Nursing Assessment Before Training of Unlicensed Staff

Purpose

The Division of Developmental Disabilities is providing a clarification of Administrative Rule 116 regarding Nurse-Trainer assessment of individuals before the training of unlicensed staff as stated in Section 116.40 b).

Background and Explanation

Before a Nurse-Trainer can train unlicensed staff to administer oral and topical medications to individuals served, the Nurse-Trainer must develop a clear picture of an individual's physical, mental and medication status. Administrative Rule 116.40 b) addresses this: "Prior to training non-licensed staff to administer medication, each nurse-trainer shall perform the following for each individual to whom medications will be administered by non-licensed staff [20 ILCS 1705/15.4(c)] ….: 1) An assessment of the individual's physical and mental status and medical history. 2) An evaluation of the medication orders and medications prescribed."

It is recognized that an individual Nurse-Trainer will not necessarily be the only Nurse-Trainer supervising and training unlicensed staff to administer medications. In addition, there will be situations of illnesses, vacations, events and departures that will necessitate the substitution of one Nurse-Trainer for another. Necessarily, health care practitioners, to provide a continuity of services and safety for individuals served, must rely on documented health information that is passed from one health care practitioner to another.

Process and Procedure

The Nurse-Trainer must have an understanding and knowledge of the physical and mental status, medical history, medication orders and medications prescribed to initially train and authorize unlicensed staff to administer medications and to provide any additional medication related training of unlicensed authorized staff. The following is acceptable evidence of that understanding and knowledge.

• The registered nurse completing the assessment of an individual's health as required by Section 116.90 a) of Administrative Rule 116 must sign and date the assessment. To be valid, this assessment can be no more than one year prior to the date of the training.
• If the Nurse-Trainer initially training and authorizing unlicensed staff or providing additional training is not the registered nurse who completed the assessment of an individual's health as required by Section 116.90 a) of Administrative Rule 116, there must be evidence that the Nurse-Trainer has reviewed an individual's assessment before doing any training or providing direction about medication administration about that individual.
• There must be clear evidence that the Nurse-Trainer consulted the nursing assessment before any teaching of or providing direction to unlicensed staff.