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What is medication assistance and how is it different from medication administration?
What assistance can a caregiver provide?
What is the difference between Adult Family Homes, Boarding Homes, In-home Settings, and In-home Services?
Can a licensed nurse delegate nursing tasks to a caregiver?
In a community based setting, who can administer non-prescribed over-the-counter (OTC) medications such as herbal medicines or supplements?
Who can administer eye drops if a resident is unable to self-administer?
How can a caregiver assist a resident with insulin injections?
How can a caregiver alter medications for medication assistance?
How can a caregiver assist a resident with medications in a nebulizer?
Who can administer non-routine and narcotic medications?
Can a caregiver dial the dose for a resident using an insulin pen?
Can a caregiver place medication in a mediset?
What is medication assistance and how is it different from medication administration?
Washington State Law allows
caregivers
to provide
medication assistance with
legend drugs and controlled substances to a
resident who meets certain criteria
and resides in a
community-based care setting or
an
in-home care setting
(WAC 246-888-020).
However,
medication administration must be done
only by a resident, family member, licensed medical professional or by nurse
delegation (WAC 246-840-910 to 970).
What assistance can a caregiver provide?
Under Washington State law,
caregivers
can not provide the services of a licensed health care provider
(RN, LPN, ARNP or pharmacist) or function in the capacity of a nursing assistant
(NAC or NAR). The
caregiver
must be familiar with the rules specifically regulating their residential setting
and the tasks that they are legally authorized to provide.
Chapter 246-888 WAC,
chapter 388-78A WAC &
chapter 388-76 WAC
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What is the difference between
Adult Family Homes, Boarding Homes, In-home Settings, and In-home Services?
An
Adult Family Homes is considered a
community based setting.
It is a residential home licensed to care for two to six residents.
They provide room, board, laundry, and necessary supervision, assistance with
activities of daily living, personal care, and social services. Some provide
nursing care or may specialize in serving people with mental health problems,
developmental disabilities, or dementia.
Chapter 388-76 WAC.
A
Boarding Home is a community based facility
licensed to care for seven or more
residents. Boarding homes provide board,
help with activities of daily living, and assume general responsibility for the safety
and well-being of the resident. Some boarding homes offer limited nursing services and
others may specialize in serving people with mental health problems,
developmental disabilities, or dementia.
Chapter 388-78A WAC
An
In-Home Settings is an individual?s
place of temporary or permanent residence that does not include acute care or
skilled nursing and not a
community-based care setting.
RCW 18.79.260(3)(e)(ii)
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In-Home Services may occur in any
of these settings and may provide any of the following:
- Home Health Services are provided to ill, disabled, infirm, or vulnerable individuals. These services include but are not limited to nursing services, home health aide services, physical therapy services, occupational therapy services, speech therapy services, respiratory services, nutritional services, and home medical supplies or equipment services.
- Hospice Services provide symptom and pain management to a terminally ill resident and emotional spiritual, and bereavement support for the resident or family in a place of temporary or permanent residence. Hospice Services may include the provision of home health and home care services for the terminally ill resident.
- Home Care Services provide non-medical services and assistance to ill, disable, infirm, or vulnerable individuals that enable them to remain in their residences. Home care services include, but are not limited to: Personal care, such as assistance with dressing, feeding, and personal hygiene to facilitate self-care; homemaker assistance with household tasks, such as housekeeping, shopping, meal planning and preparation, and transportation, respite care assistance and support provided to the family; or non-medical services.
- Hospice Care Centers provide a homelike, non-institutional facility
where hospice services are offered, and that meets the requirements for operation
under
RCW 70.127.280
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Can a licensed nurse delegate nursing tasks to a caregiver?
Any registered
nurse licensed in Washington State may delegate in accordance with the
Nurse Practice Act
(WAC 246-840-700 through 710).
The
Nurse Delegation Program allows only nursing assistants (NAC or NAR) who work in
certain settings to perform certain tasks (such as administration of prescription
medications or blood glucose testing) normally performed only by licensed nurses.
Licensed Practical Nurses (LPNs) are not allowed to delegate.
RCW 18.79.260 (3)(e);
WAC 388-76-625;
WAC 246-840-910;
WAC 246-840-970.
In a community based setting, who can administer non-prescribed over-the-counter (OTC) medications such as herbal medicines or supplements?
The
resident, if able,
may independently
administer
prescribed or
OTC medications when no
assistance is required. However, if a resident is unable to independently
administer, and
OTC medications are used
to treat a condition,
nurse delegation may be necessary.
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Who can administer eye drops if a resident is unable to self-administer?
If a
resident cannot safely
self-administer medication,
then the medication must be
administered
by a person legally authorized to do so (RN, LPN, ARNP or pharmacist) or by
nurse delegation.
WAC 246-840-910 to 970.
How can a caregiver assist
a resident with insulin injections?
A
caregiver can only communicate appropriate information
regarding
self-administration; remind/coach the
resident
to take as prescribed; hand a pre-filled insulin syringe to a resident.
WAC 246-888-020.
How can a caregiver alter medications for medication assistance?
A
caregiver may help in the preparation of
legend drugs or controlled substances for
self-administration.
The licensed practitioner must determine and communicate orally or by written direction that crushing tablets,
cutting tablets in half, opening capsules, mixing powdered medications, or mixing tablets or capsules with foods
or liquids is appropriate
(WAC 246-888-050).
The
resident receiving assistance must be aware of the alteration
if added to their food.
Caregivers may not put medication into the resident?s mouth.
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nebulizer?
A
caregiver can transfer the medication into the nebulizer
for the purpose of an individual dose. The
caregiver can also turn
on the machine, communicate appropriate information regarding
self-administration;
remind/coach the
resident to take as prescribed.
WAC 246-888-020;
WAC 246-888-070.
Who can administer non-routine and
narcotic medications?
Non-routine and
narcotic medications must be administered by
a person legally authorized to do so (RN, LPN, ARNP or pharmacist) or by
nurse delegation
WAC 246-840-910 to 970.
Under
self-directed care,
the
caregiver can provide these medications under
the direction of the
resident.
WAC 388-71-05640;
chapter 74.39 RCW
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Can a caregiver dial the dose for a resident using an insulin pen?
No, except when directed by the
resident under
self-directed care.
Can a caregiver place medication in a mediset?
No, except when directed by the
resident under
self-directed care.
- Caregiver?s Frequently Asked Questions
- Glossary of Terms for Caregivers
- Useful Links for Caregivers
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