Would you prepour meds for nursing assistant to admin later??

Nurses General Nursing

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An assisted living facility I know of asks nurses to prepour medications and leave them for a nursing assistant to admin later. They ( the facility) states it is legal for nurse to prepour and leave med's but not for the NA to pour herself. So my question concerns the legality for the lic nurses ( RN or LVN) I told my nurse friend think it is illegal but asking the minds here on Allnurses..

thank you

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Thank all of you for these replies- I omitted information this was an assisted living facility but many of you picked up on that anyways. I have opted to not work at this facility any longer because I simply do not feel comfortable leaving meds up in a cupboard for CNA to dispense in morning. I figure they can make another arrangment or provide additional training to the CNA's...so it is legal and I am not responsible for the medications being given. I am not the only nurse to have left for this reason.

Specializes in Neuro.

I worked as a home health aide both in homes and in a retirement community (for assisted and independent residents). My only experience "passing meds" was a med. "reminder" service for some of the forgetful independents. The nurse set up the pill box weekly, and we would take the proper day's box to the resident's apartment at breakfast time and dinner time, knock on the door and remind them to take the pills. We could open the box (d/t arthritis/neuropathy concerns) but that was it. We could not "administer" the medication.

Similar rules applied for a few companionship cases I did where pts either had a pill box or just the bottles. I could remind them to take the meds, and open the bottles, but that was as far as I could go.

In these situations what I did was fine because the facility was not actually responsible for administering the meds for these patients. The patients were independent in that respect -- I just provided assistance with accessing the meds and reminders to do so at the proper time. When I worked in LTC and even for most of the ALF patients, my hands never touched meds and the nurses had them take the meds under their supervision.

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Specializes in LTC.

There is no way I would feel comfortabel on either end of this deal. If I dont pull it I dont give it and I would not let an un-licensed staff administer meds for me! Tell your friend to find a new job!

:no:

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An assisted living facility I know of asks nurses to prepour medications and leave them for a nursing assistant to admin later. They ( the facility) states it is legal for nurse to prepour and leave med's but not for the NA to pour herself. So my question concerns the legality for the lic nurses ( RN or LVN) I told my nurse friend think it is illegal but asking the minds here on Allnurses..

thank you

The scope of practice here in CA says CNAs can't give people medications. And I don't think the nurses taught the CNAs any pharmacology or the 5 rights.

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Specializes in Nurses who are mentally sicked.
An assisted living facility I know of asks nurses to prepour medications and leave them for a nursing assistant to admin later. They ( the facility) states it is legal for nurse to prepour and leave med's but not for the NA to pour herself. So my question concerns the legality for the lic nurses ( RN or LVN) I told my nurse friend think it is illegal but asking the minds here on Allnurses..

thank you

Recent post:

Thank all of you for these replies- I omitted information this was an assisted living facility but many of you picked up on that anyways. I have opted to not work at this facility any longer because I simply do not feel comfortable leaving meds up in a cupboard for CNA to dispense in morning. I figure they can make another arrangment or provide additional training to the CNA's...so it is legal and I am not responsible for the medications being given. I am not the only nurse to have left for this reason.

I don't think I will give the meds to the CNA's....it is not their responsibilities to give meds....

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Specializes in ER/ ICU.

Depends on if they are QMA's or NA's. If they have been certified absolutely they can- but they then sign not you. Please be careful- it's your license and you worked very hard for it.

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Specializes in Brain injury,vent,peds ,geriatrics,home.
An assisted living facility I know of asks nurses to prepour medications and leave them for a nursing assistant to admin later. They ( the facility) states it is legal for nurse to prepour and leave med's but not for the NA to pour herself. So my question concerns the legality for the lic nurses ( RN or LVN) I told my nurse friend think it is illegal but asking the minds here on Allnurses..

thank you

Recent post:

Thank all of you for these replies- I omitted information this was an assisted living facility but many of you picked up on that anyways. I have opted to not work at this facility any longer because I simply do not feel comfortable leaving meds up in a cupboard for CNA to dispense in morning. I figure they can make another arrangment or provide additional training to the CNA's...so it is legal and I am not responsible for the medications being given. I am not the only nurse to have left for this reason.

How does the facility know its legal ???Do they have a copy of the board of nursing laws pertaining to your license??Anyone can tell you anything.Its up to you to protect your patients and license.Also just think about it , lets say just a mom.Would you leave harmful medicines laying around that your kids could get a hold of??Some patients,even in assisted living,can behave like kids.Need to keep it safe.Find out for yourself what the laws regarding this are.

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Specializes in Critical Care, Pediatrics, Geriatrics.

