<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".04" citation="COMAR 10.39.03.04" title_num="10" subtitle_num="39" chapter_num="03" heading="Scope of Responsibility.">
  <paragraph num="A.">
    <text>The CMA may be delegated medication administration by the RN or LPN under the following conditions:</text>
    <paragraph num="(1)">
      <text>The licensed nursing supervision requirements in Regulation .05 of this chapter have been met;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The CMA is assigned to administer medication;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>There is a written medication order;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>The CMA is physically present on a continuing basis in the unit of care to accomplish the following as instructed and directed by the RN or LPN:</text>
      <paragraph num="(a)">
        <text>Monitor the therapeutic effects of the medication;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Observe and report untoward effects of the medication;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Report observed changes in client behavior and clinical status; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Withhold administration of the medication if necessary.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>The CMA may perform the following RN or LPN delegated nursing functions:</text>
    <paragraph num="(1)">
      <text>Prepare, administer, and chart medications administered:</text>
      <paragraph num="(a)">
        <text>Orally;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>By nebulizer, metered dose inhalant, and, in the case of oxygen, by nasal cannula or mask;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Topically, excluding wound or decubitus site care;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>By suppository; and</text>
      </paragraph>
      <paragraph num="(e)">
        <text>By eye, ear, and nose drops;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Prepare, administer, and chart:</text>
      <paragraph num="(a)">
        <text>Nonlegend PRN medications; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Controlled schedule drugs after the RN or LPN:</text>
        <paragraph num="(i)">
          <text>Makes a bedside assessment of the patient;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Documents the assessment; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Gives permission to the CMA to administer that medication; and</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>When the licensed nurse delegating medication administration provides access to the controlled schedule drug cabinet, sign for and administer controlled schedule drugs.</text>
    </paragraph>
  </paragraph>
</regulation>