Ask ECRI: Home Health Hospice Aides and Medication Administration

A risk manager recently asked for guidance regarding a private duty home health hospice aide's scope of practice to administer PRN (i.e., as needed) medications. In our response, we acknowledge that there are several concerns and challenges considering home health hospice aides who are unlicensed and, therefore, do not have a defined scope of practice. Unfortunately, state laws are inconsistent regarding aides administering medications.

Because home health hospice aides can neither assess nor evaluate patients, nor plan their care, knowing when they can provide PRN medication creates a challenge. Qualified licensed nurses must assume the responsibility of assessing patient or client's care needs. This assessment must be completed before the nurse delegates a nursing activity to the home health hospice aide. A reasonable and prudent nurse must determine that the nursing activity (i.e., administration of PRN medication) is delegable within the scope of nursing judgment; that it does not require the...