Nurse Delegation of Medication Administration .for Elders in Assisted Living

ABSTRACT 
This study examined medication delivery in Assisted Living (AL) settings, using multiple approaches: 1) Interviews with Board of Nursing (BON) executives, creating a summary and analysis of the regulatory environment (nurse practice acts and assisted living regulations) across the 50 states; 2) Gathering the perspectives of key informants in the field; 3) Conducting focus groups with nurses and administrators in this practice setting, and 4) participant observation of two sessions of stakeholders involved in the Assisted Living State Policy Summit. These sources elucidated the following salient findings: 1) Medication administration is an important and common issue in AL settings; 2) There is considerable variation across states regarding medication administration from both the perspective of BONs and AL licensing agencies; 3) Communication and coordination between agencies within states is limited; 4) Lack of clarity in definitions and practice parameters results in confusion and procedures that might "push the envelope"; 5) While professionals were concerned about safety, there was not evidence of harm related to medication administration. This study highlighted the limited articulation of policies between agencies and across states in this important and growing LTC setting. Gerontological nurses have the opportunity to shape this evolving practice arena and to enhance awareness of the professional and clinical issues inherent in working with unlicensed personnel in medication delivery.