Can a nurse delegate tasks to home care caregivers in Arizona?

Yes. Arizona Board rules let an RN delegate predictable, low-risk tasks that need no nursing judgment to unlicensed staff, in any setting. In licensed home health agencies, an RN assigns aide tasks in writing and checks competency. The rules do not say whether ordinary home care aides can be delegated medication administration or insulin. A separate licensed health aide route lets licensed family members give medications and tube feedings to their own child on AHCCCS.

What conditions apply?

• The aide must have the education, legal authority, and shown competency for the task
• The task must fit the aide's job description and follow clear, exact, unchanging directions
• The results must be reasonably predictable
• The task cannot need assessment, interpretation, or independent decisions
• The task must pose minimal risk to the client
• The RN gives clear directions, supervises, and checks outcomes
• Licensed home health agencies: an RN assigns tasks in writing to each home health aide, verifies the aide's competency, directs the aide's services, and meets with the patient at least every 60 days (every two weeks if nursing or therapy is also provided)
• Licensed health aides: a parent, guardian or family member licensed by the Board of Nursing may give medication, tracheostomy, enteral (tube) and routine ventilator care, but only to their own family member under 21 who is an AHCCCS member needing continuous skilled nursing. They must be employed by a Medicare-certified home health agency and are supervised like a CNA

Is there an exception for self-directed care?

The Nurse Practice Act exempts free care given by friends or family members of a sick person. It also exempts work by nurse aides and attendants who do not perform registered nursing.

What is the difference between medication reminders and administration?

Reminding a client to take their medicine, or handing them a container they open themselves, is usually treated as assistance. Giving the medicine, such as placing pills in the mouth, giving an injection or crushing tablets, is administration and generally needs a license or nurse delegation. Check your state's rule and the client's care plan.

What should you confirm with the state?

Check the Arizona Board of Nursing advisory opinions on medication and delegation before aides give any medications.