November 22, 2022
In last month’s blog post, we talked about how consumers would be better served if home care agencies were required to use levels of care, similar to how hospitals treat their patients. You can read about that here. This month, we want to look at another idea that, if used consistently by the home care industry, could also benefit consumers: nurse delegation.
The demand for in-home clinical (or medical) care is growing rapidly because more and more people want to not just age in their own homes, but also manage chronic illnesses and recover from hospitalizations at home. Consumers of all ages are choosing in-home care, but especially older adults—and that population is growing quickly as Baby Boomers age.
Nurse delegation is what it sounds like: A nurse, where allowed by state regulations and under appropriate circumstances, can delegate low-risk duties to a certified nursing assistant (CNA). In Washington state, for example, CNAs are allowed to do tasks such as administering prescription medications or blood glucose testing.
The patient benefits by receiving nurse-supervised care at home, but is not reliant on (and doesn’t pay for) the nurse’s presence in their home. Home care providers benefit by the ability to serve more clients with existing nursing staff.
Nurse delegation is permitted in many states, and “states/jurisdictions have different laws and rules/regulations about delegation,” according to the National Council of State Boards of Nursing (NCSBN). The NCSBN and the American Nurses Association together developed the “National Guidelines for Nursing Delegation” to guide states’ efforts, with important caveats such as, “The licensed nurse cannot delegate nursing judgment or any activity that will involve nursing judgment or critical decision making.” Nurse delegation is also subject to what are called the “Five Rights”:
- The “right” patient
- The “right” task
- The “right circumstances
- “Right” directions and communication
- “Right supervision and evaluation
The website RegisteredNursing.org, which publishes a review guide for the NCLEX-RN, the exam nurses must pass to become an RN, emphasizes the care nurses must take when delegating:
“The client is the center of care. The needs of the client must be competently met with the knowledge, skills and abilities of the staff to meet these needs. In other words, the nurse who delegates aspects of care to other members of the nursing team must balance the needs of the client with the abilities of those to which the nurse is delegating tasks and aspects of care, among other things such as the scopes of practice and the policies and procedures within the particular healthcare facility.”
At Wellspring Personal Care, we believe nurse delegation can be an important part of both ensuring clients receive excellent care at home, and that home nursing agencies can continue to serve their ever-growing client needs. What are your thoughts? Please email us at wpc@homecarechicago.com – we’d love to hear from you.