A registered nurse, employed in a licensed ICF/MR, may delegate to certified medication aides the administration of medications and tube feedings to residents when:
There is not a licensed nurse on duty in the facility.
The nurse utilizes the guidelines found in the next paragraphs and which have been established in previous declaratory rulings to assure safety of the residents.
The delegation occurs only as long as the residents are free of complications related to the gastrostomy tube.
The registered nurse provides inservice education for the certified medication aides. The nurse observes the successful demonstration of the task by the certified medication aides and documentation thereof is contained in the personnel file of the certified medication aides.
The registered nurse observes at least one administration of medications and feedings via gastrostomy tube by the certified medication aides on a quarterly basis to assess skills.
The registered nurse provides annual review of the procedure in the administration of medications and feedings via gastrostomy tube for the certified medication aides and documentation thereof is contained in the personnel file of the certified medication aides.
The nurse uses the National Council of State Boards of Nursing’s position paper, Delegation: Concepts and Decision-making Process, adopted by the board in March of 1996 in making the determination to delegate.
The facility has a written policy identifying that the registered nurse may delegate the task only under the ascribed conditions.
The tube feeding has been prescribed by the physician as a written order.
The registered nurse retains accountability for the delegated functions.
This statement on delegation applies only to gastrostomy tube feedings and enteral medications administration and is limited to licensed intermediate care facilities for the mentally retarded. The person to whom the tasks are delegated must be a certified medication aide. For additional information or to obtain a copy of the National Council of State Boards of Nursing’s position paper, Delegation: Concepts and Decision-making Process, you may Email or write to: Iowa Board of Nursing, 400 SW 8th Street, Suite B, Des Moines, IA 50309-4685.