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Standards of Safe Medication Administration for Medication Aides

1 Contact Hour
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This peer reviewed course is applicable for the following professions:
Certified Medication Assistant (CMA), Medication Aide
This course will be updated or discontinued on or before Thursday, September 24, 2026

Nationally Accredited

CEUFast, Inc. is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. ANCC Provider number #P0274.


Outcomes

≥ 92% of participants will know the standards of safe medication administration by certified nursing aides.

Objectives

After completing this continuing education course, the participant will be able to meet the following objectives:

  1. Identify medications that a certified medication aide can give.
  2. Identify medications that a certified medication aide cannot give.
  3. Determine how to maintain a safe environment for medication administration.
  4. Describe the responsibilities of a certified medication aide.
  5. Outline legal requirements to working as a medication aide.
CEUFast Inc. and the course planners for this educational activity do not have any relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

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Standards of Safe Medication Administration for Medication Aides
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To earn a certificate of completion you have one of two options:
  1. Take test and pass with a score of at least 80%
  2. Attest that you have read and learned all the course materials.
    (NOTE: Some approval agencies and organizations require you to take a test and "No Test" is NOT an option.)
Author:    Julia Tortorice (RN, MBA, MSN, NEA-BC, CPHQ)

Certification as a Medication Aide

A nursing home, residential care facility, or ICF/IID can use medication aides if the aide has a current valid medication aide certificate and the facility makes sure the regulations are met.

To be eligible to apply for a medication aide certificate, the applicant must be at least 18, have a high school diploma or equivalent, and have completed a medication aide training program. If the aide is going to work as a medication aide in a nursing home, they have to be a nurse aide in the nursing home. Suppose a person is going to be a medication aide at a residential care facility or ICF/IID. In that case, they need at least one year of direct care experience in a facility. These certified medication aides can only work in the type of facility where they have one year of experience. Some situations may cause you to be ineligible, such as a felony conviction.

If you have a certificate or license from another state, you may be issued a certificate. The board may issue a certificate if someone has good work experience, a government certification, or other private certification. The certificate is valid for two years unless it is suspended or revoked. There is a renewal fee.

photo of medication aid with patient

Standards of Safe Medication Administration

A medication aide with a current and valid certificate may give prescription medications to residents of a nursing home, residential care facility, or ICFs/IID. This responsibility is delegated to a mediation aide by an RN or LPN acting at the direction of a registered nurse. A nurse can only withdraw the delegation from a medication aide in cases of resident safety.

A medication aide can give prescription medications using the following methods of administration.

  • Oral
  • Topical
  • Drops to the eye, ear, or nose
  • Rectal
  • Vaginal
  • Inhalants delivered by inhalers, nebulizers, or aerosols, using a single dose of a fixed, pre-measured dose

A certified medication aide cannot give an as-needed medication (PRN) until after a nurse assesses the resident.They can split pills if the prescription requires them to be split. However, the medication aide cannot split pills to change the dose being given. For example, if the doctors wrote a new prescription for a lower dose of the same drug, that would require nursing judgment, so the medication aide has to wait for the new dose to be dispensed.

A certified medication aide cannot give:

  • Schedule II controlled substances
  • Medications requiring dosage calculation, including inhalants delivered by inhalers, nebulizers, or aerosols
  • Medications that are not approved drugs
  • Medications being administered as part of clinical research; or
  • Oxygen.

They also cannot give injections, intravenous (IV) therapy, or through a jejunostomy, gastrostomy, nasogastric, or oral gastric tube. The facility must prevent the medication aides from having access to controlled substances.

Certified mediation aides cannot:

  • Receive, transcribe, or alter medication orders
  • Give the initial dose of a medication ordered for anyone
  • Give medications to a person other than a resident of a nursing home or residential care facility
  • Give any medication without the task having been delegated by a nurse
  • Give medications to pediatric residents

A certified medication aide must always show their title when giving medications. They are responsible for demonstrating competence and accountability and maintaining knowledge of their responsibilities and accountability.

Documentation must be done immediately after the medication is given. This documentation must include the name of the medication, dose, route, date and time, the certified medication aide’s name, or the resident's refusal to take the medication. Most medication administration records (MAR) contain all this information.

