QMAP Online Refresher Courses

The medication administration program is established in accordance with Section 25-1.5-301, C.R.S et seq. The medication administration course is designed to teach unlicensed staff to safely administer medications in settings authorized by law. Staff who successfully complete the medication administration course are not certified or licensed in any way, and are not trained or authorized to make any type of judgment, assessment or evaluation of a client. Staff who successfully complete the course are considered Qualified Medication Administration Persons (QMAP). Successful applicants will pass written exam and a hands-on practical exam. 

The Importance of Safe Administration of Medications 

• The administration of medications is a privilege. 
• This role is a major responsibility that affects the quality of clients’ lives. 
• Improper or careless administration of medications may result in death. 
• You are responsible for what you administer. It is best practice to administer 

medications that you have prepared. 

 – You may administer medications using medication reminder boxes (MRBs) that others (client, family, other facility staff) have prepared. 

Administering medications is a very important task. Current regulations and requirements for medication administration in Colorado became effective July 1, 2017.

The purpose of the Medication Study Guide is to help students become more knowledgeable with administering medications and better prepared for the test. 

This study guide was also developed as a training tool in addition to on the job training you will receive from your employer. Remember, this study booklet/ curriculum is only a guide! The questions on the test will be similar to the questions in this study guide. There will be questions on the test pertaining to each of the areas in the study guide. 

We all know that taking tests can be stressful. The medication administration test being given by Pronursing Education will be on the basics of medication administration. Using this study guide should help you not only be better prepared for the test but also become more knowledgeable and skilled with administering medications. Becoming more competent in administering medications will help clients in authorized designated settings avoid serious medication-related problems. 

Overview	3
Course Objectives	4
Authorized settings and Requirements	4
Cautions	5
Definitions	6
Unit 1 – Concepts	7
Monitoring, administering, self-administration	7
Seven rights	8
Route	8
Conversion tables	9
Unit 1 – Review	10
Unit 2 – Uses and Forms of Drugs	11
Purpose for drugs and defining for	12
Controlled substance	12
Drug Diversion	12
Drug Effects	12
Additional resources	12
Unit 2 – Review	13
Unit 3 – Medication Orders	14
Dose -vs- strength	14
Metric System	14
Measuring device	15
Abbreviation	17
Medication Order Practice	18
Dose Practice	19
Administration question	20
Unit 3 Review	21
Unit 4 – Medication Administration Records (MAR)	23
Rules for documenting	23
Practice MAR	24
Unit 4 Review	25
Unit 5 – Medication Reminder Boxes (MRB)	27
Define MRB	27
Administration from MRB	27
Filling an MRB	28
Unit 5 Review	29
Unit 6 – Medication Administration Procedures	30
Standards precautions	30
Additional preparations	31
Steps and procedures	32
Unit 6 Review	39
Unit 7– Medication Errors	40
Defining errors and examples of errors	40
Determining an error and documenting an error	40
Unit 7 review	41
Unit 8 – Medication Storage	42
Storage Requirements	42
Expiration –vs- refills	42
Additional Definitions	43

Course objectives: The QMAP course objectives are focused on the following;

• Safe administration of medications according to written physician’s orders  
• Maintaining proper documentation of the administration of both prescription and nonprescription drugs 
• Use of proper techniques when administering medications by the various routes  
• You will know and demonstrate mastery of the following: 

1. 1. Comprehension of important guidelines 
   2. Use and forms of drugs 
   3. Medication orders 
   4. Documentation 
   5. Medication reminder boxes 
   6. Steps of procedures 
   7. Medication errors 
   8. Medication storage 

• Safely and accurately fill and administer medications to and from medication reminder boxes with oversight from a licensed person or qualified manager 

At the completion of this course, you should be able to demonstrate: 

• Proper reading, understanding and transcribing of physician’s orders 
• Safe administration of medications via multiple “routes” (ingested, applied, inhaled, inserted) in designated settings using written physician orders according to the  7 rights of administration”  
• Documentation of medication administration according to state board of health regulations 
• SAFE administration of medications from Medication Reminder Boxes (MRB) 

Authorized Settings     

1. Assisted living residences. 
2. Alternative care facilities. 
3. State certified adult day programs/ Centers. 
4. Residential Child Care Facilities 
5. Adult  foster care facilities
6. Secure residential treatment centers as defined in section 26-6-102(9), C.R.S
7.  Program approved service agencies (PASA) serving people with intellectual and developmental disabilities

This QMAP course is not appropriate for the following settings:

1. Facilities regulated by the Department of Corrections have a qualified medication administration curriculum specifically developed for the administration of medications in correctional facilities.
2. Child Care less than 24 hour care

Requirements

1. You must pass the written test with a minimum score of 85%.    
2. You must score 100% in the practicum exam to pass the course; this includes hands on demonstrations and filling an MRB.  
3. You should keep your original completion letter and recognition of completion document. A copy must be provided to your employer.  
4. Employers must provide “on the job training and mentoring” for all QMAPs.  
5. You will know the difference between monitoring, administration and self -administration of medications. 

SCOPE OF PRACTICE: The qualified medication administration Person (QMAP) is an individual who has successfully completed the medication administration course provided by Innovations Nursing & Residential Services approved training entity. A QMAP is permitted to administer medications via oral, sublingual, ear, and eye, topical, nasal, inhalant, rectal and vaginal routes. Gastrostomy tube medication administration may be done ONLY after additional approved training and under supervision of licensed nurse. 

