Arizona State Board of Nursing

1. Arizona State Board of Nursing Implementing and Evaluating the Medication Technician Pilot Program

2. Problem • Under existing laws and statutes, a nurse cannot delegate the administration of medication to an unlicensed person. • In many situations, laws exist that allow a facility to establish policies etc. that bypass the nurse to accomplish the administration of medications: • Schools • Assisted living

3. Medication Technician Project • Pilot Study Medication Technician Project • Authorized RN/PN to delegate medication administration to CNA with training • In six long term care facilities • Silver Ridge Village—Bullhead City • Heritage Health Care—Globe (unable to participate) • Copper Mountain Inn—Globe • Shadow Mountain—Scottsdale • Good Shepherd—Peoria • Mountain View--Tucson

4. Education • Education prescribed by the Board • 100 hour course • 45 hours classroom • 15 hours skill lab • 40 hours closely supervised clinical practice • Instruction at facility with an RN • Instructors trained • Nurses received delegation education • Students screened for ability to succeed • Board prescribed curriculum/text

5. Safety • Safety measured • Naïve observation method—Flynn • Pre and post error rates—no differences • Staff satisfaction—high satisfaction among all participants • Cost of Research-$90,000.00 • D and S Diversified Technologies is collected data • Outside consultant Jill Scott-Cawiezell RN Ph.D

6. Testing • Instructor develops unit tests/quizzes • State developed competency written and manual skills exam • Item pool of over 500 items developed in conjunction with Diversified D & S Technology • Skill test developed using skill check-off lists developed by steering committee • Limited number of chances to pass

7. Results • All data collected and analyzed • Report written • 21+ Medication technicians trained and passed test • Positive reports from facilities • Legislation passed AZ house with all 60 members voting in favor • Only 5/6 facilities completed pilot

8. What we learned • Curriculum demanding—but then so is medication administration to this population • Carefully selected and taught CNAs will succeed • Nurses more positive than expected • Turnover and shortages of both CNAs and RN instructors at facilities makes implementation challenging • Culture of medication safety needs to be established in the facility • Stakeholder input is important • Reported decreases in staff turnover after implementation of med tech role

9. Questions • Access study at www.azbn.gov • Contact: Pamela Randolph • prandolph@azbn.gov • 602-771-7803