Scope of Practice & Delegation

[IdahoBlues]

Yes I would like to know if anyone on here is familiar with Idaho laws concerning LPN's delegating to Med Certified CNA's.

Can an LPN lawfully delegate to a Medication Certified CNA to assist in the administration of a medication to a patient who needs assistance given that:

-The LPN popped the meds from the pharmacy provided packaging in front of the aid.

-The LPN signed them out.

-The LPN gave specific directions to said Med Certified CNA on how to give these medications

-The LPN had absolute trust in this specific Med Certified CNA to complete the task

-The medications were routine, none were new meds being administered to this patient for the first time.

-Finally, the LPN walked to the room with the Med Certified CNA before parting ways.

Also, are there limitations to types of medications that can be passed by Med Certified CNA's in the state of Idaho?

I have been reading the IDAPA Board of Nursing codes and it would seem to me that CNA's are under the category of UAP (Unlicensed Assistive Personnel) whom it would seem do not have their own scope of practice. Further on it reads that UAP's that have taken a medication course and passed as Med certified are allowed to pass medications so long as they are not the First Initial dose of a New med, and that they are not medications that require the direct nursing assessment for change in condition.

Any expertise on this situation would be greatly appreciated.

[StillNursin, LPN]

It looks like you've done your homework... Idaho is unfortunately (or fortunately, depending upon how you look at it) silent on a lot of scope questions for LPNs, but they are VERY specific in your responsibility when delegating - you are the license in the line. So, while you can delegate meds as you outlined above to a CNA which in Idaho is considered an UAP, they have to ALSO be a MA-C, which is a separate certification course of 80 hours and 40 hours of supervised practice. They also require CPR certification in Idaho.

I've been an LPN for 11 years, and have not seen many CNA/Med Assistants-Certified, probably because Medical Assistants and LPNs have some scope overlap. You tend to have one or the other at a facility.

My advice when delegating would be to ALWAYS check and double check, and remember that good, bad or indifferent - the responsibility rests on your shoulders. Good luck!

http://www.legislature.idaho.gov/idstat/Title54/T54CH14SECT54- 1406A.htm

[jake the nurse]

To be honest if you are pulling the medications, signing, and delivering to the room with the CNA you might as well just administer them yourself considering you have done 90% of the task. Delegate other tasks that can be completed soley by the CNA to maximize your time efficiency.

[Glycerine82, LPN]

Right away, I see a red flag. You don't give meds you didn't directly pull yourself.

[Elpeon75]

What healthcare setting is this in? What is the facility policy? Why would you sign for a medication you didn't give? Sounds like a slippery slope and if I were you I'd stop. It's YOUR license on the line, why would you jeopardize like that? Only place I've ever seen med aides administering medications in Idaho are group home and assisted living facilities.