey
visit.
K.
SANCTIONS
AND WITHDRAWAL OF APPROVAL
1. For the
protection and safety of the public, any program that engages in non-compliance
that jeopardizes the safety of the public shall not be permitted to admit new
students or proceed with new cohorts/classes. Non-compliance that jeopardizes
the safety of the public includes, but is not limited to:
a. Failure to utilize qualified
instructors;
b. Failure to
supervise students during Clinical experience;
c. Failure to provide adequate training
hours;
d. Failure to ensure
students complete Classroom and Laboratory training before the students proceed
to Clinical experience.
2. Any sanction imposed upon a program shall
not be lifted unless or until the program receives written correspondence from
the Board or the Board's designee acknowledging the program has returned to
full compliance with applicable regulations and this Rule.
3. The Board may withdraw Approval when:
a. The program refuses to permit an
unannounced visit by the Board or the Board's designee.
b. The program's non-compliance jeopardizes
the safety, health or well-being of the public.
c. When the program is unable to successfully
address its graduate's low performance on the state Competency Evaluation.
4. The Board may
withdraw Approval when the Board determines the program is non-compliant with
state and federal regulations and this Rule after evaluating the program's
response to the Board's request for documentation/proof of
compliance.
5. Programs whose
Approval is withdrawn shall not be able to apply for Approval of a new program
until a period of twelve months has elapsed from the date Approval is
withdrawn.
L.
INACTIVE AND CLOSED PROGRAMS
1.
A program will be deemed inactive when:
a. No
trainees have been admitted or are not expected to be admitted for a period of
twelve months; or
b. A program is
determined to have ceased operation as evidenced by lack of current contact
information for its governing body or Program Coordinator.
2. Inactive programs shall not be required to
submit an annual report or complete their scheduled biennial
inspection.
3. In order to return
to Active Status, an inactive program shall:
a. Furnish the necessary information
documenting the names and qualifications of the Program Coordinator and Primary
Instructor(s).
b. Furnish a copy of
the course schedule which outlines the delivery of the Curriculum.
c. Furnish (where applicable) a copy of the
contract with each Approved Clinical Resource.
d. Submit to a site survey visit.
4. Inactive programs will be
considered closed when the program does not return to Active Status within a
period of twelve months.
5. Closed
and Inactive Status programs shall retain student records for a period of no
less than two years.
6. Closed and
Inactive Status programs shall service student records for no less than one
year from the date a student completed the program.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.