Per Chapter 24 State Regulation, a QMAP is permitted to administer medications in the following authorized settings; assisted living residences, adult foster care facilities, alternative care facilities, residential care facilities, secure residential treatment centers, state certified adult day programs and program approved service agencies for people with intellectual and developmental disabilities. 

As a QMAP and individual providing support to vulnerable adults, you are required to (to the best of your ability) report any suspicions regarding abuse, neglect or misappropriate of an individual’s property. Adults with intellectual and developmental disabilities are at risk for mistreatment, abuse, neglect, and exploitation, (M.A.N.E.) due to their lack of ability in interpreting social cues, inability to report problems or concerns, inability to understand self-safety measures and more. The definitions (M.A.N.E.) will be reviewed during agency orientation. 

If you suspect that abuse, neglect, mistreatment or theft is occurring you need to report it to your supervisor. As you are working you need to be aware of what your co-workers are doing. Knowledge of what constitutes abuse, neglect, or mistreatment will help you prevent such occurrences. Substantiated allegations for M.A.N.E. or misappropriation will be reported to the proper authorities such as the police and the state

CAUTIONS 

1. This course does not lead to certification or a license.

Upon successful completion of this course you will be considered qualified to administer medications, as a Qualified Medication Administration Person (QMAP).

1.  Persons successfully completing this course are not trained or authorized to make any type of judgment, assessment or evaluation of medications. 
2. You may be required to retake an approved medication course and competency evaluations if the  authorized regulatory agency determines the need for such training  
3. Every employer using QMAP’s must have QMAP sign a disclosure statement that he or she has never had a QMAP qualification, a professional license to practice nursing, pharmacy, or medicine revoked in ANY state for reasons related to the administration of medications. If you have, you must disclose the information on the disclosure form. A copy of the disclosure form is required to be provided to employer.
4.  FEES policy. Your paid fees will be forfeited if you are registered for a class/testing and do not attend or miss any portion of without making appropriate arrangements with the instructor. Students will pay training fee and $14 verification and processing fee. 6.Verification of QMAP status must be obtained on the CDPHE QMAP website verification tab on: www.healthfacilities.info  

 QMAPs MAY NOT take phone orders for any medications including changes or discontinuation

FOR THIS COURSE MEDICATION ADMINISTRATION IS: 

• As defined by law: ‘Assisting an individual in the ingestion, application, inhalation, or using universal precautions, rectal or vaginal insertion of medication including prescription and non-prescription drugs according to the written or printed directions of a licensed physician or other authorized practitioner and making a written record thereof with regard to each medication administered, including the time and amount taken.’ [25-1.5-301(1) C.R.S.] 
• Accurately and safely administering medications from medication reminder boxes (MRB) with oversight from a licensed individual (nurse or pharmacist) or Qualified Manager. 
• Filling of medication Reminder Boxes with oversight by a Qualified Manager or Licensed individual (nurse or pharmacist). REQUIRES SEPARATE AND SPECIALIZED TRAINING  
• Administering medications through a Gastrostomy Tube – EXTRA TRAINING AND OBSERVATIONS ARE REQUIRED IN ORDER TO ADMINISTER ANYTHING THROUGH A G-TUBE (MUST ALSO MEET REQUIREMENTS FOR GASTROSTOMY SERVICES PRIOR TO ADMINISTERING ANY MEDICATION, NUTRIENT OR LIQUID THROUGH A GASTROSTOMY TUBE!). 

REMEMBER: WHEN ADMINISTERING MEDICATION, YOU ARE RESPONSIBLE FOR YOUR ACTIONS!

Medication Restriction: QMAPs are not allowed to administer medications through IV ports, gastrostomy tube, and nasogastric tube or for injection into the bloodstream or skin including insulin pens. QMAPs are not allowed to inject insulin, draw up or dial an insulin pen for injection. As stated, 7.4 Qualified medication administration persons shall not administer medication through a gastrostomy tube or administer insulin unless specifically authorized to do so pursuant to rules adopted by the Department of Health Care Policy and Financing or the Department of Human Services.

*EPI Pens*  

 MEDICATION ADMINISTRATION PRACTICE STANDARDS

7.5 A qualified medication administration person shall not administer epinephrine injections unless the QMAP: (A) Has been directed to do so by a 911 emergency call operator as an urgent first aid measure, or

(B) Has completed an anaphylaxis training program conducted by a nationally recognized organization and is authorized to use an epinephrine injector pursuant to section 25-47-103, C.R.S.

The assistant process of helping someone with an epinephrine is covered under  your first Aid training and can only be done after being directed by emergency services (911 operator or EMT) and has had anaphylactic training recognized by a national organization (AHA; Red Cross)

Injections:  QMAPs are not allowed to inject any medication of any kind. When a client requires injections, the client, a licensed nurse, the family/friend or outside agency will need to administer the injection.

INFORMATION FOR EMPLOYERS AND STUDENTS 

1. QMAP students must provide proof of age. Minimum age of 18.
2. Students should not work the overnight shift before attending the QMAP class and should not work overnight before testing. 
3. Students must read, write and speak English 
4.  4.Students should have basic math skills 
5. Students must provide photo identification at the class 
6. Employers must conduct a criminal background check prior to allowing medication administration by the QMAP employee.