I agree with the others, and I want to make another point:

My state's nurse practice act specifically states that medication administration can NOT be delgated to anyone other than a licensed nurse.

Now, in many doctor's offices in this area, there are medical assistant's that are giving injections (vaccinations, B12 shots, etc). They are falling under the doctor's license. If I was working in the same doctor's office, I am not legally able to delegate med administration to that medical assistant. If I did, and the pt experienced an adverse reaction the BON has the right to revoke my license because I am in violation of the NPA.

If you work in a state that certifies medication aides, I would be sure to check with the BON and read the nurse practice act to clarify whether they have made the exception for you to delegate this responsibility. Otherwise, you are practicing outside your scope of practice. Ultimately, they are the governing body that determines whether you keep your license, not the facility.

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I would not pre pour meds for a NAC to admister later, however, I would and have handed an NAC who is feeding a resisident, the residents medication (crushed in applesauce for instance). To give to that resident while he/she is being fed. With explicit instructions on which resident and that they where to report back to me if the resident was not able to take all the medication. I am getting conflicting information from my DON now. Does anyone out there have the definitive, referancable, answer. Thanks

According the my states practice act, I as an RN am able to delegate medication adminstration.

http://apps.leg.wa.gov/RCW/default.aspx?cite=18.79.260

(3) A registered nurse may delegate tasks of nursing care to other individuals where the registered nurse determines that it is in the best interest of the patient.

(a) The delegating nurse shall:

(i) Determine the competency of the individual to perform the tasks;

(ii) Evaluate the appropriateness of the delegation;

(iii) Supervise the actions of the person performing the delegated task; and

(iv) Delegate only those tasks that are within the registered nurse's scope of practice.

(b) A registered nurse, working for a home health or hospice agency regulated under chapter 70.127 RCW, may delegate the application, instillation, or insertion of medications to a registered or certified nursing assistant under a plan of care.

© Except as authorized in (b) or (e) of this subsection, a registered nurse may not delegate the administration of medications. Except as authorized in (e) of this subsection, a registered nurse may not delegate acts requiring substantial skill, and may not delegate piercing or severing of tissues. Acts that require nursing judgment shall not be delegated.

(d) No person may coerce a nurse into compromising patient safety by requiring the nurse to delegate if the nurse determines that it is inappropriate to do so. Nurses shall not be subject to any employer reprisal or disciplinary action by the nursing care quality assurance commission for refusing to delegate tasks or refusing to provide the required training for delegation if the nurse determines delegation may compromise patient safety.

(e) For delegation in community-based care settings or in-home care settings, a registered nurse may delegate nursing care tasks only to registered or certified nursing assistants. Simple care tasks such as blood pressure monitoring, personal care service, or other tasks as defined by the nursing care quality assurance commission are exempted from this requirement.

(i) "Community-based care settings" includes: Community residential programs for the developmentally disabled, certified by the department of social and health services under chapter 71A.12 RCW; adult family homes licensed under chapter 70.128 RCW; and boarding homes licensed under chapter 18.20 RCW. Community-based care settings do not include acute care or skilled nursing facilities.

(ii) "In-home care settings" include an individual's place of temporary or permanent residence, but does not include acute care or skilled nursing facilities, and does not include community-based care settings as defined in (e)(i) of this subsection.

(iii) Delegation of nursing care tasks in community-based care settings and in-home care settings is only allowed for individuals who have a stable and predictable condition. "Stable and predictable condition" means a situation in which the individual's clinical and behavioral status is known and does not require the frequent presence and evaluation of a registered nurse.

(iv) The determination of the appropriateness of delegation of a nursing task is at the discretion of the registered nurse. However, the administration of medications by injection, sterile procedures, and central line maintenance may never be delegated.

(v) The registered nurse shall verify that the nursing assistant has completed the required core nurse delegation training required in chapter 18.88A RCW prior to authorizing delegation.

(vi) The nurse is accountable for his or her own individual actions in the delegation process. Nurses acting within the protocols of their delegation authority are immune from liability for any action performed in the course of their delegation duties.

(vii) Nursing task delegation protocols are not intended to regulate the settings in which delegation may occur, but are intended to ensure that nursing care services have a consistent standard of practice upon which the public and the profession may rely, and to safeguard the authority of the nurse to make independent professional decisions regarding the delegation of a task.

(f) The nursing care quality assurance commission may adopt rules to implement this section.

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Specializes in Geriatrics, MS, ICU.

Absolutely NOT! I believe that is an illegal practice. I worked entirely too hard for my license and plan on keeping it, Thank you very much! The NA does not do assessments and would not know when certain medications should not be given due to a patient's condition or changes. What a scary thought!

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