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

Yes. Hawaii lets an RN delegate nursing care tasks to unlicensed assistive personnel in any setting, including a client's home, with indirect supervision when the RN is not on site. The Board says delegation should be the exception and requires RNs to follow the NCSBN delegation process. The rule does not list tasks or say whether medication administration or insulin can be delegated.

What conditions apply?

• Only an RN may delegate nursing care tasks to unlicensed assistive personnel; LPNs may not
• The Board says delegation should be the exception, and the RN must be able to justify the need
• The RN may delegate in any setting; when not regularly on site, the RN provides indirect supervision
• The RN must follow the NCSBN delegation decision-making process and protocols the Board recognizes

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?

Hawaii's rule does not address medications directly; confirm with the Hawaii Board of Nursing before delegating medication tasks.