The certified mediation aide is responsible for following the seven rights of medication administration:

  • Right Resident?
    •  Are you giving the medication to the person it was prescribed for?
  • Right Reason?
    • Do you know why you are giving the medication?
    • Is it the reason for which it was ordered?
  • Right Medication?
    • Is the medication you are giving the correct medication?
    • Is the name of the medication the same as the name of the medication on the prescription or order?
    • What should you do if they are not?
  • Right Dose?
    • Are you giving the right amount of medication?
    • Are you giving the amount of medication that is prescribed? Check the number of milligrams (mg) or other units (mcg, i.u., etc.) to make sure that the dose you have matches the order. You might need to break a scored pill in half or give two capsules to get the right dose.
  • Right Time?
    • Is it time to give this medication?
    • Is the medication supposed to be given in the morning or at night? The right time medication should be given on time. “On time” means that the medication should be given within one hour before to one hour after the scheduled time. Be careful to give at the right time of day. It is easy to give a medication ordered for 9 PM at 9 AM. Some medications must be given at specific intervals. You may not rearrange the schedule for these medications for the convenience of the staff or resident.
  • Right Route?
    • Make sure that oral medications are swallowed, eye drops are dropped into the eye, and ear medications are in the ear.
    • Are you giving an eye medication in the eye or the ear?
  • Right Documentation?
    • Did you document that you gave the medication on the MAR immediately after giving it?
    • You must document missed medications correctly and document PRN medications.

Certified medication aides are responsible for giving medications in accordance with the standards discussed in this course and maintaining a safe environment. This includes reporting problems, correctly storing and preparing medications, verifying the resident’s identity, witnessing the resident consuming the medication, and reporting medication errors.

Report to a nurse promptly if the resident is uncomfortable and may need PRN medication. Let the RN know if there is any deviation from normal drug administration. Examples are refusing medication or having an unexpected reaction. Report anything about the resident that concerns you. For example, the resident does not look as good as usual or is acting funny.

Certified medication aides are responsible for correctly preparing and storing all medications. All medication must be kept centrally stored in a locked cabinet, locked cart, or locked storage area at all times. Controlled medications must be double-locked. Use only the medication delivery process that is currently used at the facility. You can give medications that a nurse gives you to administer. Over-the-counter medication should be stored and removed from the manufacturer’s originally labeled container. Remove medications only if they are in the properly labeled container that they were dispensed in. A proper medication label includes the medication name, dose, resident’s name, and expiration date.

Before giving a medication, check to see that you have the correct resident. Some residents will nod or say yes no matter what name you call them, so have the resident tell you their name. If the resident cannot tell you their name, rely on a picture in the MAR or ask other staff to confirm the resident’s name. Make sure the resident swallows any oral medication. Sometimes, residents will hide the medication in their mouths and spit it out after they leave.

Medication error means failing to follow the prescriber's instructions when administering a prescription medication. Medication errors include giving outdated medications, giving the wrong medication, giving the wrong dose, taking the wrong route, giving the wrong resident, and using the wrong technique or method. A medication error also includes failure to give the medication as ordered, incorrect preparation, storage, or administration, or giving a medication that a nurse did not delegate you to give. Immediately report and document medication errors.

Distractions cause medication errors! Find a quiet place to work without a lot of noise or activity. Distractions include talking to others, using a cell phone, texting, watching TV, looking at social media, or listening to music. Always prepare, give, and document medications for one resident at a time. Preparing multiple residents' medication early causes medication errors.

A certified medication aide cannot accept any care assignment that would interrupt or conflict with the process of giving medication. You can be assigned to care that will not prevent you from giving medication.

Responsibilities

The federal Health Insurance Portability and Accountability Act (HIPAA) protects residents' privacy. Certified medication aides can only read information if they need to know. They cannot tell others about their residents. They cannot share stories at home, even if they do not mention the resident's name. When discussing a resident’s care, do it in a private setting.

