Response by Ann Amburn to
Medication Administration Interventions That Must Be Performed By a Registered Nurse
by Greer Glazer Greer, Legislative column editor (Feb. 28, 2002)

Dear Editor:

I write in response to the Legislative Column, "Medication Administration Interventions That Must Be Performed By a Registered Nurse"

Kentucky (KY) continues to struggle with implementing legislation mandating that medication administration by unlicensed assistive personnel (UAP) be allowed only after the unlicensed person has attended a medication training program approved by the Board of Nursing and when the medication is administered under the supervision and delegation of a nurse. KY already has statutes that are applicable to medication administration in long term care. However, these statutes do not apply to other areas, such as programs serving the mentally retarded and developmentally disabled, personal care settings, and assisted living settings, among others. In KY, statutes that govern assisted living facilities, identify the service pertaining to individuals taking medication as "assistance with self-administration of medication." At the same time, assisted living facilities have "Alzheimer's units" which include individuals who have severe cognitive impairment. The conflict there is obvious.

I have been advocating for changes that need to be implemented to protect some of the most vulnerable citizens of our state, i.e., those with mental illness, mental retardation, and the elderly. I am concerned that the legislation regarding medication administration by UAP, that is currently being considered, will allow a loophole to exclude the requirements of delegation and supervision by a nurse. Your column points to the fact that medication administration is not just a "task," but rather an activity that requires the assessment and evaluation process. Legislators must understand the importance of this assessment and evaluation process. I wholeheartedly agree with your comment, "We owe it to the profession and the public to identify medication administration tasks that must be performed by an RN versus those that can be safely delegated. If we do not do this, others will be happy to do it for us. And we have no assurance that this will be in the best interest of nurses or the public." I would only add that, as nurses, we must also advocate to ensure that tasks that are clearly nursing tasks, such as medication administration, must only be delegated to personnel having appropriate training and that these tasks must always remain under the supervision of a nurse.

Thank you,

Ann Amburn RNC
Hardinsburg, KY
waamburn@bbtel.com

Go to the column.

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