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

Yes. Colorado lets nurses delegate routine nursing tasks to unlicensed people in any setting. The delegation is for one person, one client, and a set time, with the nurse assessing, training, and supervising. Certified nurse aides an RN has checked off can place prepackaged medicine in a stable client's mouth and give tube feedings. The rule spells out insulin delegation only for schools, child care, and developmental disabilities programs.

What conditions apply?

• The task must be routine and repetitive, with no nursing judgment needed
• Delegation is limited to one named person, one named client, and a set time frame
• The nurse assesses the client's needs, stability, and risk, and the task's invasiveness and potential for harm
• The nurse teaches the task or verifies competency and explains how to handle foreseeable risks
• The nurse sets the level of supervision and monitors tasks that repeat
• The nurse documents the client assessment, the task, the delegatee, the time frame, and periodic evaluations
• The delegatee cannot pass the task on to anyone else
• Certified nurse aides that an RN finds competent may place presorted, nurse- or pharmacist-packaged medication in a stable client's mouth, give G-tube or J-tube feedings, give enemas or suppositories, give oxygen, and change ostomy bags, with competency rechecked yearly
• Insulin delegation is described only for schools, licensed child care, and developmental disabilities nurse settings

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?

The rule doesn't directly address giving medication or insulin through a home care agency. Confirm with the Board of Nursing and the CDPHE home care agency rules.