NJSNA recognizes that there are alternate living circumstances which medications are administered by or given with the assistance of unlicensed personnel. Such living arrangements may include congregate living situations and other varied structured settings where nursing supervision may not always be available.

NJSNA supports medication administration or assisted self-administration by unlicensed personnel when the following guidelines are met:

1) Education - Professional nursing must be actively involved in the curriculum development and implementation of training for unlicensed personnel.  - This education should be standardized and approved by the Board of Nursing.

2) Standards and Policy Setting  - Professional nursing must be actively involved in the development and implementation of standards, policies, and procedures related to medication administration.

3) Evaluation - Professional nursing must be actively involved in the development and implementation of the evaluation process including but not limited to initial and continuing competency. (Burrus, Ashworth & Arikian, 1193; Watters, 2000).

Nursing practice, as defined by the NJ Nurse Practice Act (New Jersey Board of Nursing, ND), includes those "therapeutic measures essential to the effective management and execution of the nursing regimen" (p.14) Medication administration is a component of such measures.

The nursing profession should define the appropriate education, standards, evaluation and role of any individual providing services within the scope of nursing practice.

Unlicensed personnel are defined as those individuals affiliated with any of the above living arrangements and are administering or assisting with self-administration of medication. These individuals have successfully passed a standardized curriculum and evaluation approved by the Board of Nursing; and have NOT completed a nursing course of study and have not passed a licensing examination by the Board of Nursing.

In those instances when medication administration is delegated by the nurse, the delegatory clause, in the Nurse Practice Act (New Jesey Board of Nursing, N.D.), states that "the registered professional nurse may delegate selected nursing tasks in the implementation of the nursing regimen to licensed practical nurses and ancillary nursing personnel". (pp. 56-57) It further states that concerning task delegation, the registered professional nurse is responsible for exercising that degree of judgement and knowledge reasonably expected to assure that a proper delegation has been made.

Medications can cause adverse effects when taken alone or in combination with food or other drugs. Persons administering or assisting with self-administration of medications should be knowledgeable of concepts relating to the same. Nurses are the licenses authority to assess residents for reactions to medications and to safeguard against errors in administration of medication.

It is the responsibility of professional nursing to be actively involved in curriculum development, delivery of training and provide initial and ongoing evaluation of knowledge, skill and competency. Furthermore, professional nursing must oversee the development of standards, policies and procedures relating to the administration and assistance with self-administration of medications. (Craven, 1997).

Unlicensed personnel must receive education, which is developed, taught and evaluated by a registered professional nurse. It is the responsibility of the registered professional nurse to verify the preparation of the unlicensed personnel to perform the administration or assistance with self-administration of medication. NJSNA encourages the Board of Nursing to approve curriculum preparation and evaluation methods involved in medication administration by unlicensed personnel. The registered nurse should understand the delegatory clause of the Nurse Practice Act and her/his role and responsibility of supervision of the unlicensed assistive personnel.

Burruss RA; Ashworth ND; Arikian VL. (1993). Medication administration by non-RN personnel: a safe and cost- effective response to the RN shortage. Health Care Supervisor. 11 (4) p. 64-74

Craven GA. (1997) Nurses testify before legislature in safe care. Massachusetts Nurse 671 0(6) p. 1-8.

New Jersey Board of Nursing (N.D.).  New Jersey Board of Nursing Statues:  Nurse Practice Act retrieved on November 14, 2006 from:  http://www.state.nj.us/lps/ca/nursing/nurselaws.pdf

Watters, R.D. (2000).  Medication administration by unlicensed personnel.  Missouri Nurse, 69(4), 10-11.