Nev. Admin. Code § 449.Sec. 13.3

Current through November 8, 2024

Section 449.Sec. 13.3 - NEW

1. A course must:

(a) Be conducted entirely in English and consist of:

(1) At least 16 hours of training in the management of medication, consisting of not less than 12 hours of classroom training and not less than 4 hours of practical training; or

(2) At least 8 hours of refresher or remedial training in the management of medication.

(b) Include, without limitation, instruction concerning:

(1) The duties, responsibilities and authorized activities of a caregiver who administers or assists with the administration of medication to residents;

(2) Common abbreviations used by physicians, physician assistants, advanced practice registered nurses and pharmacists when writing prescriptions and instructions for using medications;

(3) Following a plan for managing the administration of medications maintained by a residential facility pursuant to paragraph (d) of subsection 1 of NAC 449.2742 and any other policies concerning ordering new prescriptions, reordering existing prescriptions, requesting refills, storage and handling of different types of medication, destruction of medication in accordance with subsection 9 of NAC 449.2742 and maintaining a log of medication deliveries;

(4) Common classifications of medications, including, without limitation, generic, brand name, statins, blood thinners, nitroglycerin, laxatives, antihistamines, antibiotics, bronchodilators, diuretics, antihypertensives, analgesics, antidepressants, anti-anxiety, sedatives, hypnotics, antipsychotics, anti-ulcer, anti-osteoporosis, eye drops and ear drops;

(5) Controlled substances and other medications commonly prescribed to residents;

(6) Types of orders commonly given by physicians, physician assistants and advanced practice registered nurses;

(7) Routes by which medication can be administered, including, without limitation, oral, sublingual, transdermal, topical, otic and ophthalmic;

(8) Types of packaging for medication, including, without limitation, bottles, bubble packs, blister packs and patches;

(9) Forms of medication, including, without limitation, tablet, capsule, cream, elixir, enteric-coated tablet, fast-dissolving tablet, gel capsule, powder, inhaler, ointment, solution, suspension and transdermal patch;

(10) Allergies, interactions between drugs, contraindications, side effects, adverse reactions and toxicity;

(11) Reading the medication label;

(12) The importance of:

(I) Administering medications as prescribed, including, without limitation, the effect of the manner in which medication is administered on the level of medication in the bloodstream and the therapeutic effect of the medication; and

(II) Ensuring that over-the-counter medications and dietary supplements are administered only as authorized by NAC 449.2742;

(13) Determining the schedule for administering a medication based on the instructions provided by the prescribing physician, physician assistant or advanced practice registered nurse;

(14) The rights of a resident concerning the administration of medication;

(15) Verifying before and during the administration of medication that:

(I) The medication is being administered to the correct resident;

(II) The correct medication is being administered to the resident;

(III) The dosage of the medication is correct;

(IV) The medication is being administered according to the schedule established by the prescribing physician, physician assistant or advanced practice registered nurse;

(V) The medication is being administered through the correct route; and

(VI) The administration of the medication is documented properly;

(16) Checking the name of the resident receiving medication, the strength and dosage of the medication and the frequency of administration against the order or prescription, the record of the administration of the medication maintained pursuant to NAC 449.2744 and the instructions on the container of the medication;

(17) When to cut or crush a pill and the proper procedure for cutting or crushing a pill;

(18) When and how to administer a liquid medication, including, without limitation, measuring the amount of a liquid medication;

(19) Antibiotic therapy and achieving therapeutic levels of an antibiotic in blood serum;

(20) Situations where it is appropriate to administer topical solutions, including, without limitation, antibiotic cream, without an order from a physician, physician assistant or advanced practice registered nurse;

(21) Determining when to administer a medication if the directions provide for administration as needed;

(22) Maintaining a record of medication administration in accordance with NAC 449.2744;

(23) Actions to take if an error is made in the administration of medication;

(24) Signs and symptoms of an allergic reaction to medication and other changes in the condition of a resident to whom medication is administered that must be reported to a physician, physician assistant or advanced practice registered nurse;

(25) Situations where it is necessary to seek the assistance of providers of emergency medical services;

(26) Assisting residents who use oxygen, residents who receive kidney dialysis and residents with diabetes, dementia, Parkinson's disease and asthma;

(27) Dealing with medication-seeking behavior and other problematic behavior of residents relating to medication;

(28) Assisting residents with the self-administration of medication;

(29) Preventing infectious diseases, including, without limitation, proper procedures for hand washing and actions to take when exposed to blood-borne pathogens; and

(30) Finding necessary information concerning medications.

(c) Require a participant in the course to demonstrate competency in:

(1) Washing hands;

(2) Putting on and removing gloves;

(3) Pouring medication and passing the medication to a resident while performing the duties described in subparagraphs (15) and (16) of paragraph (b);

(4) Assisting with the administration of medication orally, sublingually, topically or through eye drops, ear drops, nose drops or spray and inhalers;

(5) Cutting and crushing pills;

(6) Reading and interpreting the label of a prescription medication;

(7) Labeling over-the-counter medications and nutritional supplements;

(8) Counting the amount of a controlled substance;

(9) Properly storing medications;

(10) Recording the administration of medication in a record of medication administration maintained pursuant to NAC 449.2744 if:

(I) The medication is administered pursuant to a routine schedule; and

(II) The instructions of the prescribing physician, physician assistant or advanced practice registered nurse provide for administration as needed;

(11) Recording an order to discontinue medication in a record of medication administration maintained pursuant to NAC 449.2744;

(12) Completing a report documenting an error in the administration of medication;

(13) Documenting the delivery and destruction of medication in a log maintained pursuant to NAC 449.2744;

(14) Completing a form to notify the physician, physician assistant or advanced practice registered nurse who prescribed or ordered a medication for a resident if the resident refuses or otherwise misses an administration of the medication as required by subsection 7 of NAC 449.2742;

(15) Recording a change to an order or prescription in the record of medication administration and on the container of the medication; and

(16) Destroying unused medication in accordance with subsection 9 of NAC 449.2742.

(d) Require a participant in the course to achieve a passing score of at least 80 percent on an examination in order to receive a certificate of completion. The examination must:

(1) Consist of questions prescribed by the Division; and

(2) Be administered in a manner approved by the Division.

(e) Result in the award of a certificate of completion approved by the Division to each person who successfully completes the course, including, without limitation, successfully completing the competency demonstration described in paragraph (c) and achieving a passing score on the examination described in paragraph (d). The certificate must be signed by the instructor and must include, without limitation:

(1) The number of hours of training completed;

(2) The names of the person who completed the course and the instructor;

(3) The date of the training;

(4) The approval code issued by the Division pursuant to section 12; and

(5) The approval code issued by the Division to the instructor of the course pursuant to section 14.

2. A person or entity that offers a course shall:

(a) Ensure that, upon the request of a participant in a course, the participant is provided with the written evaluation of the content and presentation of the course provided to the Division pursuant to paragraph (d) of subsection 1 of section 12 to the participant;

(b) Allow the participant to complete the evaluation; and

(c) Review and consider the completed evaluation.

3. The person or entity that offers a course shall:

(a) Maintain attendance records for the course for at least 2 years after the final date on which the course took place; and

(b) Provide those records to the Division upon request.

Nev. Admin. Code § 449.Sec. 13.3

Added to NAC by Bd. of Health by R043-22A, eff. 7/26/2023

NRS 439.200, 449.0302