Appendix B

Competency Standard #I- Recognize the recipient's right to personal privacy regarding health status, any diagnosis of illness, medication therapy and items of a similar nature. Information of this nature should only be shared with appropriate interdisciplinary team members.

Some examples to use in order to assess competency include but are not limited to the following:

• Can identify what specific information about the recipient is considered private and confidential.
• Can identify who some appropriate interdisciplinary team members would be in regards to sharing personal information.

Competency Standard #2- Recognize and honor the recipient with capability and capacity to make an informed decision about medications right to refuse medications and at no time force a recipient to take medications. In the case of a recipient who does not have capability and capacity to make an informed decision about medications, recognize the requirement to seek advice and consultation from the caretaker or the licensed health care professional providing direction and monitoring regarding the procedures and persuasive methods to be used to encourage compliance with medication provision. Recognize that persuasive methods should not include anything that causes injury to the recipient.

• Some examples to use in order to assess competency include but are not limited to the following: Knows that a recipient may refuse to take their medication.
• Can state what to do if a recipient who does not have capability and capacity to make informed decision about medications refuses to take their medication.
• Can tell you who is responsible for direction and monitoring for three specific recipients that they will work with.
• Can tell you the difference between persuasive methods and abusive methods to persuade a recipient to take medications.

Competency Standard #3- Follow currently acceptable standards in hygiene and infection control including handwashing.

• Some examples to use in order to assess competency include but are not limited to the following:
• Can demonstrate and/or describe the proper procedure for handwashing.
• Can identify in regards to providing medications, when it is appropriate to wash their hands.
• Can distinguish between clean and dirty items.
  Can tell you what to do with medication that is dropped on the floor.

Competency Standard #4- Follow facility policies and procedures regarding storage and handling of medication, medication expiration date, disposal of medication and similar policies and procedures implemented in the facility to safeguard medication provision to recipients.

• Some examples to use in order to assess competency include but are not limited to the following:
• Can state how medications are stored and handled at their place of employment.
• Can properly identify the following routes on the medication label or directions per policy at place of employment: oral, inhalation, topical and instillation.
• Knows that if the right medication is not given, the right person does not receive the medication, the medication is not given at the right time, the right dose of medication is not given and/or that the right route is not given, that this information needs to be reported to the person responsible for direction and monitoring.

Competency Standard #5- Recognize general unsafe conditions indicating that the medication should not be provided including change in consistency or color of the medication, unlabeled medication or illegible medication label, and those medications that have expired. Recognize that the unsafe condition(s) should be reported to the caretaker or licensed health care professional responsible for providing direction and monitoring.

• Some examples to use in order to assess competency include but are not limited to the following:
• Can identify what to do if a medication is not its normal consistency or color.
• States what they would do with medication that was not properly labeled.
• States what they would do if they could not read the medication label.
• States what to do with medication that has expired.
• Can identify to whom these conditions should be reported.

Competency Standard #6- Accurately document medication name, dose, route and time administered, or refusal.

• Some examples to use in order to assess competency include but are not limited to the following:
• Can properly document medication provision on place of employment's medication record.
• Can identify the information that should be documented for each medication given.
• Knows that refusal of medication needs to be documented and how that is done at their place of employment.

Competency Standard #7- Provide the right medication, to the right person, at the right time, in the right dose, and by the right route.

• Some examples to use in order to assess competency include but are not limited to the following:
• Knows how to read the medication label or directions per policy at place of employment to be sure the right medication is given.
• Knows how to identify recipients at place of employment.
• Can identify the importance of giving medication at the designated time and what to do if not given at this time.
• Can accurately measure dosages of medications including liquid medications.
• Can demonstrate and/or explain how to give eye, ear, and nose drops.
• Can explain how to give eardrops to age appropriate recipients per place of employment policy.
• Can identify that there is a difference between giving eardrops to a child vs an adult.
• Can explain how to give inhalers to age appropriate recipients per place of employment policy.
• Can identify that there is a difference between giving an inhaler to a child vs an adult.

Competency Standard #8- Provide medication according to the specialty needs of recipient's based upon such things as age, swallowing ability, and ability to cooperate.

• Some examples to use in order to assess competency include but are not limited to the following:
• In regards to providing medications, can identify what to do if recipient is having difficulty swallowing.
• In regards to providing medications, can identify what to do if the recipient is not cooperative.
• Can identify why medications may need to be liquid or crushed.
• Can state how the procedure for giving eardrops to an adult is different than when giving them to a child.