Professional boundaries are guidelines, expectations, and rules. They set limits for safe, acceptable, and effective behavior. You learn many of these boundaries in your training and will learn other boundaries in your workplace. As a healthcare worker, you set boundaries between yourself and others. You communicate boundaries by attitude, activity, and communication. Communication is verbal, written, and non-verbal. Non-verbal communication includes facial expressions, body posture, and hand movements. A certified medication aide must establish and maintain professional boundaries with each resident.

A certified medication aide is responsible for ensuring resident privacy. Do not use social media, texting, emailing, or other forms of communication with or about a resident for anything that is not part of your job. The residents should be treated with courtesy and respect. Do not seek or obtain personal gain or inappropriate personal involvement with a resident. Do not make false, misleading, or deceptive statements.

Do not cause physical, verbal, or emotional abuse or anything that may appear to be abuse. Do not have sexual relations or anything that looks sexual with a resident. This includes physical or verbal behavior. These residents are, in general, not capable of giving full and free consent for sexual relations. Therefore, that behavior will be seen as sexual abuse by the certified medication aide. The residents are vulnerable and dependent on your care. Additionally, you have access to their healthcare and personal information (Gamble, 2022). So, they think you are more powerful. Maliciously withholding medication is a form of abuse.

Delegation

An RN or LPN acting at the direction of a registered nurse who delegates giving medication to a medication aide is not liable for damages to any person or government entity in a civil action for injury, death, or loss to a person or property that allegedly arises from an action or omission of the medication aide in performing the medication administration. This limitation of liability is contingent on the delegation being made appropriately and the medication aide holding a current, valid certificate. A certified medication aide does not have the authority to delegate any task about giving medication to anyone else. Anyone who reports a medication error in good faith is not subject to disciplinary action by the board of nursing or government entity.

Continuing Education

Medication aides are required to complete continuing education for each certificate renewal period. If you earn more hours than needed, you cannot use those hours in another renewal period. You have to keep your certificates of completion and provide them to the board if requested. If you fail to meet the continuing education requirements, you may be ineligible to renew, reactivate, or reinstate your certificate until the requirements are met. If you are in the active military, you can apply for an extended time to complete the continuing education.

Case Study

Scenario

June was delegated medication administration for the West Wing, including 7 AM, 12 PM, and 3 PM medication times. The charge nurse also assigned June to cover the dining room at lunch.

Intervention

June objects to the assignment because she cannot be in the dining room and give noon medications simultaneously.

Outcome

The charge nurse recognized her error and removed June from the lunch assignment.

Strengths and weakness

Had June accepted the assignment, she would have been very rushed giving medications and would probably have been late for lunch. Objecting to the assignment allowed the charge nurse to be aware of medication administration tasks when making assignments.

Summary

A nursing home, residential care facility, or ICF/IID can use medication aides if the aide has a current, valid certificate and the facility meets the regulations. The certified medication aide must follow safe medication administration standards and fulfill other responsibilities.

Select one of the following methods to complete this course.

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Implicit Bias Statement

CEUFast, Inc. is committed to furthering diversity, equity, and inclusion (DEI). While reflecting on this course content, CEUFast, Inc. would like you to consider your individual perspective and question your own biases. Remember, implicit bias is a form of bias that impacts our practice as healthcare professionals. Implicit bias occurs when we have automatic prejudices, judgments, and/or a general attitude towards a person or a group of people based on associated stereotypes we have formed over time. These automatic thoughts occur without our conscious knowledge and without our intentional desire to discriminate. The concern with implicit bias is that this can impact our actions and decisions with our workplace leadership, colleagues, and even our patients. While it is our universal goal to treat everyone equally, our implicit biases can influence our interactions, assessments, communication, prioritization, and decision-making concerning patients, which can ultimately adversely impact health outcomes. It is important to keep this in mind in order to intentionally work to self-identify our own risk areas where our implicit biases might influence our behaviors. Together, we can cease perpetuating stereotypes and remind each other to remain mindful to help avoid reacting according to biases that are contrary to our conscious beliefs and values.

References

  • Gamble, J. (2022). Professional boundaries in healthcare: Be aware of these red flags. Sentinel, 41(3), 6–7. Visit Source.