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

In limited cases. In Florida, an RN can delegate medication administration to a certified nursing assistant or home health aide who works for a licensed home health agency. The aide needs a 6-hour approved course, a competency check and yearly training, and can give oral, tube, topical, eye, ear, rectal and inhaled medicines. Injections, including insulin, are not on the list. Trained unlicensed staff can also help a stable patient take their own medicines and use a glucometer.

What conditions apply?

• Delegation of medication administration applies to certified nursing assistants and home health aides working for a licensed home health agency, not to homemaker or companion staff
• Allowed routes: oral, transdermal, eye, ear, rectal, inhaled, enteral (tube) and topical prescription medications
• The aide must finish a 6-hour medication course approved by AHCA, be found competent by an RN or physician, and complete a 2-hour in-service every year
• Any delegated task must be routine, follow set steps, have a predictable outcome and need no ongoing assessment or clinical judgment
• No Schedule II to IV controlled substances
• Separately, trained unlicensed home health agency staff may assist a medically stable patient with self-administration (bringing the medicine, opening it, placing a pill in the hand), with the patient's written informed consent
• Assistance with self-administration does not include injections, tube medications, or rectal, urethral or vaginal preparations; it does include helping with a glucometer for blood sugar checks

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?

Non-medical homemaker and companion services are not covered by the home health aide medication law; check with AHCA before their staff handle medicines.