Assisted Living Medication Management: Registered Nurse Delegation

The role of the RN in an assisted living facility is dependent on the facility’s expectations and the RN’s job description or contract.
Responsibilities of an RN may include:

  • Medication administration
  • Resident assessment
  • Individualized service plan development
  • Staff training and orientation
  • Policy and procedure development
  • Supervision of staff (may or may not include delegation)
  • Performance of health screening and TB tests
  • Audits of medication system

Delegation is a skill needed by any RN who supervises and directs delegated nursing tasks performed by unlicensed individuals, regardless of the setting. Delegation is a powerful tool when used correctly. However, when these tasks are not properly delegated, the results can be life threatening.

The RN who delegates these tasks should follow nursing protocols, including training, evaluation, supervision and documentation, pursuant to Wis. Admin. Code § N 6 – Standards of Practice for Registered Nurses and Licensed Practical Nurses. It is the nurse's responsibility to delegate only those activities that are legally and ethically correct.

Relevant Regulations

Adult Family Home (AFH):
Wis. Admin. Code § DHS 88.02(20)
Wis. Admin. Code §DHS 88.04(2)(g)1
Wis. Admin. Code §DHS 88.06(2)(a)

Community-Based Residential Facility (CBRF):
Wis. Admin. Code § DHS 83.02(35)
Wis. Admin. Code § DHS 83.37(1)(e)2
Wis. Admin. Code § DHS 83.37(1)(h)1
Wis. Admin. Code § DHS 83.37(1)(k)2
Wis. Admin. Code § DHS 83.37(2)(b)
Wis. Admin. Code § DHS 83.37(2)(b)1
Wis. Admin. Code § DHS 83.37(2)(b)2
Wis. Admin. Code § DHS 83.37(2)(c)
Wis. Admin. Code § DHS 83.37(2)(e)
Wis. Admin. Code § DHS 83.37(3)(a)
Wis. Admin. Code § DHS 83.37(3)(a)1
Wis. Admin. Code § DHS 83.37(3)(a)2
Wis. Admin. Code § DHS 83.42(1)(v)

Residential Care Apartment Complex (RCAC):
Wis. Admin. Code § DHS 89.13(22)
Wis. Admin. Code § DHS 89.13(24)
Wis. Admin. Code § DHS 89.23(4)(a)2
Wis. Admin. Code § DHS 89.26(3)(b)

Resources

FAQs

1. Can a RN delegate injections?

A RN can delegate injections as long as facility regulation or facility policy do not prohibit and the RN follows the nurse practice act. For example, CBRF regulations (Wis. Admin. Code § DHS 83.37) requires delegation for injections. If the RN has: delegated tasks commensurate with educational preparation and demonstrated abilities of the person supervised, provided direction and assistance to those supervised, observed and monitor the activities of those supervised and evaluated the effectiveness of acts performed under supervision, then the RN can delegate injections in a CBRF.

2. Does the RN need to be in the building when they delegate medication administration?

The level of RN supervision will be determined by the RN and should be based on the patient condition, task delegated and the delegation principals of Nurse Practice Act N6.

 

Last Revised: March 5, 2018