Can a nurse delegate tasks to home care caregivers in North Carolina?

Yes. North Carolina lets nurses delegate Board-approved nursing care activities to unlicensed staff whose competence an agency RN has verified, for clients whose condition is stable. Under home care licensing rules, in-home aides may assist clients with self-administration of their prescribed medications. The rules fetched do not authorize home aides to administer medications or insulin injections.

What conditions apply?

• RNs and LPNs may delegate nursing care activities to unlicensed personnel, regardless of title, that fit the person's knowledge, skill and validated competence; the Board determines which nursing care activities may be delegated
• An RN employed by the agency must verify the unlicensed person's clinical competence
• The client's condition must be stable and predictable with no risk of complications
• Licensed home care agency in-home aides may assist clients with self-administration of prescribed medications and follow written care instructions from a health care practitioner
• In-home aides providing extensive ADL assistance must be listed on the Nurse Aide Registry
• The plan of care is signed by the health care practitioner and the client, and the initial assessment is done in the home

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?

The Board of Nursing publishes lists of tasks for Nurse Aide I and Nurse Aide II; check them and confirm with the Board before aides go beyond assisting with self-administration.