64B9-15.0025. CNA Medication Administration

With the exception of those aspects of medication administration deemed outside the scope of practice of the certified nursing assistant by Rule 64B9-15.0026, F.A.C., and subject to the approval of the home health agency with whom the certified nursing assistant is employed or the approval of the nursing home facility with whom the certified nursing assistant is employed as a qualified medication aide, any certified nursing assistant who meets the requirements of this rule is authorized to administer medications to a patient of a home health agency or to a resident of a nursing home facility, respectively, as delegated by a registered nurse and as further described in this rule.

(1) A certified nursing assistant shall complete an initial six-hour Board approved training course on medication administration and be documented to be competent in the safe and sanitary administration of medication by a registered nurse licensed under Chapter 464, F.S., a physician licensed under Chapter 458, F.S., or an osteopathic physician licensed under Chapter 459, F.S.

(2) The initial six-hour training course curriculum shall include:

(a) A glossary of common terminology for labeling of legend medications.

(b) Safe administration of oral, transdermal, ophthalmic, otic, rectal, inhaled, enteral, and topical prescription and over-the-counter medications.

(c) Record keeping and documentation of medication administration.

(d) Safe storage and proper disposal of medications.

(e) Prevention of medication errors.

(f) Home health care agency policies and procedures regarding medications.

(g) Recognizing, documenting and reporting adverse reactions to medications.

(3) For a certified nursing assistant to be eligible to administer medications to a patient of a home health agency, upon completion of the initial six-hour training course, the certified nursing assistant shall be assessed on both theoretical knowledge and practice, as well as clinical practice and competence. The clinical practice assessment must be witnessed by a registered nurse who shall validate the competency regarding the certified nursing assistant’s ability to safely administer medications.

(4) For a certified nursing assistant to be designated as a qualified medication aide and eligible to administer medications and perform associated tasks to a resident of a nursing home facility, the following is required:

(a) Holding a clear and active certification as a nursing assistant from the state for a minimum of 1 year immediately preceding delegation by a registered nurse;

(b) Completion of the initial six-hour training course in subsection 64B9-15.0025(2), F.A.C., with the substitution of training in nursing home facility policies and procedures for the training in home health care agency policies and procedures in paragraph (2)(f);

(c) Completion of an additional 34-hour training course curriculum which shall include:

1. An overview of the laws and regulations governing medication administration in nursing home facilities.

2. Infection control practices related to medication administration including application of principles to prevent spread of infection, hand hygiene, standard precautions and use of personal protective equipment, transmission-based precautions, bloodborne pathogens and diseases, multi-drug resistant organisms, and antibiotic stewardship.

3. Anatomy and physiology in relation to health and disease with commonly prescribed medications.

4. Additional information on safe administration of oral, transdermal, opthalmic, otic, inhaled, and topical prescription and over-the-counter medications including terminology and abbreviations, measurement and dosage preparations, and the rights of medication administration.

5. Additional information on documentation and the legal aspects of record keeping.

6. Controlled substances.

7. Oxygen administration, continuous positive airway pressure tasks, blood glucose monitoring, and insulin administration.

(d) Upon completion of the initial six-hour training course and the additional 34-hour training course, which may be combined into a single 40-hour course, the certified nursing assistant shall be assessed on both theoretical knowledge and practice, as well as clinical practice and competence. The clinical practice assessment must be witnessed by a registered nurse who shall validate the competency regarding the certified nursing assistant’s ability to safely administer medications and complete associated tasks. Upon validation, the certified nursing assistant may be designated as a qualified medication aide.

(e) Medication administration and performance of associated tasks may only be performed by a qualified medication aide under the direct supervision of a licensed registered nurse or a licensed practical nurse. The licensed practical nurse must be qualified to supervise in accordance with Rule Chapter 64B9-16, F.A.C.

(5) Education Providers: The certified nursing assistant medication administration training courses in subsections 64B9-15.0025(2) and (4), F.A.C., must be sponsored by a provider of continuing education courses approved by the Board pursuant to Rule 64B9-5.005, F.A.C. To be qualified to teach any such course, the instructor must be a currently licensed registered nurse in good standing in this state, have at least one year of experience teaching adults, and at least one year of professional nursing experience, including one year home health care or one year nursing home facility experience, as appropriate, and the supervision of certified nursing assistants. The provider will be responsible for issuing a certificate verifying completion of the requisite number of hours and course content. In addition, all of the training under subsections 64B9-15.0025(2) and (4), F.A.C., must be through in-person instruction.

(6) Nontraditional Education. Continuing education providers may utilize nontraditional education alternatives for teaching the theoretical content in subsection 64B9-15.0025(8), F.A.C. Nontraditional education alternatives include:

(a) Interactive videos,

(b) Self study,

(c) Other nontraditional education that may be submitted to the Board for consideration and possible approval. Any continuing education providers using nontraditional education must make provisions for demonstration of and verification of knowledge.

(7) Clinical Competence. The courses must be followed by supervised clinical practice in medication administration as needed to demonstrate clinical competence. Initial and annual verification of clinical competence shall be the responsibility of each institution employing a certified nursing assistant based on institutional protocol. Such verification shall be given through a signed statement of a Florida licensed registered nurse with knowledge of the certified nursing assistant’s competence. Annual validation of clinical competency must be completed on or before the anniversary date of the initial validation.

(8) In addition to other inservice training hours required under Rule 64B9-15.011, F.A.C., certified nursing assistants found to be competent to administer medications shall annually and satisfactorily complete two (2) hours of inservice training in medication administration and medication error prevention approved by the Board. The initial two (2) hours annual inservice training shall be completed within one year of verification of clinical competence.

Rulemaking Authority 400.211(5), 464.2035(3) FS. Law Implemented 400.211(5), 464.0156, 464.2035 FS. History–New 7-15-21, Amended 3-13-24.