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

Not confirmed. Pennsylvania's home care agency rules let direct care workers assist clients with self-administered medications as part of personal care, after training or a competency test that covers it. The Board of Nursing's rules do not set out a process for RNs to delegate medication administration or other nursing tasks to unlicensed home care staff. No source found allows home care aides to give insulin injections.

What conditions apply?

• Licensed home care agencies and registries may provide personal care, which includes assistance with self-administered medications
• Direct care workers who provide personal care must pass a competency exam or training that covers assistance with self-administered medications, with competency reviewed at least yearly
• Board of Nursing rules on drug administration address only RNs supervising graduate nurses and nursing students; they do not provide for delegating medication administration to unlicensed staff

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?

Confirm with the Pennsylvania State Board of Nursing and Department of Health before aides do anything beyond assisting with self-administered medications.