Competency Standard #9- Recognize general conditions, which may indicate an adverse reaction to medication such as rashes/hives, and recognize general changes in recipient condition which may indicate inability to receive medications. Examples include altered state of consciousness, inability to swallow medications, vomiting, inability to cooperate with receiving medications and other similar conditions. Recognize that all such conditions shall be reported to the caretaker or licensed health care professional responsible for providing direction and monitoring.

• Some examples to use in order to assess competency include but are not limited to the following:
• In regards to providing medications, if a .recipient has a rash, can state what to do.
• In regards to providing medications, if a recipient were vomiting, can state what to do.
• In regards to providing medications, if a recipient were not as alert as previous, can state what to do.
• In regards to providing medications, if a recipient were having trouble swallowing, can state what to do.

Competency Standard #10- Safely provides medications for all ages of recipients according to the following routes: oral, topical, inhalation and instillation.

• Some examples to use in order to assess competency include but are not limited to the following:
• Can demonstrate and/or explain how to provide medications according to the oral route.
• Can demonstrate and/or explain how to provide medications according to the topical route:
• Can demonstrate and/or explain how to use an inhaler.
• Can demonstrate and/or explain how to use a nebulizer.
• Can demonstrate and/or explain how to provide oxygen, including use of concentrator and nasal cannula.
• Can identify expiration date of medication and explain procedure to follow if medication is expired.
• Can explain the procedure for administering medications at their place of employment.
• Can state how recipients are identified at their place of employment.

Competency Assessment #11- Recognize the limits and conditions by which a medication aide may provide medications.

• Some examples to use in order to assess competency include but are not limited to the following:
• Knows that a medication aide can provide medications according to the five rights and document the medications they provide.
• Knows that a medication aide may give an oral medication.
• Knows that a medication aide may give an inhalant medication including inhalers, nebulizers and oxygen.
• Knows that a medication aide may give topical medication.
• Knows that a medication aide may give instillation medications to the eye, ear and nose.
• Knows conditions under which a medication aide can give an inject-able medication.
• Knows conditions under which a medication aide can give a PRN medication.
• Knows conditions under which a medication aide can participate in monitoring.
• Knows conditions that need to be in place for a medication aide to give Tylenol for a headache.
• Knows who can give direction to provide medications.
• Knows who can monitor for the effects of medications provided and the requirement to know who that person is.

Competency Standard #12- Recognize the responsibility to report and the mechanisms for communicating such to appropriate authorities if reasonable cause exists to believe that a child has been subjected to abuse or neglect or observes a child being subjected to conditions or circumstances which would result in abuse.

• Some examples to use in order to assess competency include but are not limited to the following:
• Knows medication aide's responsibility regarding abuse or neglect of an adult. Can state some examples of adult neglect.
• Can state some examples of adult abuse.
• Can identify the department to which adult abuse is reported or can identify how to find out to whom to report adult abuse or neglect.

Competency Assessment #13- Recognize the responsibility to report and the mechanisms for communicating such to the appropriate authorities if reasonable cause exists to believe that a child has been subjected to abuse or neglect or observes a child being subjected to conditions or circumstances which reasonably would result In abuse or neglect.

• Some examples to use in order to assess competency include but are not limited to the following:
• Knows medication aide's responsibility regarding abuse or neglect of a child.
• Can state some examples of child neglect.
• Can state some examples of child abuse.
• Can identify the department to which child abuse or neglect is reported or how to find out to whom to report child abuse or neglect.

Competency Standard #14- Recognize the recipient's property rights and physical boundaries.

• Some examples to use in order to assess competency include but are not limited to the following:
• Can state some appropriate ways to show respect for a recipient's personal belongings and property.
• Can identify what appropriate physical contact/boundaries with a recipient would be.
• Knows if it is ok to borrow money from a recipient.
• Knows if it is ok to borrow any personal belongings from a recipient. Knows if it is ok to accept gifts from a recipient.
• Knows if it is ok to kiss a recipient.
• Knows if it is ok to have sexual contact with a recipient.
• When providing a topical medication to an adult recipient's genital area, they make a sexual comment to you. Can state an appropriate response to this recipient.