SECTION 310:677-13-4. Curriculum

(a)   The certified medication aide training program shall include a minimum of forty (40) hours of combined classroom and supervised practical training with a minimum of sixteen (16) hours of supervised practical training.

(b)   The certified medication aide training shall include, but is not limited to each of the following subject areas:

(1)   Preparation and administration of medication.

(A)   Documentation of medication administration.

(B)   Proper medication storage procedures.

(i)   Scheduled controlled substances.

(ii)   Internal and external medications.

(C)   Purposes of medications.

(D)   Oral medications.

(E)   Topical medications.

(F)   Eye, ear, and nose medications.

(G)   Vaginal medications.

(H)   Rectal medications.

(I)   Oral inhalants.

(J)   Transdermal medications.

(K)   Medical terminology, symbols, and abbreviations.

(L)   The rights of medication administration, including the right patient, drug, date, time, dosage, route and form.

(M)   Controlled drug procedures.

(N)   Recognizing appropriate situations requiring assistance of the charge nurse.

(O)   Drug-reference sources.

(P)   Vital sign measurement with drug administration.

(Q)   Medication labeling.

(2)   Observe, report, and document resident's status.

(A)   Blood pressure measurement and documentation.

(B)   Drug to drug interactions.

(C)   Drug to food interactions, and medication timed to coincide with meals.

(3)   Principles of safety.

(A)Infection control techniques.

(B)   Principles of positioning for medication administration.

(4)   Knowledge of measurement systems.

(A)   Distinguish weight and volume measurements.

(B)   Decimal and fraction concepts in medication administration.

(C)   Appropriate measurement equipment.

(5)   Body systems and common diseases.

(A)   Digestive system and common diseases to medication administration.

(B)   Respiratory system and common diseases to medication administration.

(C)   Drug metabolism.

(D)   Cardiovascular system and common diseases to medication administration.

(E)   Endocrine system in relation to diabetes and hormone therapy.

(F)   Elimination system and common diseases to medication administration.

(G)   Skin system and common diseases to medication administration.

(H)   Muscular-skeletal system and common diseases to medication administration.

(I)   Nervous system and common diseases to medication administration.

(c)   The advanced training program for care of diabetes and the administration of diabetic medications by CMAs shall include:

(1)   A minimum of twelve hours of classroom training and a minimum of four hours of supervised practical training;

(2)   Training in the following subject areas with curriculum standards as indicated:

(A)   Pathophysiology of diabetes, with the successful learner able to:

(i)   Define diabetes as a chronic metabolic disorder in which the body is unable to metabolize glucose properly;

(ii)   Describe the action of insulin in the body; and

(iii)   Explain the differences between the types of diabetes;

(B)   Diabetes disease management, with the successful learner able to:

(i)   Describe the relationship between insulin, diet, and physical activity in management of diabetes; and

(ii)   Explain how diet relates to blood glucose control;

(C)   Blood glucose testing and use of equipment, with the successful learner able to:

(i)   Explain the purpose of blood glucose testing;

(ii)   Demonstrate how to use blood glucose testing equipment, and demonstrate accuracy; and

(iii)   Explain the quality control requirements for glucose monitoring equipment, demonstrate both high and low controls, and explain their purpose and frequency of control testing;

(D)   Stable and unstable diabetes, with the successful learner able to:

(i)   Identify appropriate blood glucose levels for persons with diabetes;

(ii)   Define hypoglycemia and list three causes and three symptoms;

(iii)   Define hyperglycemia and list three causes and three symptoms; and

(iv)   Define and describe the difference between stable and unstable diabetes;

(E)   Diabetes care by managing blood glucose levels, with the successful learner able to:

(i)   List three carbohydrate choices used to treat hypoglycemia;

(ii)   Describe measures to prevent hypoglycemia;

(iii)   Describe the relationship between blood glucose levels and indications for glucagon use;

(iv)   Describe measures to prevent hyperglycemia; and

(v)   State when to contact and what to report to a licensed health care provider;

(F)   Charting, graphing, and record-keeping, with the successful learner able to:

(i)   Explain the reason for accurate documentation of all aspects of diabetes management and care, including blood glucose results, quality control testing, medication administration, and adverse reactions;

(ii)   Identify correct forms for documentation; and

(iii)   Demonstrate the ability to accurately document diabetes management and care;

(G)   Diabetic medications and adverse reactions (Insulin), with the successful learner able to:

(i)   Describe the purpose of insulin;

(ii)   State the types of insulin and each onset, peak and duration of action;

(iii)   Explain the difference between basal and bolus insulin; and

(iv)   State common side effects, adverse reactions and precautions for insulins;

(H)   Diabetic medications and adverse reactions (Oral agents), with the successful learner able to:

