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Medication Administration

Medication Administration training and certification developed by DODD authorizes caregivers to perform a variety of tasks for people with many different medical conditions. 

Self-Administration

People have an inherent right to self-administer medication through OAC 5123:2-6-02. A Self-Administration Assessment is used to prove the need to override that right, and to ensure that the person is not able to safely accomplish medication administration or complete health care tasks. Use the Introduction-Instruction Self-Administration Assessment for assessment instructions.

Assessments are completed every three years and are updated annually. DODD-approved self-administration assessments must be used. Visit the Forms page.

Self-Administration Assessments include

  • general – oral/topical medication,
  • use of glucometer,
  • health-related activities,
  • inhaled medications,
  • oxygen,
  • G-J tube,
  • And insulin-metabolic glycemic disorder treatments.

Providing Medication or Treatment through Family Delegation

When a person lives with a family member and the provider of services is not employed by an agency but is an independent provider, the family can delegate Medication Administration and health care tasks if they meet the requirements in the family delegation law.  

When a person lives with a family member, the family member is authorized to administer medication without a requirement for Medication Administration Certification. Learn more about medication administration by family members

Providing Medication or Treatment with DODD-Approved Certification

Direct service providers, or DSPs, require special certification to administer most medications and treatments. Once certification is earned it must be renewed annually. Certification is issued by DODD. All certifications can be verified through Medication Administration Certification. Use the "For More Information" box to the right.

There may also be a requirement for nursing delegation, in addition to certification, depending on the setting size or the type of medication or task. View the Medication Administration Reference Grid (to the right) that illustrates the actions and settings specified in rule according to location type, certification, and need for delegation.

Before administering medication or treatment to a person, the certified personnel must also receive individual-specific training. The employer or delegating nurse supervises to ensure safe, accurate medication and treatment administration.

  • Category 1 certification allows personnel to administer oral, topical, and inhaled medications, as well as 13 health-related activities if they have been prescribed for a person.
  • Category 2 certification allows personnel to administer medications through a Gastrostomy or Jejunostomy (G/J) tube if the DSP has been delegated to do so by a nurse. This certification is in addition to Category 1.
  • Category 3 certification allows personnel to administer insulin and injectable treatments for metabolic glycemic disorders if the DSP has been delegated to do so by a nurse. This certification is in addition to Category 1.

There are three treatments or actions that DSPs can perform with only DODD annual training. These are stand-alone training sessions that are not included or related to medication administration certifications.

  • Use of an epinephrine auto-injector for allergic reactions.
  • Use of a VNS magnet for seizures.
  • Use of over-the-counter topical medications for cleansing, comfort, and protection of intact skin (including hair, nails, teeth and oral surfaces).

For questions specifically about medication administration certification or rules, contact ma.database@dodd.ohio.gov. Include your name and phone contact information.

Medication Administration Certification — Category 1 

The initial Category 1 certification training must include a minimum of 14 hours of classroom instruction taught by a DODD-certified registered nurse trainer, or RN trainer.

Routes of medications and health-related activities include

  • prescribed medications taken by mouth, or applied to skin, ears, eyes, nose, vaginally or rectally.
  • prescribed medications that are inhaled, including oxygen and metered-dose inhalers and nebulizers.
  • over-the-counter (OTC) topical medications for musculoskeletal comfort.
  • 13 health-related activities (or tasks):
  • 1. taking vital signs;
  • 2. application of clean dressings that do not require health assessment;
  • 3. basic measurement of bodily intake and output;
  • 4. oral suctioning;
  • 5. use of glucometers;
  • 6. external urinary catheter care;
  • 7. emptying and replacing ostomy bags;
  • 8. pulse oximetry reading;
  • 9. use of continuous positive airway pressure machines, including biphasic positive airway machines;
  • 10. application of percussion vests;
  • 11. use of cough assist devices and insufflators;
  • 12. application of prescribed compression hosiery
  • 13. and collection of specimens by noninvasive means.

About Training

To attend training, DSPs must be at least 18 years old; have a High School Diploma (or GED), and have background check results completed by a developmental disabilities agency (or by being a DODD-certified independent provider).

