Date of Award


Document Type



College of Nursing

Degree Name

Doctor of Nursing Practice (DNP)

Project Mentor

Mo-Kyung Sin


Erin Brown


Background: Facility-based long-term care provide a variety of health care services, including medication management. However, medication errors are common and such errors contribute to disability and mortality. Due to an inadequate number of nurses, Washington State passed the Medication Assistant Endorsement law, allowing certified nursing assistants (CNAs) with specialized training as medication assistants (MAs) to administer certain medications under a register nurse’s supervision in assisted living facilities and nursing homes. However, initial medication assistant training is limited. Providing continuing education for CNAs can address gaps in knowledge and skills needed for safe medication administration and help enhance patient safety. Furthermore, training CNAs as MAs allocates more time for licensed nurses to perform roles that require clinical judgment, reduces costs, and offers additional resources to MAs for career advancement.

Purpose: The purpose of this project was to develop an education program for certified nursing assistants to improve confidence in knowledge of medication management and skills in safe medication administration at an assisted living facility.

Methods: Based on research and staff input, an educational program was developed and disseminated to nursing assistants through an in-person presentation. Quasi-experimental preand post-test measured perception and confidence with a survey questionnaire, and skills related to safe medication administration via observation of nursing assistants at an assisted living facility in Washington State. Descriptive statistics and thematic analysis were conducted to analyze the data.

Results: 12 CNAs participated in the study. 11 themes were identified in perceptions on barriers to safe medication administration, with all participants reporting a lack of understanding in administering different forms of medications as a barrier. Statistically significant improvement was found in confidence on knowledge of medication management. Participants also showed increased skills for safe medication administration after education intervention.

Conclusion: Addressing medication management challenges in assisted living facilities requires collaboration between nurses and certified nursing assistants. With continuing education and training, a culture of patient safety can be established, resulting in improved safe medication administration practices by certified nursing assistants.