Can a nurse delegate tasks to home care caregivers in District of Columbia?

Yes. In DC, personal care aides can only help clients take their own medications. A home health aide who is also a certified medication aide can give medications under nurse supervision, including oral, topical, drops and suppositories. Certified medication aides can also do finger-stick glucose checks and give insulin from a prefilled syringe. They cannot calculate doses or give medications to unstable clients or when the supervising nurse cannot be reached.

What conditions apply?

• An RN may delegate to unlicensed assistive personnel only after a full assessment, when the task recurs, follows set steps with predictable results and minimal risk, needs no ongoing assessment, and the agency has delegation policies in place. The RN must stay available to instruct, monitor, verify and evaluate
• Personal care aides may only assist clients with self-administration of medication; home health aides may also administer medications if they are certified as medication aides (MA-C)
• An MA-C may give oral, eye, ear, nose, suppository and topical drugs, perform finger-stick glucose tests under a written order with set ranges, and give insulin or other Board-specified subcutaneous injections from a prefilled syringe
• An MA-C may not give drugs if the dose must be calculated or converted, if the supervising nurse cannot be reached in person or by phone, or if the client is unstable
• Home health aides and MA-Cs work only under supervision of a licensed nurse, never independently. Tasks needing ongoing assessment or decision-making cannot be delegated
• Separately, trained medication employees (D.C. Code 21-1201 et seq.) may give medications only in programs for people with intellectual or developmental disabilities

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.