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

Yes. North Dakota lets a licensed nurse delegate administration of specific medications for a specific client to a registered unlicensed assistive person, after teaching that person each medication and watching them give it until competent. Registered Medication Assistants III can give a wide range of medications, including subcutaneous injections such as insulin, to stable clients under organization policy. Delegation is not allowed for clients with unstable or changing needs.

What conditions apply?

• A licensed nurse may delegate administration of specific medications for a specific client to an unlicensed assistive person (UAP) registered with the Board, under the 'specific delegation' rule
• For specific delegation, the nurse teaches each UAP the client's medications (names, purpose, side effects, route, when to call the nurse), observes until competent, verifies competency, documents the training and re-evaluates when orders change
• Separately, Board-registered Medication Assistants III may give medications in ambulatory and other settings by oral, eye, ear, nasal, rectal, vaginal, topical, inhaled, nebulized, intramuscular, subcutaneous, intradermal and gastrostomy, jejunostomy or nasogastric tube routes
• Medication assistants may not use central lines, IV, colostomy or urethral catheter routes, medication pumps, or chemotherapy (except oral maintenance)
• Delegation is precluded for clients with unstable or changing nursing care needs; assessment of need or response and PRN judgment cannot be delegated
• Outside facilities, the nurse follows the organization's policy for supervision

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.