(a) A medication aide under Texas Health and Safety Code, Chapter 242, Subchapter N, may:
  (1) observe and report to the facility's charge licensed nurse reactions and side effects to medication shown by a resident;
  (2) take and record vital signs before the administration of medication that could affect or change the vital signs;
  (3) administer regularly prescribed medication to a resident if the medication aide:
    (A) is trained to administer the medication;
    (B) personally prepares the medication or sets up the medication to be administered from a unit dose pack; and
    (C) documents the administration of the medication in the resident's clinical record;
  (4) administer oxygen per nasal cannula or a non-sealing mask only in an emergency, after which the medication aide must verbally notify the licensed nurse on duty or on call and appropriately document the action and notification;
  (5) apply specifically ordered ophthalmic, otic, nasal, vaginal, and rectal medication;
  (6) administer previously ordered PRN medication, if:
    (A) the facility's licensed nurse on duty or on call authorizes the medication;
    (B) the medication aide documents in the resident's records the symptoms indicating the need for the medication and the time the symptoms occurred;
    (C) the medication aide documents in the resident's records that the facility's licensed nurse was contacted, symptoms were described, and the licensed nurse granted permission to administer the medication, including the time of contact;
    (D) the medication aide obtains authorization to administer the medication from the facility's licensed nurse on duty or on call each time the symptoms occur; and
    (E) the medication aide ensures that the resident's record is co-signed by the licensed nurse who gave authorization by the end of the nurse's shift or, if the nurse was on call, by the end of the nurse's next shift;
  (7) measure a prescribed amount of a liquid medication to be administered to a resident;
  (8) break a tablet to be administered to a resident, if:
    (A) the resident's medication card or its equivalent accurately documents how the tablet must be broken before administration; and
    (B) the licensed nurse on duty or on call has calculated the dosage;
  (9) crush medication, if the medication aide:
    (A) obtains authorization to crush the medication from the licensed nurse on duty or on call; and
    (B) documents the authorization on the resident's medication card or its equivalent; and
  (10) electronically order a refill of medication from a pharmacy, if the refill request is signed by the licensed nurse on duty or on call.
(b) A medication aide under Texas Health and Safety Code, Chapter 242, Subchapter N, may not:
  (1) administer medication by the injection route including:
    (A) intramuscular route;
    (B) intravenous route;
    (C) subcutaneous route;
    (D) intradermal route; and
    (E) hypodermoclysis route;
  (2) administer medication used for intermittent positive pressure breathing treatments or any form of medication inhalation treatments;
  (3) administer previously ordered PRN medication, except in accordance with subsection (a)(6) of this section;
  (4) administer medication that, according to the resident's clinical records, has not been previously administered to the resident;
  (5) calculate a resident's medication doses for administration;
  (6) crush medication, except in accordance with subsection (a)(9) of this section;
  (7) administer medications or feedings by way of a tube inserted in a cavity of the body;
  (8) receive or assume responsibility for reducing to writing a verbal or telephone order from a healthcare professional;
  (9) order a resident's medications from a pharmacy, except in accordance with subsection (a)(10) of this section;
  (10) apply topical medications that involve the treatment of skin that is broken or blistered or when a specified aseptic technique is ordered by the attending physician;
  (11) steal, divert, or otherwise misuse medication;
  (12) violate any provision of the Texas Health and Safety Code or this chapter;
  (13) fraudulently procure or attempt to procure a permit;
  (14) neglect to administer appropriate medications, as prescribed, in a responsible manner; or
  (15) administer medications if the person is unable to do so with reasonable skill and safety to residents by reason of drunkenness or excessive use of drugs, narcotics, chemicals, or any other type of material.
(c) If a practice is not described in subsection (a) of this section the practice is prohibited for a medication aide under Texas Health and Safety Code, Chapter 242, Subchapter N.

Source Note: The provisions of this §557.105 adopted to be effective September 24, 2018, 43 TexReg 6328