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

Yes. In Maine's home care setting, an RN can delegate medication administration to a certified nursing assistant whose competency the agency has documented, even without the full CNA medication course. Delegable tasks include oral medications, drops, patches, inhalers, G-tube feedings and insulin injections with pre-filled syringes for stable diabetics. The client must be stable and sign consent on the care plan. As-needed medications and other injections cannot be delegated.

What conditions apply?

• In home care, only an RN may delegate medication tasks, and only to a certified nursing assistant listed on the Maine Registry of Certified Nursing Assistants and Direct Care Workers
• The client must have a stable, predictable pattern of need, and the client, family or designee must consent by signing the care plan
• The CNA must have documented competency under the agency's policies before delegation
• Delegable in the home: oral medications, eye and ear drops, non-narcotic patches, insulin injections for stable diabetics using pre-filled syringes, topical medications, inhalers and long-term nebulizers, vaginal and rectal medications, scheduled Schedule II drugs, and established G-tube and G-J tube feedings
• Not delegable: as-needed (PRN) medications and intrathecal, IV, intramuscular or subcutaneous injections other than insulin
• The RN decides the degree of supervision and must be available in person if needed

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?

This route covers certified nursing assistants; uncertified personal care staff are covered only by the Board's general rule on overseeing unlicensed personnel.