Nurse Delegation and the law

If you require oral, rectal, topical ointments and/or eye or ear drop medication or medical procedure(s) normally done by a licensed nurse and you or your loved one cannot self-administer the medications or preform e medical procedure(s), CareForce offers the service of Nurse Delegation. Nurse delegation allows our caregivers (NACs, NARs, CHCAs’) to receive special, supervised authority to administer some medications or do some procedures that otherwise are done by a family member or a licensed nurse. Nurse Delegation offers a less expensive alternate to licensed nursing care when medication administration or other procedures usually performed by a licensed nurse and the client is unable to do these tasks independently. These include tube feeding, blood glucose testing, etc.

Nurse Delegation services are unique benefit approved in Washington State that combines the skill and expert guiding care of RNs with specifically trained caregivers. This type of care is very safe and more cost effective than having a nurse provide all of your skilled care needs.

Nurse Delegation is a specific client situation where a registered nurse (RN) evaluates you and determines that your medical illness is stable and predictable. If the RN determines that it is safe for a properly trained and licensed caregivers to do the task normally by an RN or LPN, then Nurse Delegation Services will be started. The RN comes to your home to assess your ability to self-administer your medication and/or preform a simple, non-sterile dressing change. Depending on the situation, the teaching may be done in your home, at the CareForce office, or over the phone.

Which Caregivers can provide Nurse Delegation? Caregivers must have a current Washington State license and have successfully completed two different classes: Fundamentals of Caregiving and Nurse Delegation. A third course must be completed for the caregiver to be qualified for insulin delegation.

Which clients qualify for nurse delegation? There are many situations where nurse delegation is appropriate Examples include a client who has or had strokes or have paralysis, are very weak, cannot feed himself/herself or are recovering from surgery that prevents him/her from being able to assist with medication administration and end-of-life care. The client must be in a predictable and stable condition and need the caregiver to place medications in his/her mouth; apply ointment on his/ her skin; administer eye and/or ear drops, rectal suppositories or insulin injection; or preform some medical procedures.

Why is the nurse required to teach the caregiver at my home with me and/or my loved one? The law says that, because a nurse is actually giving the caregiver permission to administer the medication under his/her registered nursing license, the nurse must teach each caregiver with each specific client.  The nurse has the opportunity to talk about how each medication is administered, medical procedure in preformed and under what specific conditions that medication administration or medical procedures may be done. The goals of this process are to provide the utmost safety in supervising the caregiver and ensuring that all questions are answered as they take on this important task.