Shifting the Paradigm: Empowering Unlicensed Staff to Administer Medication
The recent CMS mandate requiring nursing homes to deliver 3.48 hours of daily direct care per patient will be a major challenge for our industry. While the goal is to ensure residents receive the high-quality care they deserve, many facilities are already struggling to meet current staffing requirements amidst a nationwide nursing shortage.
In nursing homes, routine tasks like medication administration often consume a large portion of a nurse's shift. This often leaves critical tasks unfinished or handed off to the next shift. It also prevents nurses from working to the highest level of their licensure. For years, our industry has been underutilizing nurses' skills by having them perform tasks that could be safely delegated. It’s not that passing medications is beneath a nurse, but rather we should optimize expertise where it is needed most, especially given our nationwide nursing shortage.
Many states already allow Certified Nursing Assistants (CNAs) to pass medications with proper training and certification. By investing in the development of our unlicensed staff, we can ensure they have the skills and knowledge to take on these responsibilities safely and competently. This shift not only supports our workforce but also helps nursing homes comply with staffing standards more effectively.
Delegating routine tasks to trained unlicensed staff allows nurses to focus on providing better oversight and more time for assessments and patient centered care. This change would significantly improve operational efficiency, boost staff morale, and could enhance the sustainability of the industry. Financially, it makes sense too! Using CNAs trained for medication administration is more cost-effective than relying solely on higher-paid nurses. For the cost of two RNs, we could staff an RN and two CNAs to pass medications. Doing so could help meet the new CMS required care hours for unlicensed staff. This approach could also help mitigate some of the nursing shortage by redeploying nurses to shifts and units needing more RN coverage.
Implementing this change requires careful planning and investment in training unlicensed staff to ensure they can administer medications safely. Policies and procedures will need to be updated to support this new model. Continuous monitoring and support are essential for success.
Facilities can leverage the $75 million provided by CMS for marketing nursing home jobs and creating financial incentives for nurse aide training. By fostering a culture of continuous learning and professional development, we empower our staff to take on greater responsibilities, enhance the overall quality of care, and improve employee retention by showing that we value their contributions.
Empowering unlicensed staff to administer medications offers numerous benefits, including improved patient care, enhanced efficiency, and a more sustainable nursing profession. Nursing home administrators and policymakers could help our industry by promoting this paradigm shift and making a difference by helping organizations improve quality of care.
Although the new CMS staffing mandate will not be enforced for a few years, and may face legal challenges, extending our capacity to fulfill medication administration should be considered as a significant way our nationwide shortage could be addressed. The efficiencies and cost savings achieved through early compliance are invaluable.
It is time to invest in our workforce, support their development, and embrace innovative solutions to the challenges we face. Let’s rise to the occasion and make this necessary change for the betterment of our industry and the well-being of our residents!