Tennessee Code Title 68. Health, Safety and Environmental Protection § 68-11-244

Current as of January 02, 2024 | Updated by Findlaw Staff

(a) As used in this section:

(1) “Ambulatory outpatient hospital clinic” means a clinic or physician office that is owned and operated by a hospital licensed under this title and that provides treatment to patients who are not admitted as inpatients to the hospital;

(2) “Certified medical assistant” means personnel with training to function in an assistive role to a licensed physician, physician assistant, or licensed nurse in the provision of patient care activities in a facility used as an ambulatory outpatient hospital clinic as delegated by the physician, physician assistant, or licensed nurse; and

(3) “Licensed nurse” means an individual engaged in the practice of professional nursing as defined in § 63-7-103 or an advanced practice registered nurse as defined in § 63-7-126.

(b) Physician assistants licensed under title 63, chapter 19 and medication aides certified under § 63-7-127 are not subject to the certification requirements or practice restrictions of this section.

(c) A hospital licensed under this title, may employ certified medical assistants to administer approved medications to the hospital's patients in an ambulatory outpatient hospital clinic as set forth in this section.

(d) When carrying out responsibilities under this section, a certified medical assistant shall wear a name tag visible to others that displays the designation “certified medical assistant”.

(e) An individual employed as a certified medical assistant within an ambulatory outpatient hospital clinic must:

(1) Be at least eighteen (18) years of age;

(2) Have completed the twelfth grade or its equivalent, or have successfully passed the test for and received a high school equivalency credential approved by the state board of education; and

(3) Be certified or registered by a recognized certifying body, which includes the following:

(A) American Medical Technologists (AMT);

(B) American Association of Medical Assistants (AAMA);

(D) National Healthcareer Association (NHA); or

(E) National Association for Health Professionals (NAHP).

(f) An ambulatory outpatient hospital clinic shall verify compliance with subsection (e) and shall keep records regarding compliance available for the health facilities commission.

(g) An ambulatory outpatient clinic is responsible for training and verifying the competency of a certified medical assistant pursuant to this section, which includes ensuring additional training and validation to administer medications, if necessary.

(h) Certified medical assistants shall not administer medications to hospital inpatients or patients in an emergency department.

(i)(1)(A) A certified medical assistant may administer approved, standardized dosage vaccines to the patients of an ambulatory outpatient hospital clinic that use certified medical assistants pursuant to this section. A certified medical assistant shall administer other medications only pursuant to delegation by a licensed nurse, physician assistant, or physician.

(B)(i) A delegation of medication administration or other nursing tasks to a certified medical assistant from a licensed nurse shall be carried out in accordance with the rules for nursing delegation adopted by the board of nursing.

(ii) The board of nursing may promulgate rules related to the administration of vaccines and other tasks that may be delegated by a licensed nurse to certified medical assistants under this chapter.

(C)(i) A delegation of medication administration or other tasks to a certified medical assistant from a physician must be carried out in accordance with the rules adopted by the board of medical examiners.

(ii) The board of medical examiners may promulgate rules related to the administration of vaccines and other tasks that may be delegated by a physician to certified medical assistants registered by the department under this chapter.

(D) A certified medical assistant may only administer vaccines after:

(i) An individual is assessed by a physician, physician assistant, or licensed nurse; and

(ii) The physician, physician assistant, or licensed nurse makes a determination that it is appropriate for the individual to receive the immunization administered by a certified medical assistant.

(E)(i) A delegation of medication administration or other tasks to a certified medical assistant from a physician assistant must be carried out in accordance with the rules adopted by the board of physician's assistants.

(ii) The board of physician's assistants is authorized to promulgate rules related to the administration of vaccines and other tasks that may be delegated by a physician assistant to certified medical assistants under this section. The rules must be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

(2)(A) In exercising the authority to administer medications pursuant to a physician's, physician assistant's, or licensed nurse's delegation, a certified medical assistant may administer or prepare only those medications that have been ordered by an authorized healthcare provider and are in either:

(i) A single dose, appropriately labelled, ready-to-administer packaging; or

(ii) A multi-dose, appropriately labelled packaging for which a specific dose is ordered and a dose calculation is not required by the certified medical assistant.

(B) The medications that a certified medical assistant may administer or prepare, as described in subdivision (i)(2)(A), include the following categories:

(i) Intramuscular, intradermal, or subcutaneous medications;

(ii) Vaccines;

(iii) Oral, sublingual, and buccal medications;

(iv) Topical medications;

(v) Irrigants;

(vi) Topical ophthalmic medications;

(vii) Metered hand-held inhalants;

(viii) Unit dose nebulizers;

(ix) Otic medications, excluding injectables;

(x) Nasal medications, excluding injectables;

(xi) Rectal medications;

(xii) Medications prepared by the certified medical assistant for administration by the provider;

(xiii) Urethral, transurethral, or intravesicular medications;

(xiv) Vaginal medications, excluding injectables; and

(xv) Anesthetic agents, limited to the following:

(a) Transdermal;

(b) Subcutaneous, not to exceed provider's ordered dose and limited to trunk and extremities, excluding the digits or genitals; or

(3) A certified medical assistant may engage in other patient care activities as delegated by a physician, physician assistant, or licensed nurse, including, but not limited to, vital sign measurement, phlebotomy, simple dressing changes, collection of patient's medical history data, or preparation of patient care areas. A licensed nurse shall not delegate patient care activities that require nursing judgment in altering care delivery based on the needs of the individual. A physician shall not delegate patient care activities that constitutes the practice of medicine or requires diagnostic analysis. A physician assistant shall not delegate any patient care activity that requires the exercise of physician assistant's judgment in assessing, planning, or altering care based on the needs of the individual patient.

(j) A physician, physician assistant, or licensed nurse shall not delegate to a certified medical assistant the administration or preparation of:

(1) Intravenous medications;

(2) Blood or blood products;

(3) Investigational drugs;

(4) Chemotherapy drugs;

(5) Drugs given through an implanted device;

(6) Insulin;

(7) Controlled substances;

(8) Deleted by 2026 Pub.Acts, c. 755, § 12, eff. April 13, 2026.

(9) Medications used for cosmetic procedures;

(10) A medication or vaccination requiring calculation of dosage;

(11) Contrast media;

(12) Allergy antigen agents;

(13) A medication requiring patient monitoring and assessment of response when a licensed nurse, physician assistant, or physician is not immediately available to provide monitoring or assessment;

(14) Inhaled gases for anesthesia;

(15) Anesthetic agents, not including the agents described in subdivision (i)(2)(B)(xv);

(16) Aesthetic medications, including botulinum toxin, fillers, or chemical peels;

(k) This section does not apply to personnel employed by a physician performing duties in settings other than in an ambulatory outpatient hospital clinic.

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Cite this article: FindLaw.com - Tennessee Code Title 68. Health, Safety and Environmental Protection § 68-11-244 - last updated January 02, 2024 | https://codes.findlaw.com/tn/title-68-health-safety-and-environmental-protection/tn-code-sect-68-11-244/

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