Ohio Republicans want Nurse Aids to pass meds to our elderly in Nursing H

[liberalnurse]

Nursing Home medication administration issue:

This is an update from a previous post wherein;

The Ohio General Assembly, in lame duck session, want to push through legislation for nurse aids to pass meds to our vulnerable elderly....a cost savings yes, a life threatening health risk,yes!

Here is the update of my actions:

Action Alert #2
December 3, 2004

Thanks to all of you who have already contacted your legislators and members of the House Commerce and Labor Committee about the plan to authorize unlicensed individuals to administer medications in nursing homes. We need to continue our push to make sure the effort by the long-term care industry is not successful during the brief time left in the current General Assembly session.

We hear rumors that SB 196 may no longer be the vehicle for the amendment, but there are other possibilities including a yet to be drafted capital appropriations bill that will be enacted before adjournment; or SB 222 sponsored by Sen. John Carey, dealing with municipal hospitals, that is before the House Health Committee and scheduled for hearings on Wednesday December 8th.

We now need to concentrate our efforts on members of the Health and Finance Committees in the House. To that end ONA is asking you to contact the individuals listed below and emphasize the following points:
The "pilot" is in reality a phased-in approach to permanently allowing the long-term care industry to use unlicensed persons to administer medications without any statutory constraints. The "pilot" becomes permanent automatically across the state in 18 months to two years even before the study data have been evaluated.

There are no limitations in the proposed statute regarding the kinds of drugs that can be administered by unlicensed people, and only minimal limitations on the route of administration. Conceivably, these unlicensed people could administer controlled substances, stock medications, titrated drugs, PRN (as needed) medications and even medications given via a gastric or jejunostomy tube.

No language requires nurse delegation although other states utilizing unlicensed individuals do require that level of nurse oversight. The amendment language avoids this important issue by merely requiring a nurse to be in the building at all times. It is not clear what the nurse's responsibility or liability will be whereas with delegation the role of the nurse is clearly established. Delegation provides important checks and balances to assure patient safety.

There is no requirement that the unlicensed person first complete the basic nurse aide training course before administering medications. (This 75-hour course is required before an aide can even bathe a nursing home patient; yet amazingly, upon completion of an unspecified amount of training, an unlicensed person would be authorized to administer potentially fatal medications to a vulnerable population in Ohio). In the 11 other states that allow medication administration by unlicensed individuals in nursing homes, completion of the basic nurse aide training is a prerequisite to training in medication administration. Further, without requiring the individual to be recognized as a state tested nurse aide, the individual would not necessarily be required to be a high school graduate, nor is there an express requirement for a BCII criminal records check.

The statute provides no guidance regarding the length of the training course or the course curriculum contents.
Nurses are concerned that this important change to Ohio's standard of care for its elderly and disabled citizens is being rushed through, without adequate discussion, during the waning days of the 125th General Assembly. Please allow time for ALL interested parties to work together to develop a genuine pilot program that assures the safety of those participating in the study and provides legitimate data that can be used to validly and reliably determine whether using unlicensed individuals to administer medications to residents in nursing homes, residential care facilities and ICFs/MR is indeed a safe practice.

[slor]

1. For rethuglicans, this is a win-win situation...

they save money by allowing the unlicensed to dispense meds, but if a patient dies, they no longer incur the medical/social costs of that patient. I really believe that is how they look at it.

[liberalnurse]

2. Thats the simple truth.......

It drives me crazy! I think I fell into another dimension or something! What is wrong with humanity? Why won't people think?

Our country is,, what it is...because of our parents and grand-parents. They deserve sooooo much better.

[liberalnurse]

3. Somebody help kick this.....

I'm stressed about this. I fear for our grandparents! Evey one has parents and grandparents!

[RedCon1]

4. Nurse aids operate under the

licenses of an RN here in Texas (I'm a former 27 year resident of Ohio BTW). If the Nurse's aid screws up and kills somebody, the RN loses her license over it (and possibly much more). Aids are supposed to take vital signs, give baths, pass out the dinner trays, feed those who can't feed themselves, etc. Nurses are, among other things requiring high level clinical judgment skills, supposed to make sure that the right drugs are administered to the right patient, in the right amount, via the right route, at the right time, with the right documentation verifying all of this. I shudder to think of what would happen if Nurses aids, lacking the intense RN training of an accredited institution, were given authority to administer drugs to the elderly of all people (who are even more difficult to administer meds to due to their polypharmaceutical existence and their multiple weakened/failing organ systems). Any hospital administrator that allowed this to happen is looking to put his/her hospital out of business. You would be amazed at the big problems that a little error can cause, especially in the elderly.

[liberalnurse]

5. Good news......

We stoppped the repugs on Wednesday. They, the Ohio Senate, repugs, decided not to introduce the "attatchment" to SB 196 or SB 222. We let them know we were out in force....We being, Ohio Nurses Association and other stakeholders....I brought in, networked the Ohio Board of Pharmacy and several LPN school instructors...who were there at the Hearing.


ONA is the leader here on at least getting open discussion about the issue. We don't want med techs at all but it may be a difficult battle to hold off. Many other states are getting hammered with the med tech pilot program legislation.

Here is the press release:

Nurses Win Victory for Elderly, Disabled Patients

COLUMBUS-The Ohio Nurses Association (ONA) applauds the grassroots lobbying efforts from its membership and the general nursing and patient communities to stop a proposed amendment to Senate Bill 196, sponsored by Sen. Lynn Wachtmann (R, Napoleon). The amendment, said to give authority for unlicensed persons to administer medication to patients in nursing homes and residential care facilities, was scheduled to be introduced this morning in the House Commerce and Labor Committee. It was not.

ONA, the Licensed Practical Nurses Association of Ohio (LPNAO) and other stakeholders fought vigorously this past week to alert members of the Ohio General Assembly of the grave risks to patient safety, especially for the elderly and disabled, the amendment implied. While termed a "pilot program" by its supporters in the long-term care industry, in reality the proposed language allowed for a two-year phase-in of statewide medication aides with few statutorily imposed directions or constraints.

"We applaud the Ohio General Assembly for refusing to rush through such a complex issue," said Jan Lanier, director of health policy for ONA. "Unlicensed persons administering medication affects all of us. We need systems in place, directed by a legislative body, to ensure that patient safety and quality of care is not compromised."

ONA was committed to an open dialogue with representatives from the long-term care industry earlier this year. According to ONA, points for discussion include the training, education and regulation of unlicensed persons passing drugs. Because of the complexity of the issue, ONA has requested continuously for a stand-alone bill as a vehicle of discussion.

"We're grateful to the nurses and patients who stood with us in our effort to oppose this last-minute amendment," said Lanier. "This is their victory. While ONA understands this issue needs discussion in the future, we're convinced that it must be open to public debate. Parties interested in this issue need to come together with members of the Ohio General Assembly in an effort of compromise and open dialogue."

ONA is the recognized advocate for nurses and nursing issues in the state, representing the over 140,000 registered nurses in Ohio. As the 4th largest state association of its kind in the country, ONA's mission is to advance the nursing profession in the service of quality healthcare to Ohioans.