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

In limited cases. Arkansas nurses may delegate personal care and some non-invasive tasks to unlicensed aides in any setting. Medication administration cannot be delegated to agency aides; certified medication assistants may give medications only in nursing homes and other Board-approved facilities. Under the Consumer Directed Care Act, a client can direct their own aide in the home for health maintenance tasks. Even then, injections such as insulin are excluded.

What conditions apply?

• A nurse assesses the client before delegating, except for basic personal care tasks
• The nurse has written procedures for each task and documents the aide's competency
• The delegating nurse is readily available in person or by phone
• Tasks beyond basic care need the nurse's direct responsibility for the care plus a training protocol covering instruction, competency, and reevaluation
• Medication administration and IV therapy cannot be delegated, except to Medication Assistants-Certified in Board-approved facilities and in schools
• Delegated tasks cannot be carried over to other clients
• Consumer-directed care: a physician, APRN, or RN decides whether the designated care aide can do the activity safely at home, and the aide shows they can do it
• Consumer-directed care excludes all injectable medications and IV therapy

Is there an exception for self-directed care?

Under the Consumer Directed Care Act of 2005, a competent adult (or a caretaker of a minor or incompetent adult) may direct a designated care aide at home to do health maintenance activities. Those activities cannot include injectable medications or IV therapy. Free care by family or friends is also exempt.

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.