Published Jul 17, 2004
I have a question about delegation and have read Rule 224, 225 from TX BNE rules and regulations. I have a concern about delegating medication administration and expecially PRN meds in personal care homes who have unlicensed caregivers. This is in regards to a RN who is directing care, assessing, and managing a Hospice patient. I have difficulty understanding the rules on delegation of this task. Of course I am concerned about patient safety as my number one priority, but I know ultimately the RN who is delegating is responsible. The Hospice agency is not clear about this and the Executive Administrator does not give any clear rules, policies, or guidance on this matter. Is anyone familiar with rules and regs on Hospice, Home Health? Hospice does fall under Home Health.
when you mention unlicensed caregivers, does that include the family members? i ask because family members administer meds all the time to the hospice patient. otherwise, how would the patient receive their meds unless an rn was there 24/7???
No, not family, because in Home Health a RN TEACHES a family member or the patient---with unlicensed personnel, a RN DELEGATES and delegating falls under rules and regulations by both the authoritative board for nurses (Board of Nursing Examiners) in each state and also under the administrative boards of each state (Health). It is a differnt ballgame because the RN who delegates is accountable and has a license that can be revoked etc. My concern is that the rules of delegation are so difficult to understand.
Our state rules are spelled out rather simple about what the RN needed to do in this regard. I remember as a caregiver I needed to take an 8/h class put on by the state before I could be delegated too. Then, if you have ever worked LTC, I was instructed by the RN much like a self-med program for residents returning home.
I can not say about TX but I just happened to be reading Ohio Delegation Rules earlier this evening.
In Ohio, the CNA may assist the alert and oriented pt in taking their meds. The nurse can delegate to the CNA to assit the pt.
The pt must be able to verify that the bottle the CNA is handing them is correct. The CNA can open the bottle, even help the pt getting the dose the pt asks for out of the bottle and into their mouth (or topical application).
In short, the CNA can only help the pt with meds he/she has stated they need, have identified, confirmed the dose, etc.
I would guess Tx is very similar, but check wiith your BON website for sure.
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