(i)   Describe the purpose, action and recommended doses of each oral agent; and

(ii)   State common side effects, adverse reactions and precautions for each oral agent;

(I)   Administration of diabetic medications, with the successful learner able to:

(i)   State the correct administration times for insulin and oral agents relevant to meals and mechanisms of action;

(ii)   Identify the preferred sites for an insulin injection and describe site rotation patterns;

(iii)   Discuss the proper storage of insulin;

(iv)   Demonstrate the accurate measurement and correct technique for preparation of a single and a mixed dose of insulin;

(v)   Explain why it is required to check insulin type and dose drawn with another certified medication aide or licensed health care provider; and

(vi)   Demonstrate administration of a dose of insulin (or saline) to self or another person and/or to a training mannequin appropriate for injections during classroom training; and

(vii)   Demonstrate administration of a dose of insulin (or saline) to self or another person during supervised practical training;

(J)   Infection control and universal precautions for blood borne pathogens, with the successful learner able to:

(i)   Define the term "universal precautions";

(ii)   Demonstrate safe handling of syringes, needles, pen devices, glucometer equipment and test strips, lancing devices and lancets; and

(iii)   Explain proper disposal of used syringes, needles, test strips and lancets; and

(3)   Return demonstrations of skill with a proficiency of 100% and didactic testing measuring curriculum knowledge at 90% or greater.

(d)   The advanced training program for administration of medications and nutrition via nasogastric and gastrostomy tubes, and for administration of oral metered dose inhalers and nebulizers, shall include:

(1)   A combined minimum of eight (8) hours of classroom and supervised practical training;

(2)   Training in at least the following subject areas:

(A)   Gastrointestinal system and alternative methods for providing medications and nourishment;

(B)   Nasogastric and gastrostomy equipment and supplies;

(C)   Procedures and techniques for insertion of nasogastric tube by a licensed nurse, and assessment of patient by registered nurse after placement of nasogastric or gastrostomy tube and before administration of medication or feedings;

(D)   Procedures and techniques for checking stomach contents through a gastrostomy tube prior to the administration of medication and/or feedings per licensed nurse delegation, when assessment of gastrostomy tube placement and assessment of resident status by a licensed nurse is not indicated based on the resident's current assessment and care plan and/or status and condition;

(E)   Methods and techniques for administration of medications and nutrition via nasogastric and gastrostomy tubes;

(F)   Identification of and responses to potential problems associated with administration of medications and nutrition via nasogastric and gastrostomy tubes;

(G)   Respiratory system and methods for delivery of medications;

(H)   Equipment and supplies for administration of medication via metered dose inhalers and nebulizers;

(I)   Methods and techniques for administering medications via metered dose inhalers and nebulizers; and

(J)   Identification of and responses to potential problems associated with administration of medications via metered dose inhalers and nebulizers; and

(3)   Return demonstrations of skill with a proficiency of 100% and didactic testing measuring curriculum knowledge at 90% or greater.

(e)   The advanced training program for care of diabetes and the monitoring of blood glucose only, with no administration of insulin by CMAs, shall include:

(1)   A minimum of six (6) hours of classroom training and a minimum of two hours of supervised practical training;

(2)   Training in the subject areas identified in subparagraphs (c)(2)(A), (B), (C), (D), (E), (F) and (J) of this section; and

(3)   Return demonstrations of skill with a proficiency of 100% and didactic testing measuring curriculum knowledge at 90% or greater.

(f)   The advanced training program for administration of medications and nutrition via nasogastric and gastrostomy tubes only, with no administration via oral metered dose inhalers and nebulizers, shall include:

(1)   A combined minimum of four (4) hours of classroom training and two (2) hours of supervised practical training;

(2)   Training in the subject areas identified in subparagraphs (d)(2)(A), (B), (C), (D) and (E) of this section; and

(3)   Return demonstrations of skill with a proficiency of 100% and didactic testing measuring curriculum knowledge at 80% or greater.

(g)   The advanced training program for administration of oral metered dose inhalers and nebulizers only, with no administration via nasogastric and gastrostomy tubes, shall include:

(1)   A combined minimum of two (2) hours of classroom training and one (1) hour of supervised practical training;

(2)   Training in the subject areas identified in subparagraphs (d)(2)(F), (G), (H) and (I) of this section; and

(3)   Return demonstrations of skill with a proficiency of 100% and didactic testing measuring curriculum knowledge at 80% or greater.

[Source: Added at 12 Ok Reg 3087, eff 7-27-95; Amended at 23 Ok Reg 559, eff 12-22-05 (emergency); Amended at 23 Ok Reg 2422, eff 6-25-06; Amended at 24 Ok Reg 2045, eff 6-25-07]