Medication Administration – Wisconsin The most efficient general resource of WI medication administration information is located at: http://dhs.wisconsin.gov/rl_dsl/MedManagement/asstlvgMMI.htm For WI training information/regulations – click on “Staff Training”; a new train-the-trainer model utilizing a standardized state-approved medication administration curriculum and state-approved trainers is being implemented in 2010 ***************************************************************************** Family Care is Wisconsin’s Medicaid Managed Care Program which supports frail elders and individuals with physical and/or intellectual/developmental disabilities An integral component of quality member care in WI’s Family Care program is the interdisciplinary team (IDT) comprised of a social worker, registered nurse, the member and other support persons of the member’s choice. According to the WI Department of Health Services’ contract with the state’s managed care organizations (MCO), it is the responsibility of the registered nurse to complete a health assessment with each member within the first 10 days of enrollment, every six months thereafter, and whenever there is a change in the member’s long term care or health care condition or situation. Medication assessment, which includes the member’s ability to self administer as well as the reconciliation of medications taken with medications ordered, is an essential component of this health assessment. State Policy for medication administration states: “When a service provider [under contract with the MCO] is responsible for the administration of medications to a participant, there must be a written order from a physician and a properly labeled prescription, including the dosage. Medications given on an as needed basis require a clear definition of the circumstances under which the medication is given. A registered nurse affiliated with or employed by the provider is responsible to assure that staff who assist with administration of medications are appropriately trained in administration of the medications that are specific to each participant. Staff document each medication administration at the time of administration. Documentation of errors takes place as soon as discovered.” Oversight “The MCO is responsible for monitoring the performance of providers in the administration of medications to participants. The Division of Quality Assurance (DQA) regulates licensed and certified residential facilities including annual onsite monitoring and investigation of complaints and incidents with those facilities. Any findings related to health and safety including medication errors found in a facility where a participant resides are reported to the MCO and the Office of Family Care Expansion which oversees the contracts with MCOs. The external quality review organization (EQRO) evaluates the performance of MCOs for appropriate medication management as part of annual quality reviews.” Delegation RNs are authorized and licensed to delegate medication administration to Unlicensed Assistive Personnel (UAP). The limits of this authority are governed by the laws and rules that regulate nursing practice in WI and the type or facility or entity in which the RN works. The scope of duties of a UAP in regulated settings is defined by the requirements of their training and subject to the delegation of medication administration tasks to them by licensed health care professionals. It is the responsibility of the health care professional to know the extent of delegation permitted in any given setting and to exercise professional judgment in making the determination whether a task should be delegated to a UAP.
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