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

Yes. Kentucky lets an RN or LPN delegate nursing tasks to unlicensed people in any setting, as long as the task needs no independent nursing judgment and the nurse has trained or checked the person. The nurse keeps responsibility for the client's care and decides how much supervision is needed. The rule does not list specific tasks or say whether medication administration or insulin can be delegated.

What conditions apply?

• An RN or LPN may delegate a nursing task to an unlicensed person after determining the client's nursing care needs
• The nurse keeps responsibility for assessment, planning, evaluation and documentation
• The nurse must instruct the unlicensed person in the task or confirm the person is competent
• The task must be one a reasonable and prudent nurse would delegate, safe for the delegatee to do, and must not need independent nursing judgment
• The nurse decides the level of supervision based on client stability, delegatee training, task complexity and how close and available the nurse is

Is there an exception for self-directed care?

The Board's rule defines 'unlicensed person' to exclude the client and the client's family or legal guardian, so the delegation rule does not govern care given by those people.

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?

Kentucky's rule does not address medications in home care; confirm with the Kentucky Board of Nursing (it publishes advisory opinion statements on delegation).