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Nurse Delegation

In Washington State, Nurse Delegation allows paid in-home care workers to receive special authority to administer some medications or do some procedures that might otherwise require a family member or other medical professional to be present. This can be very helpful when an individual can no longer take medications with assistance only. Nurse Delegation requires specific training for the patient and the in-home care worker on tasks that are usually only performed by licensed nurses. It has been practiced for years in Washington’s adult family homes, but was only authorized for Home Care agencies in late 2003. Professional caregivers routinely assist with medication for their clients, however Nurse Delegation May BE REQUIRED if the person receiving care is unable to take their medication with assistance and needs medication administration instead.

Nurse Delegation offers a less expensive alternative to licensed Nursing care when medication administration is required and family members are not available or they do not wish to take on this responsibility. Without delegation, there are certain instances when a family member or friend must be present to administer the medication, an LPN or RN must be hired, or a nursing facility considered. Many individuals do not have family or friends who can be present to administer medications or breaks from caregiving are needed. LPN’s and RN’s are expensive to have on an hourly basis providing care and are in short supply. Nurse Delegation allows persons needing medication administration to remain at home and receive the best possible care.

Very few private-pay in-home care agencies have delegating nurses and in-home care workers ready to offer nurse delegation. If this is a potential need, it is good to ask if the home care agency can provide this service.

What Can and Can’t Be Delegated

What tasks a non-nurse can and can’t do are governed by rules written into law. A brief summary is included below. For more detailed information, read the state rules in the Washington Administration Code 246-840-910 through 970.

What Can Be Delegated

A non-nurse may give you prescription medications as ordered. If you have a long-standing health problem, such as diabetes, he or she can test your blood sugar levels. Other health care tasks could include special bowel programs, tube feedings, bladder emptying, or simple wound care.

What Can't Be Delegated

The nurse may never delegate injectable medications, procedures that are considered sterile, or tasks that require nursing judgment.

Washington’s Community Living Connections staff are available to help you explore your options to meet your current needs or create a plan for the future.

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