Big Mac: The Nurse Delegation Program Can Be a Mouthful, but Its Digestible

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Big Mac The Nurse Delegation Program Can Be a
Mouthful, but Its Digestible

• Anne Penney, Ed.D., Executive Director
• Sandra Moncrief, B.S.N.,R.N., Director of
  Nursing
  
• Selena Sanford, M.Ed., Director of Residential
  Services
  
• Sharlene McDaniel, M.S., Director of Quality
  Assurance/Performance Improvement
  
• East Alabama Mental Health-Mental Retardation
  Center

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Agency Philosophy

• EAMH-MRC is a comprehensive mental health center
• Implementation of this philosophy

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Administrative Support for NDP

• Necessity of NDP
• Nurse Delegation Act
• Staff response

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Why Nurse Delegation?

• Delegation is not a new concept
• Many other states participate in Nurse Delegation

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Delegation vs. Certification

• Defining Certification
• The act of training someone to complete a task
• Defining Delegation
• The act of assigning an action but withholding
  the direct responsibility of the assigned task
  
• By delegating to a MAC worker, the nurse allows
  that person to work under his/her license

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Certification Training Levels

• MATT Certification
• MAS Certification
• MAC Certification

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Required Classroom Components

• Designated classroom
• MAC I 12 hours
• MAC II 12 hours

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EAMH-MRCs MAC I Training

• MAC I lecture 12 hours
• Content determined by DMH/ABON cannot alter
• Taught by MATT or MAS nurse

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EAMH-MRCs MAC II Training

• MAC II classroom clinical 8 hours
• Hands-on, practical training
• Can be specific to agencys needs
• Taught by MATT or MAS nurse
• MAC II on-site 4 hours
• Specific to MACs assigned program
• MAC demonstrates skills learned in classroom
• Proficiency check

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Implementation of the Big MAC Training

• He aint right
• Grandma Floyd
• You work over there where they killed that
  fella, dont cha?

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 Training Documentation

• Attendance log
• Sample certificates
• Delegation to unlicensed personnel
• Suspension or revocation of delegation
• Quarterly review

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Compliance Reporting Requirements
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Integration of QA/PI Systems

• No duplicate systems
• Shared responsibilities
• MACs, Nurses, QA/PI staff, HR staff, Program
  Directors, RSD, etc. are all involved

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Reporting Categories

• Medication given, wrong dosage
• Medication given, wrong medication
• Medication given, wrong time
• Medication not available
• Medication not given

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Results of NDP Implementation
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Reporting to Outside Agencies

• Department of Mental Retardation
• Department of Mental Illness
• Department of Substance Abuse
• Reporting to Board of Nursing

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Practical Implications

• Medication administration in day/residential
  settings
  
• Staff assignment
• Medication on time
• Peer checks
• Controlled substances count
• Informing consumers families of NDP
• Positive effects for programs, consumers,
  staff
  
• Improves QA/PI for programs
• Improves safety quality of care for consumers
• Improves staff accountability and morale
• Increases opportunities for positive staff
  feedback
  

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Any Questions?