Section 116.40  Training and Authorization of Non-Licensed Staff by Nurse-Trainers


a)         Only a nurse-trainer may delegate and supervise the task of medication administration to direct care staff.


b)         Prior to training non-licensed staff to administer medication, each nurse-trainer shall perform the following for each individual to whom medications will be administered by non-licensed staff [20 ILCS 1705/15.4(c)] once they are trained and authorized direct care staff:


1)         An assessment of the individual's physical and mental status and medical history.


2)         An evaluation of the medication orders and medications prescribed.


c)         Non-licensed direct care staff who are to be authorized to administer medications under the delegation of the registered professional nurse shall meet the following criteria:


1)         be age 18 or older;


2)         complete high school or its equivalency (G.E.D.);


3)         demonstrate functional literacy;


4)         satisfactorily complete the Health and Safety component of the Direct Support Persons Core Training Program or a DHS approved equivalent Developmental Disabilities Aide Training Program;


5)         be initially trained and evaluated by a nurse-trainer in a competency-based, standardized medication curriculum specified by DHS;


6)         receive specific additional competency-based training and assessment by a nurse-trainer as deemed necessary by the nurse-trainer whenever a change of medication or dosage occurs or a new individual that requires medication enters the program;


7)         pass the written portion of the comprehensive examination furnished by DHS based on the information conveyed to them; and


8)         score 100% on a written or oral competency-based evaluation specifically pertinent to those medications that such staff are responsible to administer.


d)         Initial competency-based training toward delegation for medication administration shall include:


1)         Best practice standards related to the rights of individuals, legal and ethical responsibilities, agency procedures and communication pertaining to medication administration.


2)         Best practice nursing techniques associated with medication administration.


3)         Classes of drugs and their effects and common side-effects.


4)         Specific information regarding the individuals to whom the staff will administer medication and the medication the staff will administer.


5)         Techniques to check, evaluate, report and record vital signs when those skills are necessary for the safe administration of medication to that individual.


6)         A final, individual-specific, competency-based evaluation performed by a nurse-trainer for each medication administered to persons at the program for whom the staff provide supports.


e)         Authorized direct care staff shall be re-evaluated by a nurse-trainer at least annually or more frequently at the discretion of the registered professional nurse. Any retraining shall be to the extent that is necessary to ensure competency of the authorized direct care staff to administer medication [20 ILCS 1705/15.4(c)], as judged by a nurse-trainer.


f)         Direct care staff who fail to qualify for competency to administer medications shall be given additional education and testing to meet criteria for delegation authority to administer medications.  Any direct care staff person who fails to qualify as an authorized direct care staff after initial training and testing must, within three months, be given another opportunity for retraining and retesting.  A direct care staff person who fails to meet criteria for delegated authority to administer medication, including, but not limited to, failure of the written test on two occasions, shall be given consideration for shift transfer or reassignment, if possible.  No employee shall be terminated for failure to qualify during the three month time period following initial testing. Refusal to complete training and testing required by this Section may be grounds for immediate dismissal. [20 ILCS 1705/15.4(h)]


g)         No authorized direct care staff person delegated to administer medication shall be subject to suspension or discharge for errors resulting from the staff person's acts or omissions when performing the functions unless the staff person's actions or omissions constitute willful and wanton conduct [20 ILCS 1705/15.4(i)].


h)         Authorization of staff to administer medication shall be revoked if, in the opinion of the registered professional nurse-trainer, the authorized direct care staff person is no longer competent to administer medication [20 ILCS 1705/15.4(c)].  The degree of retraining and reassessment of competency should occur at the discretion of the nurse-trainer.


i)          Clear documentation of training, retraining, and evaluation shall be kept in each staff or contractual person's personnel file by each agency where authorized direct care staff are employed.