1. (a) In addition to the requirements of Nur 404.05, when delegating medication administration, the delegating nurse shall specify:

   1. (1) The medication to be administered;
   2. (2) The dosage, route and time of the medication to be administered;
   3. (3) The proper method for administration;
   4. (4) Required documentation; and
   5. (5) The duty to report immediately to the delegating nurse any error in the administration.

2. (b) In addition to the requirements in paragraph (a), and when relevant to the care of the client by the delegate, the delegating nurse shall instruct the delegate on:

   1. (1) The reasons for the medication;
   2. (2) The potential side effects of the medication;
   3. (3) Observation of the client’s response; and
   4. (4) Expected actions if side effects are observed.

3. (c) A nurse may delegate medication administration when medication is administered via the following routes:

   1. (1) Topical;
   2. (2) Oral;
   3. (3) Nasal;
   4. (4) Ocular;
   5. (5) Auricular;
   6. (6) Vaginal;
   7. (7) Rectal;
   8. (8) Enteral tube; and
   9. (9) Injection of insulin or epinephrine in accordance with paragraph (f) and (g).

4. (d) A nurse shall not delegate the following:

   1. (1) Medication administered via a parenteral route, if not listed in paragraph (c);
   2. (2) Medication administered via a nasogastric tube;
   3. (3) The initial dose of a new medication or a previously prescribed medication with a dosage change; or
   4. (4) Medication administration requiring a dosage calculation by the LNA.

5. (e) A nurse may delegate PRN medications subject to the following:

   1. (1) The delegating nurse provides written instructions; and
   2. (2) The administration is authorized by the supervising nurse on duty or on call.
6. (f) A nurse may delegate the administration of insulin from a labeled and pre-set or pre-drawn Insulin delivery device.
7. (g) A nurse may delegate the administration of epinephrine from a labeled and pre-set or pre-drawn delivery device.

8. (h) In addition to the requirements of this part, when delegating medication administration to a currently licensed LNA that does not hold a certificate of medication administration, the delegating nurse shall:

   1. (1) Ensure the administration of medication is to stable clients, as defined in Nur 101.21 and pursuant to Nur 404.06(a)(1);

   2. (2) Identify a routine medication regime with a clear process for the LNA to follow, such as the use of:

      1. a. A medication planner or box that is prefilled by a licensed nurse;
      2. b. Clearly marked medication bottles or containers that provide direction for administration; or
      3. c. Written instructions on administration provided by the delegating nurse;
   3. (3) Ensure the LNA has, pursuant to Nur 404.06(a)(3), received instruction on requirements of the task delegated and understands a client medication administration record; and
   4. (4) Ensure delegation of medication administration does not, pursuant to Nur 404.06(a)(2), require independent decision-making by the LNA and shall only be appropriate when the client is unable to safely self-administer.

Source. #7741, eff 8-13-02; ss by #8873, eff 4-24-07; ss by #10299, eff 3-22-13; ss by #10571, eff 4-17-14; renumbered by #10953 (from Nur 404.06); ss by #11082, eff 4-26-16; amd by #12439, eff 12-22-17