Medical Assistance
policy
Avenue Home Care complies with the California state laws and appropriate professional acts and provisions that stipulate the assistance with self-administered medications by home health and personal care aides.
Purpose
To ensure compliance with the state law regarding the assistance with self-administered medications in the home.
To ensure proper documentation of medication used by clients.
procedure
1. A client or his/her family may request self-administration with assistance. The RN in concert makes the decision to authorize/provide self-administrated medication assistance with the client and/or family. This determination is based on whether or not the client has the cognitive ability to direct the administration of their medication and would self-administer if not for a functional limitation.
2. The home health aide/companion is limited to assistance with medications ordinarily self-administered by the client. This assistance is limited to:
(a) Reminding the client when it is time to take a medication.
(b) Reading the label of the medication container.
(c) Handing the client-owned medication container to the client.
(d) Opening the medication container.
(e) Use of an enabler or placing the medication in the hand of the client.
(f) Applying topical creams or ointments.
(g) Use of metered dose inhalers.
(h) Insulin administration under nurse delegation.
3. Enablers are physical devices used to facilitate a client’s self-administration of medication such as a medicine cup, glass, cup, spoon, bowl, pre-filled syringes, syringes used to measure liquids, especially adapted table surfaces, straws, pieces of cloth of fabric.
4. The client must be able to put the medication into his/ her mouth or apply or instill the medication.
5. If a client is not able to physically ingest or apply a medication independently or with assistance, or is not aware that they are taking medications, then the medications must be administered by an individual legally authorized to do so. A nursing assistant is not considered an authorized individual under these circumstances.
6. Oxygen is not considered a medication and is therefore not covered under this policy. The client/representative, respiratory therapist, or RN may only regulate oxygen liter flow with physician orders.
7. Assistance with self-administered medications may also apply to medications via “g-tube,” if a lawful practitioner has determined that the medication can be altered and has specified the use of the “g-tube” for the administration of the medication. Assistance with administration of medicine through a permanently placed gastrostomy tube (g-tube) by an unlicensed person may be performed only after successful completion of the training and competency program and procedures described in paragraphs the state rules.
8. Insulin administration is also allowed provided the Aide has been nurse-delegated and remains under the supervision of the nurse. RN must leave written instructions for the performance of the administration of insulin subcutaneously, nasally, or via insulin pump, including a copy of the physician’s order or instructions for the aide to use as a reference.
9. Medication assistance shall be documented on the appropriate agency form and recorded per client/family request in the home.
10. Observations and recognized changes are documented and reported to the supervising nurse managing the care of the client.
11. In the event that the client is exhibiting signs of distress initiate emergency procedures in accordance with agency policy.
12. A list of all current medications shall be kept in the client’s record.
13. Medications may be administered only under the delegation of a registered nurse.