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Is this legal?

Home Health   (2,536 Views 12 Comments)
by RN1263 RN1263 (Member) Member

6,645 Profile Views; 476 Posts

We have a quadriplegic patient that has home care aides for most of the day, the RN sets up his medications for the week and the aides put the medications in his mouth to swallow. I think they are also taking PRN medications out of the prescription bottles and administering. I thought aides in home care could only give patients reminders, not actually put the medication in the patients mouth. My DON said it's fine if it came from a med set up, anyone know for sure??? He has a wife, so I don't know why the aides are doing it anyways.

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476 Posts; 6,645 Profile Views

I am surprised that your DON admits to encouraging this.

This patient brings in a lot of cash for the agency between nursing and HCA services and they cater to him big time. The nurses have to go out and do a 930pm visits for him daily after working all day, because that's when he wants his suppository. I think it's ridiculous and on Friday I told them I refuse to do it anymore, unless I'm on-call.

Anyway, Like I said, is it legal for an aide in home care allowed to "administer" medications from a medication set up? Forget the PRN's for a minute or family involved.

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HealthyNurse has 9 years experience and specializes in Functional Medicine, Holistic Nutrition.

143 Posts; 6,295 Profile Views

Is this a private duty agency or Medicare-certified? From your description, it sounds like a private duty agency and I'm not familiar with those regulations. My initial thought would be that it probably depends on your state law regarding the administration of meds by non-licensced personnel. Some states allow non-licensed personnel, such as aides, to administer certain meds in specific settings. Other states prohibit the administration of meds by anyone except a licensed nurse or physician. The best thing to do is to check into your specific state law regarding the administration of meds by non-licensed personnel.

With Medicare-certified agencies, the Conditions of Participation state that aides can provide services that are ordered by a physician in the POC and the aide is permitted to perform under state law. So again, it would go back to your specific state law.

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KateRN1 has 20 years experience and specializes in COS-C, Risk Management.

1,191 Posts; 14,158 Profile Views

Check your state regs. If you're in Florida, then no, this is not legal.

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476 Posts; 6,645 Profile Views

I'm in Ohio and this is a Medicare-certified agency, but his services are paid for by workers compensation. I'll have to look into it more I guess if it is state law that governs this regulation. Thanks

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202 Posts; 3,733 Profile Views

It's not allowed at our Medicaid agency. We found out the family was crushing the meds and having the HHA's put it in the patients apple sauce and feeding it to her and stopped that. They can't even put OTC ointments on a patients skin.

Kyasi

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1 Article; 2,334 Posts; 18,887 Profile Views

This patient brings in a lot of cash for the agency between nursing and HCA services and they cater to him big time. The nurses have to go out and do a 930pm visits for him daily after working all day, because that's when he wants his suppository. I think it's ridiculous and on Friday I told them I refuse to do it anymore, unless I'm on-call.

Anyway, Like I said, is it legal for an aide in home care allowed to "administer" medications from a medication set up? Forget the PRN's for a minute or family involved.

It's going to depend on your State's Home Health Regs.

In many States, with delegation, it is perfectly legal for HHAs to administer all types of meds (oral/Ng/Gt/insulins) either from a mediset or directley from the bottles.

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162 Posts; 6,315 Profile Views

Before I became a nurse I was a home aide, and was Nurse Delegated by state law and it was acceptable to give meds as long as I was delegated (taught by an RN) to do so. Washington State.

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KateRN1 has 20 years experience and specializes in COS-C, Risk Management.

1,191 Posts; 14,158 Profile Views

If you discover that it is legal in your state, then the next step is to find out if it is a) allowed per your agency's Policy and Procedure Manual and b) allowed by your liability carrier.

If all of the above are in place, then I would want to know what competencies are being tested prior to an unlicensed person being allowed to give medications.

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liveyourlife747 specializes in Home Health/PD.

227 Posts; 5,260 Profile Views

At our agency, if a nurse sets it up, or the pharmacy sends it in a bubble pack, and the client is unable to put the meds in their mouth, then it is ok for the aide to give it. they should not give PRN meds. We had a client that we would give prn meds to as an aide, i never felt comfortable with it, but he became a full nursing case soon after.

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476 Posts; 6,645 Profile Views

Thanks for the replies....I called OH state board of nursing and they said if a patient is alert/oriented and asks for the medication, even right from the prescription bottle, to be placed in the patients mouth, then YES they are allowed to do that....in Ohio.

So I got my answer.

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