| (a) A medication aide permitted under this chapter:
(1) must observe and report to the facility's or home
health agency's licensed nurse on duty or on call any reactions or
side effects to medication shown by a resident or client, and document
such side effects to the medication in the resident's or client's
clinical or equivalent record;
(2) must take and record vital signs before the administration
of medication that could affect or change vital signs;
(3) may administer regularly prescribed medication
to a resident or client if the medication aide:
(A) is trained to administer the medication;
(B) personally prepares the medication or sets up the
medication to be administered; and
(C) documents the administration of the medication
in the resident's or client's clinical or equivalent record;
(4) may administer oxygen per nasal cannula or a non-sealing
mask only in an emergency, after which the medication aide must verbally
notify the licensed nurse on duty or on call and appropriately document
the action and notification;
(5) may apply specifically ordered ophthalmic, otic,
nasal, vaginal, and rectal medication unless prohibited by subsection
(b)(10) of this section;
(6) may administer medications only from the manufacturer's
original container or the original container in which the medication
had been dispensed and labeled by the pharmacy with all information
mandated by the Texas State Board of Pharmacy;
(7) may administer previously ordered PRN medication,
if:
(A) the facility's or home health agency's licensed
nurse on duty or on call authorizes the medication;
(B) the medication aide documents in the resident's
or client's records the symptoms indicating the need for the medication
and the time the symptoms occurred;
(C) the medication aide documents in the resident's
or client's records that the facility's or home health agency's licensed
nurse on duty or on call was contacted, symptoms were described, and
the licensed nurse granted permission to administer the medication,
including the time of contact;
(D) the medication aide obtains authorization to administer
the medication from the facility's or home health agency's licensed
nurse on duty or on call each time the symptoms occur;
(E) except as required by subparagraph (F) of this
paragraph, the medication aide ensures that the resident's or client's
record is co-signed by the licensed nurse who provided authorization
by the end of the nurse's shift or, if the nurse was on call, by the
end of the nurse's next on duty shift; and
(F) must, if a home health medication aide, ensure
that the client's clinical record is co-signed by the RN who provided
authorization within seven days after the notes are incorporated into
the clinical record;
(8) may measure a prescribed amount of a liquid medication
to be administered to a resident or client;
(9) may break a tablet to be administered to a resident
or client, if:
(A) the resident's or client's medication card or its
equivalent accurately documents how the tablet must be broken before
administration; and
(B) the licensed nurse on duty or on call has calculated
the dosage;
(10) may crush medication, if:
(A) authorization has been given in the original physician's
order or the medication aide obtains authorization to crush the medication
from the licensed nurse on duty or on call; and
(B) the medication aide documents the authorization
on the resident or client's medication card or its equivalent; and
(11) may, except as prohibited by subsection (d) of
this section, electronically order a refill of medication from a pharmacy,
if the refill request is signed by the licensed nurse on duty or on
call.
(b) A medication aide permitted under this chapter
may not:
(1) administer medication by the injection route including
the:
(A) intramuscular route;
(B) intravenous route;
(C) subcutaneous route;
(D) intradermal route; and
(E) hypodermoclysis route;
(2) administer medication used for intermittent positive
pressure breathing treatments or any form of medication inhalation
treatments;
(3) administer previously ordered PRN medication, except
in accordance with subsection (a)(7) of this section;
(4) administer medication that, according to the resident's
or client's clinical records, has not been previously administered
to the resident or client;
(5) calculate resident's or client's medication doses
for administration;
(6) crush medication, except in accordance with subsection
(a)(10) of this section;
(7) administer medications or feedings by way of a
tube inserted in a cavity of the body, except as specified for home
health medication aides in §558.404(h) of this title (relating
to Standards Specific to Agencies Licensed to Provide Personal Assistance
Services);
(8) receive or assume responsibility for reducing to
writing a verbal or telephone order from a healthcare professional
including a physician, dentist, podiatrist or advanced practice nurse;
(9) order a resident's or client's medications from
a pharmacy, except in accordance with subsection (a)(11) of this section;
(10) apply topical medications that involve the treatment
of skin that is broken or blistered or when a specified aseptic technique
is ordered by the attending physician;
(11) steal, divert, or otherwise misuse medication;
(12) violate any provision of the Texas Health and
Safety Code, Texas Human Resources Code, or this chapter;
(13) fraudulently procure or attempt to procure a permit;
(14) neglect to administer appropriate medications,
as prescribed, in a responsible manner; or
(15) administer medications if the person is unable
to do so with reasonable skill and safety to residents or clients
by reason of drunkenness or excessive use of drugs, narcotics, chemicals,
or any other type of material.
(c) If a practice is not described in subsection (a)
of this section the practice is prohibited for a medication aide permitted
under this chapter.
(d) A home health medication aide may not order a client's
medication from a pharmacy.
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