Delaware Health and Social Services 
Delaware Division of Developmental Disabilities Services Assistance 
 With the Administration of Medications Program 


In order to assist an individual being supported by the Division of Developmental Disabilities Services (DDDS) with their medication(s) staff must successfully complete both phases of the DDDS Assistance with the Administration of Medications (AAM) Program. 
PHASE 1: 

Successfully complete the classroom instruction that includes a demonstration of all authorized types of assistance. The classroom demonstration will consist of oral, optic (eye), topical, otic (ear), and rectal.  The classroom demonstration will not include nasal, vaginal or inhalants, although instruction will be provided in these areas. 
PHASE 2: 

Successfully complete 10 observed medication passes in the field. 

CLASSROOM PROCEDURES: 
Delaware DDDS AAM Program requires participants to complete a written test with a proficiency of 80% or better and to correctly demonstrate 5 methods of authorized assistance.  Failure to successfully complete these requirements will result in the participant having to retake the course.  Participants may take the basic course only 3 times per year. 

PRACTICUM GUIDELINES: 
The observation of a field medication pass is designed to give a trainee the invaluable opportunity to practice the application of the information that they have learned in the classroom.  The field pass is a laboratory exercise for the trainee and it serves as an opportunity for the supervisor to share his/her knowledge and expertise with the trainee. In order for this process to be effective it requires feedback from the supervisor and verbal cueing from the trainee.  The trainee should state each step out loud as it is being performed.  This will assist in committing the steps to memory and also in ensuring that all steps are followed according to procedures. 
The supervisor, in signing off on the medication pass checklist is assuming responsibility for the process from start to finish and is making a declaration that the process occurred correctly.  If it is determined that an error occurred during this process, the supervisor doing the observation will be held just as liable as the trainee.  Therefore, it is imperative that all involved understand the seriousness of this process.  In some instances, errors can be considered neglect and could result in a criminal investigation, charges and/or fines.  Inadequate supervision during the administration of medications process can result in the loss of life.  It is important that everyone participating in this process use precaution and care. 
A medication pass is defined as assistance that is provided during one 8-hour shift, regardless of the number of people for whom assistance is provided or the number of sites in which assistance is provided.  A trainee can only receive credit for the completion of one medication pass per 8-hour shift (no exceptions).  This observation 
AAM: July 2008 

Delaware Health and Social Services 
will constitute a single medication pass. Successful completion of 10 supervised field medication passes is required. Remember, the purpose of supervised passes is to help the trainee become familiar with the entire medication program, from start to finish.  


AUTHORIZED OBSERVERS: 
In order to be authorized to observe during a field medication pass and sign the supporting documentation the following provisions must be met.  It should not be rushed or done haphazardly. 
I.	The Observer is an experienced staff member with 2 (two) years of experience in the State of Delaware Disabilities Service system.  These individuals shall have no history of medication errors over the past 2 years and shall have a current certification from the Assistance with Medication class; or. 
II.	The Observer is a supervisor (i.e. Program Manager, Program Coordinator, etc.) with a minimum of 6 (six) months of experience in the State of Delaware’s Developmental Disabilities Service System.  This individual shall also possess a valid certification in the Assistance with Medication Class; or 
III.	The Observer currently holds a valid state of Delaware Nursing license, has attended the Assistance with Medication class through DDDS, and has worked in the Delaware State service system for a minimum of 3 (three) months. 
The field medication pass will include correct execution of the steps, proper documentation and adequate follow-up in the clinical notes and observations. 
Upon the successful completion of 10 supervised field medication passes the trainee will obtain an authorization from their Agency’s designee to assist with medications without direct supervision.  The Agency is responsible for ensuring that there is a system in place to monitor the on-going performance and supervision of the field medication passes occurring in all of its programs. 
The final voucher will be issued by the Agency.  The DDDS Office of Quality Management will confirm that both vouchers (classroom and practicum) are present during audits, as evidence of the authorization to assist without direct supervision during the administration of medications. 
Field Medication passes must be completed within 60 days of the course work or the trainee will have to repeat the basic AAM course. 

DOCUMENTATION: 
All Agencies will maintain a copy of the voucher for the coursework, the AAM Medication Pass Log, the Agency authorization, and the AAM Pass Checklist as evidence of compliance with the Delaware AAM Program. 
AAM: July 2008