Can a nurse delegate tasks to home care caregivers in Rhode Island?

In limited cases. In Rhode Island, home care nursing assistants may only remind clients to take medications and cannot give injections or tube feedings. A nursing assistant licensed as a medication aide can give oral, topical, inhaled, drop and suppository medications under a licensed nurse's supervision. Medication aides cannot give subcutaneous injections such as insulin, or medications by tube. An RN must assess the client at home and supervise aides on site at least every three months.

What conditions apply?

• Nurses may delegate to licensed nursing assistants, and to other unlicensed assistive personnel when the client is stable and predictable, after assessing the client's nursing needs
• Tasks involving ongoing assessment or decision-making, or tasks the delegatee has not shown competence in, cannot be delegated
• Licensed home nursing care and home care providers must use nursing assistants within the duties set by state rule, with an RN in-home assessment, plan of care review and on-site supervision at least every three months
• A nursing assistant may only remind a patient to take medication; nursing assistants may not give injections or tube feedings
• Only a nursing assistant also licensed as a medication aide may administer medications, under licensed nurse supervision: oral, sublingual, buccal, eye, ear, nasal, rectal, vaginal, topical on intact skin, premeasured nebulizer and metered inhaler
• Medication aides may not give subcutaneous, intramuscular, IV or tube medications, or Schedule II controlled substances

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.