Lots of people ask me about nurse delegation. What is it and who needs it?
Let me start by explaining that sometimes clients need a little more medical assistance than our caregivers can provide by law. This happens when an elder’s care needs change to include needing help taking medications or treatment for certain conditions.
We find that our in-home nurse delegators are often a very important part of a family’s ability to maintain an older loved one at home. The nurse delegator is able to evaluate client needs and provide special training to caregivers on how to administer medications or conduct procedures that might otherwise require a family member to be present.
Nurse Delegation Origins
Nurse delegation requires client and caregiver specific training on tasks that are usually only performed by licensed nurses. It has been practiced for years in Washington’s Adult Family Homes, but was only authorized for home care agencies in late 2003.
As you can understand, professional caregivers routinely assist with medication for their clients. However, nurse delegation may be required if the person receiving care is unable to take their medication with assistance and needs medication administration instead.
Nurse Delegation offers a less expensive alternative to licensed nursing care when medication administration is required and family members are not available or they do not wish to take on this responsibility.
Medication Assistance Versus Medication Administration
By way of background, Washington State Law has always allowed professional caregivers to provide medication assistance as long as it was designated in the plan of care. However, medication administration is a different thing. It must be done by a client, family member or licensed medical professional if oral, rectal, ointments, or eye drop medications are ordered by your physician.
Let’s look at the differences:
Medication Assistance – A professional caregiver can help with medications as follows:
• Communicating appropriate information to the client by reading the medication label.
• Handing the medication container to the client;
• Using an enabler or placing the medication in the hand of the individual;
• Opening the medication container;
• Altering or preparing medications for self-administration (e/g/ crushing or cutting tablets, opening capsules, mixing tablets, capsules or powdered medications with food or liquids ) with documentation of the consultation regarding the appropriateness of the alteration and preparation.
• Pouring liquid medication into a graduated container or syringe, such as a medication cup or measuring spoon.
• Identifying which mediset portion should be opened and handed to client by the time and day on the mediset, then handing to client or helping them to use an enabler.
• Assisting the client to feed crushed meds in applesauce to themselves.
Medication administration – must be done by a family member or licensed health care provider OR nurse delegation may be used when the following tasks are required:
• Placing the medication in the clients mouth
• Putting your hand over their hand to place the medication in their mouth
• Feeding crushed medication to the client in pudding or applesauce.
• Rubbing prescribed ointment on a rash
• Giving a rectal suppository
• Administering eye drops or ear drops to a client
For more information about nurse delegation: http://www.altsa.dshs.wa.gov/
How has nurse delegation helped you care for a loved one?