A. A nurse who is licensed pursuant to this chapter may delegate medication administration to a licensed nursing assistant who is also certified by the board as a medication assistant or to a student in an approved medication assistant program under the following conditions:

1. 1. The recipient of the medication is a resident of a licensed nursing care institution as defined in section 36-401.

2. 2. Delegated medications are limited to:

   1. (a) Regularly scheduled medications, including controlled substances, by oral, topical, nasal, otic, optic and rectal routes.
   2. (b) Following the nurse's assessment of the resident's need for the medication and at the direction of the nurse, as-needed medications for bowel care or over-the-counter analgesics. The nurse shall evaluate the effect of the medication and document findings in the resident's record.
3. 3. The delegating nurse maintains accountability for the delegation and management of the resident's medications.

B. A nurse may not delegate to a medication assistant:

1. 1. If, in the professional judgment of the nurse after evaluating the condition of and the level of services required for the resident and the conduct and skills of the certified medication assistant or medication assistant student, the delegation would pose an unacceptable risk of harm or jeopardize the health or welfare of the resident or if safe delegation cannot be accomplished.
2. 2. The first dose of a new medication or of a previously prescribed medication if the dosage is changed.
3. 3. Any new medication that arrives from the pharmacy without ensuring that it reflects the original prescription.
4. 4. As-needed medications except as provided in this section.
5. 5. The counting of controlled substances at the beginning and end of a shift and any act associated with obtaining multiple doses of controlled substances.
6. 6. Any medication delivered by a needle or by intradermal, subcutaneous, intramuscular, intravenous, intrathecal and intraosseous routes.
7. 7. The administration of any medication that must be inserted into a nasogastric tube or gastric tube.
8. 8. Changing oxygen settings or turning oxygen on or off.
9. 9. The administration of inhalant medications.
10. 10. The regulation of intravenous fluids or the programming of insulin pumps.
11. 11. The administration of topical patches or topical medications that require a sterile dressing or assessment of skin condition.
12. 12. The administration of sublingual medications.
13. 13. The administration of any medication that requires a mathematical conversion between units of measurement to determine the correct dose.