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

Yes. In Minnesota, a comprehensive home care provider can have an RN delegate medication administration to trained unlicensed staff in the client's home. The RN must teach the procedure, confirm competency and write client-specific instructions, and staff must pass written and skills tests. Agencies with only a basic home care license can give medication reminders and bring set-up medications, but cannot perform delegated nursing tasks. The statutes do not say specifically whether insulin injections can be delegated.

What conditions apply?

• Only a comprehensive home care licensee may provide medication administration; staff of a basic home care licensee may only give medication reminders and bring previously set-up medications or original containers, and may not perform delegated nursing tasks
• An RN delegates medication administration to unlicensed personnel after instructing them in proper methods and confirming they can competently follow the procedures
• The RN writes specific instructions for each client in the client's record and communicates the client's individual needs
• Unlicensed personnel doing delegated nursing tasks must pass a written or oral test and a practical skills test on all delegated tasks, or meet Medicare home health aide or nursing assistant training requirements
• The client's medication management plan must identify which medication tasks may be delegated to unlicensed personnel
• Each administered dose is documented with the staff member's signature, dose, time, method and route

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?

Insulin is not addressed directly in the home care statutes; confirm with the Minnesota Department of Health or Board of Nursing.