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

Yes. South Dakota lets nurses delegate medication administration to nursing assistants who finish a Board-approved medication course, including in a client's home. Delegable medications include oral, topical, drops, rectal, inhaled and transdermal medications. Insulin injections can be delegated under an RN's written protocol with 10 hours of diabetes training, a written test and close RN follow-up during the first month. A nurse can also delegate one specific medication for one client living at home to an aide without the full course when no nurse is available.

What conditions apply?

• A licensed nurse may delegate selected nursing tasks to a nursing assistant after evaluating the client's needs and verifying competency; the task cannot require nursing judgment and the assistant cannot redelegate
• Medication administration may be delegated to a nursing assistant with at least a high school education who completed a Board-approved medication administration training program (Board registration is required only in nursing facilities, assisted living centers and hospitals)
• Delegable: scheduled oral, sublingual, eye, ear, nasal, rectal, topical, transdermal, vaginal and inhaled medications; measuring liquids or crushing tablets when a nurse, physician or pharmacist calculated the dose; client-labeled Schedule II drugs
• Insulin by subcutaneous injection may be delegated under an RN's written protocol: 5 hours of Board-approved diabetes training, a written exam (85% to pass), 5 hours of clinical or lab instruction with a competency checklist, RN in-person visits at mealtime at least twice a week for the first four weeks, RN available at all mealtimes, and an annual competency review
• For a client living in their own residence (not a nursing facility or assisted living), a nurse may delegate one specific medication for one specific client to an untrained nursing assistant if no licensed nurse is available and it lets the client stay home, after client-specific training
• Not delegable: other injections, tube medications (except the specific-medication route), dose calculation, and locked-stock Schedule II drugs

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.