Initial training must be no less than 14 hours of classroom instruction including demonstration of all skills and must be taught by a DODD-certified RN Trainer. The DODD-approved curriculum must be used for the training and is available in DODD MyLearning.

Classes may be arranged by the employer or by attending one of the classes open to the public. View classes on the Medication Administration Certification site, found in the "For More Information" box to the right.

After training and before administering medications, personnel and employers must verify that certification is currently registered with DODD and have individual specific training for each person.

This certification is renewed every year and requires

  • an application form for renewal signed by employer verifying background check requirements,
  • at least two hours of continuing education*,
  • demonstration of skills verifying that the DSP continues to perform each action safely and accurately (view Skills Checklist),
  • and a certified RN Trainer to verify renewal requirements and enter them into DODD’s MAIS app.

(*Training in cardiopulmonary resuscitation, first aid, activation of a vagus nerve stimulator, use of an epinephrine auto-injector, administration of topical over-the-counter medication, or universal precautions for infection control may not be included in the continuing education required for certification renewals.)

  • If renewal is not completed by the certification expiration date, personnel may not continue to administer medications or treatments. DSPs have up to 60 days after expiration to complete renewal requirements after that time the entire initial training must be repeated for recertification.

Medication Administration Certification — Category 2

Administration of Medication by Gastrostomy or Jejunostomy tubes (G or J tubes)

To earn a Category 2 certification, DSPs must have a current Category 1 certification.

With Medication Administration Certification Category 2 and nurse delegation, a DSP can administer medications via a stable and labeled gastrostomy or jejunostomy tubes (G or J tubes).

Nursing delegation is when a nurse delegates or assigns responsibility for performing a nursing task to a DSP. When doing so, the nurse teaches the DSP what to do and makes sure the DSP performs that task correctly (OAC 4723-13).

The required Category 1 certification must be current for the Category 2 certification to be valid (even if it is not expired).

About Training

Initial Category 2 training must be no less than four hours of classroom instruction including demonstration of all skills and taught by a DODD-certified RN Trainer. The DODD-approved curriculum must be used for the training and is available in DODD MyLearning. View classes on the Medication Administration Certification site, found in the "For More Information" box to the right.

This certification is renewed every year and requires

  • an application form for renewal signed by employer verifying background check requirements,
  • a current Category 1 certification,
  • at least one hour of continuing education (in addition to Category 1 continuing education),
  • demonstration of safe G/J tube skills verified by a nurse (view Skills Checklist),
  • and a certified RN Trainer to verify renewal requirements and enter them into DODD’s MAIS app.

Administration of Fluid and Nutrition by G/J Tube

Certification 2 is not required for nurses to delegate the administration of food or fluid through a G/J tube. Only nurse delegation is required and is conducted according to Ohio Board of Nursing rules.

Medication Administration Certification — Category 3

To earn a Category 3 certification, DSPs must have a current Category 1 certification.

With Medication Administration Certification Category 3 and nurse delegation, a DSP can administer insulin and injectable treatments for metabolic glycemic disorders.

Nursing delegation is when a nurse delegates or assigns responsibility for performing a nursing task to a DSP. When doing so, the nurse teaches the DSP what to do and makes sure the DSP performs that task correctly (OAC 4723-13).

The required Category 1 certification must be current for the Category 3 certification to be valid (even if it is not expired).

About Training

Initial Category 3 training must be no less than four hours of classroom instruction including demonstration of all skills taught by a DODD-certified RN Trainer. The DODD-approved curriculum must be used for the training and is available in DODD MyLearning. View classes on the Medication Administration Certification site, found in the "For More Information" box to the right.

This certification is renewed every year and requires

  • an application form for renewal signed by employer verifying background check requirements,
  • a current Category 1 certification,
  • at least one hour of continuing education (in addition to Category 1 and Category 2 continuing education),
  • demonstration of safe insulin/metabolic glycemic injection skills verified by a nurse (view Skills Checklist),
  • and a certified RN Trainer to verify renewal requirements and enter them into DODD’s MAIS app.

