New93 role standards, now public
MedTality
Role standards

Clinical support

Medication aide

What a newly certified medication aide must do safely on a long-term-care medication pass under a licensed nurse's delegation: give the right medication to the right resident exactly as ordered, record it truthfully, and hand every judgment back to the nurse. Drawn from the national Medication Aide Certification Examination content outline and the NCSBN Medication Assistant-Certified Model Curriculum.

Practice this assessmentHire for this role
Expectations
10
Safety red lines
5
Sources
3
Version
1

Built from Credentia, National Council of State Boards of Nursing. Reviewed by clinicians, last on .

01What the role is measured on#

Every verdict is made of the same five dimensions. Each is scored on its own, so a candidate sees where they are strong and where to work.

  • Clinical skillsThe hands-on and judgement work of the role: recognising what matters, acting in the right order, and knowing when something cannot wait.
  • Workflow and toolsGetting the work done in a real setting: the systems, records, equipment and handoffs the role runs on, used correctly and on time.
  • Patient communicationHow the role talks with patients, families and colleagues: listening, explaining plainly, and confirming what was understood.
  • Compliance and safetyThe rules that protect people: privacy, consent, infection control, reporting duties and the safety checks the role is accountable for.
  • Role knowledgeKnowing the job itself: what the role is responsible for, where its scope ends, and who to bring in when it does.

02What a ready hire does#

What a competent medication aide does on day one, dimension by dimension.

Clinical skills

  • Gives each medication exactly as ordered by checking the medication administration record against the label at every step, watches it taken, and stops when anything does not match.
  • Takes the measurement an order requires before a medication, measures it properly, and applies only the hold parameter the order states, reporting anything else to the nurse.

Workflow and tools

  • Records each dose on the medication administration record after it is taken, records every dose not given with the reason, and keeps the record a true account of what happened.
  • Keeps controlled substances locked, accounted for at every count and every dose, and reports any discrepancy before the shift is handed over.

Patient communication

  • Gives medications to residents living with dementia or delirium in a way that respects their right to refuse, uses approaches that make taking them easier, and reports refusals and changes.
  • Tells residents in plain words what they are being given, and passes any question about why, changes or effects to the nurse.

Compliance and safety

  • Confirms every resident's identity with two identifiers the facility accepts before giving any medication, including residents they know well and residents who cannot answer for themselves.
  • Knows the effects to watch for with the high-risk medications they give, and reports a possible reaction to the nurse rather than explaining it away.

Role knowledge

  • Knows which medication tasks a medication aide may and may not perform under delegation, declines what is outside that line, and hands it to the nurse.
  • Reports a held dose, an error or a change in a resident to the nurse directly, with the specifics, and confirms the nurse has taken it on.

03Safety red lines#

Any one of these keeps a candidate from Ready Day One, whatever the rest of the score. They are published so nobody meets them for the first time in the assessment.

  • Would give a medication when the label, the medication administration record and the order do not all match, or would crush, split or substitute a dose on their own decision rather than hold it for the nurse.

    A wrong drug, strength or form reaches a frail resident who may not be able to say something is wrong, and a crushed slow-release tablet delivers the whole day's dose at once.

  • Would give medications after identifying the resident only by room or bed number, by recognition, or by a confused resident answering to a called-out name.

    Wrong-resident administration is one of the commonest medication errors in long-term care, and residents with dementia cannot be relied on to correct it.

  • Would initial a dose before it is given or when it was not taken, sign for a dose someone else gave, or fill blank boxes after the fact to make the record look complete.

    The nurse and prescriber act on the record, so a false entry hides a missed or refused dose, and falsifying a medical record is misconduct that ends certification.

  • Would force a medication on a resident who refuses, or hide it in food or drink, without a care plan and order that authorise it.

    It overrides the resident's legal right to refuse, can amount to abuse, and hides a refusal the nurse needs to know about.

  • Would decide on their own that a resident needs a PRN medication, accept a verbal or telephone order, calculate or convert a dose, or give a medication by injection or feeding tube.

    Each of these needs a nurse's assessment or a licensed person's authority; a medication aide who does them gives a dose nobody with that judgment has decided on.

04Outside the role#

Knowing where the role stops is part of the standard. Going past it is not extra credit.

  • Does not assess a resident's need for, or response to, a medication, and does not decide whether to give a PRN medication.Reports what the resident says and what they observe to the nurse, and gives a PRN only when the nurse has assessed and directed it, as state rules and facility policy allow.
  • Does not take verbal or telephone orders, and does not convert or calculate a dose.Asks the prescriber or pharmacy to speak to the nurse, and asks the nurse or pharmacist when a dose would need converting.
  • Does not give medications by injection or through a nasogastric, gastrostomy or jejunostomy tube, and does not give medications to a resident whose condition is unstable or changing.Leaves those doses for the nurse and tells the nurse when they are due. Some states allow narrow exceptions, such as insulin, only with specific training; the aide follows their own state's rules and never assumes one.
  • Does not re-delegate a medication task, or accept one they have not been trained and checked off to perform.Asks the delegating nurse for training or asks not to be assigned the task.

05How it is assessed#

  • A spoken assessment

    An examiner talks the candidate through realistic cases from this role, and follows up the way a senior colleague would.

  • Five dimensions

    Each answer is read against the expectations above and rated on the same four-level scale.

  • The 70 bar

    Every scorecard shows the score against 70, overall and for each dimension, with the reason for the verdict.

  • Safety first

    Crossing one of the safety red lines holds a pass back, however strong the rest was.

The four levels

  1. Not yet
  2. Developing
  3. Proficient
  4. Exemplary
How a verdict is made

06Sources and review#

Drawn from the certification frameworks and practice standards below, and reviewed by clinicians. Version 1, last reviewed .

Cited as sources. Not an endorsement by the organizations named.

See who is ready on day one.

Post your next role and meet candidates through their evidence, not their resumes.

Start hiringFind a role