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The Committee on Health Regulation (Peaden) recommended the

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following amendment:

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     Senate Amendment (with title amendment)

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     Between line(s) 627 and 628

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insert:

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     Section 7.  Section 400.488, Florida Statutes, is amended

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to read:

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     400.488 Nurse delegation Assistance with self-

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administration of medication.--A home health agency nurse may

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delegate nursing tasks as provided in chapter 464 and related

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rules.

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     (1) For purposes of this section, the term:

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     (a) "Informed consent" means advising the patient, or the

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patient's surrogate, guardian, or attorney in fact, that the

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patient may be receiving assistance with self-administration of

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medication from an unlicensed person.

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     (b) "Unlicensed person" means an individual not currently

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licensed to practice nursing or medicine who is employed by or

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under contract to a home health agency and who has received

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training with respect to assisting with the self-administration

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of medication as provided by agency rule.

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     (2) Patients who are capable of self-administering their

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own medications without assistance shall be encouraged and

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allowed to do so. However, an unlicensed person may, consistent

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with a dispensed prescription's label or the package directions

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of an over-the-counter medication, assist a patient whose

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condition is medically stable with the self-administration of

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routine, regularly scheduled medications that are intended to be

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self-administered. Assistance with self-medication by an

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unlicensed person may occur only upon a documented request by,

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and the written informed consent of, a patient or the patient's

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surrogate, guardian, or attorney in fact. For purposes of this

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section, self-administered medications include both legend and

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over-the-counter oral dosage forms, topical dosage forms, and

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topical ophthalmic, otic, and nasal dosage forms, including

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solutions, suspensions, sprays, and inhalers.

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     (3) Assistance with self-administration of medication

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includes:

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     (a) Taking the medication, in its previously dispensed,

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properly labeled container, from where it is stored and bringing

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it to the patient.

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     (b) In the presence of the patient, reading the label,

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opening the container, removing a prescribed amount of

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medication from the container, and closing the container.

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     (c) Placing an oral dosage in the patient's hand or

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placing the dosage in another container and helping the patient

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by lifting the container to his or her mouth.

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     (d) Applying topical medications.

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     (e) Returning the medication container to proper storage.

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     (f) Keeping a record of when a patient receives assistance

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with self-administration under this section.

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     (4) Assistance with self-administration does not include:

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     (a) Mixing, compounding, converting, or calculating

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medication doses, except for measuring a prescribed amount of

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liquid medication or breaking a scored tablet or crushing a

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tablet as prescribed.

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     (b) The preparation of syringes for injection or the

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administration of medications by any injectable route.

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     (c) Administration of medications through intermittent

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positive pressure breathing machines or a nebulizer.

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     (d) Administration of medications by way of a tube

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inserted in a cavity of the body.

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     (e) Administration of parenteral preparations.

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     (f) Irrigations or debriding agents used in the treatment

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of a skin condition.

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     (g) Rectal, urethral, or vaginal preparations.

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     (h) Medications ordered by the physician or health care

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professional with prescriptive authority to be given "as

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needed," unless the order is written with specific parameters

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that preclude independent judgment on the part of the unlicensed

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person, and at the request of a competent patient.

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     (i) Medications for which the time of administration, the

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amount, the strength of dosage, the method of administration, or

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the reason for administration requires judgment or discretion on

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the part of the unlicensed person.

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     (5) Assistance with the self-administration of medication

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by an unlicensed person as described in this section does not

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constitute administration as defined in s. 465.003.

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     (6) The agency may by rule establish procedures and

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interpret terms as necessary to administer this section.

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================ T I T L E  A M E N D M E N T ================

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And the title is amended as follows:

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     On line(s) 38, after the semicolon,

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insert:

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amending s. 400.488, F.S.; deleting provisions authorizing

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the administration of medication to home health patients

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by unlicensed staff; providing for the delegation of

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nursing tasks as provided in ch. 464, F.S., and related

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rules;

3/4/2008  1:51:00 PM     588-04355-08