Administrative Code

Virginia Administrative Code
6/25/2022

Chapter 21. Medication Administration Training and Immunization Protocol

18VAC90-21-10. Establishing a medication administration training program.

A. A program provider wishing to establish a medication administration training program pursuant to subsection L of § 54.1-3408 of the Code of Virginia shall submit an application to the board at least 90 days in advance of the expected beginning date.

B. The application shall be considered at a meeting of the board. The board shall, after review and consideration, either grant or deny approval.

C. If approval is denied, the program provider may request a hearing before the board, and the provisions of the Administrative Process Act (§ 2.2-4000 et seq. of the Code of Virginia) shall apply.

Statutory Authority

§§ 54.1-2400 and 54.1-3005 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 30, Issue 10, eff. February 27, 2014.

18VAC90-21-20. Qualifications of instructional personnel.

Instructors shall be licensed health care professionals who, consistent with provisions of the Drug Control Act (§ 54.1-3400 et seq. of the Code of Virginia), are authorized to administer, prescribe, or dispense drugs and who have completed a program designed to prepare the instructor to teach the course as it applies to the clients in the specific setting in which those completing the course will administer medications.

Statutory Authority

§§ 54.1-2400 and 54.1-3005 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 30, Issue 10, eff. February 27, 2014.

18VAC90-21-30. Content of medication administration training.

The curriculum shall include a minimum of 32 hours of classroom instruction and practice in the following:

1. Preparing for safe administration of medications to clients in specific settings by:

a. Demonstrating an understanding of the client's rights regarding medications, treatment decisions, and confidentiality.

b. Recognizing emergencies and other health-threatening conditions and responding accordingly.

c. Identifying medication terminology and abbreviations.

2. Maintaining aseptic conditions by:

a. Implementing universal precautions.

b. Insuring cleanliness and disinfection.

c. Disposing of infectious or hazardous waste.

3. Facilitating client self-administration or assisting with medication administration by:

a. Reviewing administration records and prescriber's orders.

b. Facilitating client's awareness of the purpose and effects of medication.

c. Assisting the client to interpret prescription labels.

d. Observing the five rights of medication administration and security requirements appropriate to the setting.

e. Following proper procedure for preparing medications.

f. Measuring and recording vital signs to assist the client in making medication administration decisions.

g. Assisting the client to administer oral medications.

h. Assisting the client with administration of prepared instillations and treatments of:

(1) Eye drops and ointments.

(2) Ear drops.

(3) Nasal drops and sprays.

(4) Topical preparations.

(5) Compresses and dressings.

(6) Vaginal and rectal products.

(7) Soaks and sitz baths.

(8) Inhalation therapy.

(9) Oral hygiene products.

i. Reporting and recording the client's refusal to take medication.

j. Documenting medication administration.

k. Documenting and reporting medication errors.

l. Maintaining client records according to facility policy.

m. Sharing information with other staff orally and by using documents.

n. Storing and securing medications.

o. Maintaining an inventory of medications.

p. Disposing of medications.

4. Facilitating client self-administration or assisting with the administration of insulin. Instruction and practice in the administration of insulin shall be included only in those settings where required by client needs and shall include:

a. Cause and treatment of diabetes.

b. The side effects of insulin.

c. Preparation and administration of insulin.

d. Signs of severe hypoglycemia and administration of glucagon.

5. Facilitating client self-administration or assisting with the administration of auto-injectable epinephrine pursuant to an order issued by the prescriber for a specific client in a facility licensed by the Department of Behavioral Health and Developmental Services under the provisions of subsection D of § 54.1-3408 of the Code of Virginia.

B. Pursuant to subsection L of § 54.1-3408 of the Code of Virginia, the board requires successful completion of the curriculum approved by the Department of Behavioral Health and Developmental Services (DBHDS) for unlicensed persons to administer medication via a gastrostomy tube to a person receiving services from a program licensed by the DBHDS.

Statutory Authority

§§ 54.1-2400 and 54.1-3005 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 30, Issue 10, eff. February 27, 2014; amended, Virginia Register Volume 31, Issue 5, eff. December 18, 2014; Volume 31, Issue 9, eff. February 13, 2015.

18VAC90-21-40. Post-course examination.

The program provider shall require that each student shall pass a written and practical examination at the conclusion of the training that measures minimum competency in medication administration.

Statutory Authority

§§ 54.1-2400 and 54.1-3005 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 30, Issue 10, eff. February 27, 2014.

18VAC90-21-50. Requirements for protocols for administration of adult immunizations.

Pursuant to provisions of subsection I of § 54.1-3408 of the Code of Virginia, a protocol shall be submitted to and approved by the board prior to the administration of an adult immunization program that includes the following:

1. Purpose and objectives of immunization program.

2. Target population.

3. Name and address of medical director.

4. A signed and dated medical directive.

5. Screening criteria for inclusion and exclusion.

6. Informed consent form.

7. Immunization procedures.

a. Dosage.

b. Single or multiple dose administration.

c. Injection site.

d. Vaccine storage.

e. Biohazardous waste disposal.

f. Standard precautions.

8. Post-immunization instructions.

9. Emergency guidelines, including a signed medical directive for emergency treatment.

10. Qualification of immunization providers.

a. Virginia licensure as a registered nurse, licensed practical nurse, or pharmacist.

b. Supervision of a licensed practical nurse provider.

c. Current cardiopulmonary resuscitation training.

11. Resource personnel and supervision.

12. Sample of patient record with date, vaccine, dose, site, expiration date, lot number, and administering person's signature.

Statutory Authority

§§ 54.1-2400 and 54.1-3005 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 30, Issue 10, eff. February 27, 2014.

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