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

In limited cases. South Carolina law lets nurses delegate routine personal care tasks and vital signs to trained unlicensed staff, but says unlicensed assistive personnel must not administer medications unless another law allows it. No such law covers home care agency aides. The exception is consumer-directed attendant care: a person with a functional disability (or someone on their behalf) can direct an unlicensed attendant at home to give medications and do other health maintenance tasks.

What conditions apply?

• Nurses may delegate routine nursing tasks to unlicensed assistive personnel (UAP); the tasks must be listed in the employer's policies and the employer must verify training and competency
• Delegable tasks include personal hygiene, nutrition, ambulation, elimination, vital signs, asepsis, and observing and reporting
• Medication administration is the responsibility of a licensed nurse; UAP must not administer medications except as otherwise provided by law
• Unlicensed medication technicians are authorized only in ICF/IID facilities, community residential care facilities, nursing homes and correctional facilities, not private homes

Is there an exception for self-directed care?

The Nurse Practice Act does not prohibit unlicensed attendant care services directed by or on behalf of a functionally disabled individual in need of in-home care. Attendant care includes health maintenance activities such as administration of medications, enemas, suppositories, catheter irrigation and wound care that the person could do if able. Gratuitous family care is also exempt.

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.