Providing Medication or Treatment with DODD-Approved Training Only

There are three treatments/actions that DSPs can do with only DODD required training completed annually

  • Use of an Epinephrine Auto-injector for allergic reactions
  • Use of a VNS magnet for seizures
  • Use of over-the-counter topical medications for cleansing, comfort and protection of intact skin (including hair, nails, teeth and oral surfaces).

*These are stand-alone trainings that are not included or related to medication administration certifications.

A licensed nurse or other person with current Medication Administration Certification Category 1 may provide training. The DODD-approved curriculum must be used for the training and is available in DODD MyLearning.

The training requires the DSP to demonstrate the ability to perform the task correctly. 

Once training is complete, DSPs may perform these tasks and administer these medications after they have received individual specific training about the person needing the support.

DSPs who have been trained to use an epinephrine auto-injector through other certification classes, like a first-aid course through the American Red Cross, are not required to complete additional training if that certification remains current.

DSPs may independently complete a self-directed VNS training in DODD MyLearning.

Registered Nurse Quality Assessment Reviews

Quality Assessment (QA) reviews are conducted in settings where medication/treatments are provided with DODD-approved certification and without nursing delegation (OAC 5123:2-6-07). The reviews are completed by DODD certified Registered Nurse (RN) Trainers and occur every three years. Refer to QA Form Instructions for use of form. 

The DODD approved RN QA Form must be used by the QA RN.

DODD-Certified Registered Nurse Trainers

To offer the DODD Medication Administration training classes or verify renewal requirements, an RN must be certified by DODD as an RN Trainer. The RN Trainer uses the MAIS App to enter qualifications so that DODD can issue certifications to qualified personnel.

RNs must attend a DODD Train the Trainer course offered by certified RN Instructors around the state. View classes on the Medication Administration Certification site, found in the "For More Information" box to the right.

About Training

To attend the RN Train the Trainer program an RN must hold an unrestricted license with the Ohio Board of Nursing, have 18 months full-time experience as an RN and previous experience working with people who have developmental disabilities.

Classes include pre-program preparation, training offered by a certified RN Instructor that complies with OAC 5123:2-6-04 and complete the post-program assignments to demonstrate knowledge.

This certification is renewed every two years. RN Trainer certification always expires on August 31 of odd-numbered years. Certification renewal requires

  • four hours of continuing education that relates to the information addressed in the RN Train the Trainer program or that will enhance the role of the RN Trainer,
  • and RN Trainers are responsible to enter their own renewal qualification in the MAIS app.

RN Trainers must subscribe to the RN discussion group email list to receive important communication regarding certification and medication administration. To join, email join-rn-trainer@list.dodd.ohio.gov.

All nurses or people interested in developmental disabilities health may subscribe to this list.

Using the MAIS App

The Medication Administration Information System, or MAIS, is the DODD app that records and tracks the Medication Administration certifications of unlicensed personnel and RN Trainers.

RN Trainers receive instruction on using the app in the Train the Trainer sessions. Security access to MAIS is automatically granted to RNs when they earn or renew RN Trainer certification.

Nurses can authorize non-nurses to help with data entry functions in MAIS. This is called “secretarial role” access. The secretarial role allows data entry but does not allow for finalization of certifications; only an RN Trainer can finalize certification or renewal applications.

After a non-nurse has requested DODD secretarial access to MAIS and tried to log in, the RN Trainer must go to MAIS and “associate” with the secretarial person’s record for the person to be fully granted access. RN Trainers have the option to “disassociate” and discontinue any non-nurse’s access to MAIS at any time. DODD security for the secretarial role must be renewed annually to maintain access to MAIS. View On-Line Security Request.

The instruction for using MAIS are the same for RN Trainers and Secretarial users. RN Trainers will need to provide training to their secretarial associates.

Medication Administration - "You Are Your Brother's Keeper"

In October 2013, Alex Myers, a 20-year-old from Hamilton County, died as a result of a lethal medication error at a group home for people with developmental disabilities. “You Are Your Brother’s Keeper,” produced by Alex’s family, explains the risks associated with administering medications.