I have remained quiet about certified medication aides in long term and the role of nurses in this process. I was skeptical (that's my nature) but waited to see what would evolve.
The Ohio Board of Nursing in the Spring 2009 Momentum has an excellent article, Delegation of Medication Administration to Medication Aides in Nursing.
The way job description are written in long-term care and patient care assignments are made there is no true delegation. Nursing homes in my opinion and how they are managed have attributed to the failure for most to understand the distinctions between the RN scope of practice and the LPN scope of practice because patient care is scheduled by halls, units, etc.
Now here comes the certified medication aides and nurses are utimately accountable and potentially liable for the failure to delegate in accordance with the Nurse Practice and Regulations. That's nice. Most of us are nurses are not comfortable with delegation because healthcare is provided along the lines of job descriptions and patient care assignments for efficiency and the role of the RN in delegation has become academic.
Academic meaning folks such as myself (who are not at the bedside) will research and publish on the delegation but the real world application of delegation in daily clinical practice requires a firm grasp on the Nursing Board law and rules, employer policies and procedures, and the job descriptions, scope of practice, and roles of RNs, LPNs, and Certified Medication Aides. How many employers are providing this type of intense inservicing and training on delegation? Exactly.
I can understand the rationale and economics driving the use and regulation of certified medication aides, but if you are going to create a new class of paraprofessionals who can administer medication, let those individuals be exclusively accountable, responsible, and potentially liable for their actions without adding nursing delegation to the mix. I also understand there is a need for other licensed or regulated paraprofessionals to do some of the tasks traditionally associated with nursing for a variety of reasons, but damn.
Nurses are already assuming too much risk and potential liability in healthcare without adequate safeguards to manage the risk and the sad part is the majority of us are not aware of this risk and legal liability until we hit the brick wall at 90 mph.
I know the use of certified medication aides in expanding with several states already having aides purportedly with low medication error rates, but we do things differently here in O-Hi-O and things that work in other states for some reason don't work here, so I would like to see if plaintiff attorneys bite at this in Ohio nursing home negligence case (again things that folks like me monitor who are not at the bedside) or what types of Ohio Nursing Board complaints and discipline for RNs and LPNs not delegation in accordance with the law and rules (folks like me monitor this as well) will follow this.
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