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Florida Regulations

ElderCare wants you to be well-informed about Florida regulations governing in-home care. All files are in PDF format. Download Adobe Reader. To download a file, right click the View/Download link then click Save Target As... or Save Link As...

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Administration of Drugs & Biologicals

Each nurse registry shall disseminate to its independent contractor nurses the procedures required by Chapter 464, F.S. and the rules of the Agency for Health Care Administration governing the administration of drugs and biologicals to patients.

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Drugs & Biologicals Procedures

The procedures include the following:

(a) An order for medications to be administered by the licensed nurse shall be dated and signed by the attending physician, physician assistant, or advanced registered nurse practitioner

(b) An order for medications shall contain the name of the patient, the name of the drug, dosage, frequency, method or site of injection, and order from the physician, physician assistant, or advanced registered nurse practitioner if the patient or caregiver are to be taught to give the medication; and

(c) A verbal order for medication or change in the medication orders from the physician, physician assistant, or advanced registered nurse practitioner shall be taken by a licensed registered nurse, reduced to writing, to include the patient's name, the date, time, order received, signature and title. The physician, physician assistant, or advanced registered nurse practitioner shall acknowledge the telephone order within 30 days by signing and dating the orders. A verbal order or change in medication order shall be on file in the clinical record at the nurse registry within 30 days.

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Florida Rules & Statutes - RN & LPN

59A-18.007 Registered Nurse and Licensed Practical Nurse.

The registered nurse and the licensed practical nurse shall:

  1. Be responsible for the clinical records for their patients. The clinical records shall be filed with the nurse registry, for each patient or client to whom they are giving care in the home or place of residence or when they assess the care being provided by non-licensed independent contractors, pursuant to Section 400.506(10)(c), F.S. Clinical notes and clinical records related to care given under a staffing arrangement are maintained by the facility where the staffing contract is arranged;
  2. Be responsible for maintaining the medical plan of treatment with clinical notes and filing the initial medical plan of treatment, any amendments to the plan, any additional order or change in orders, and a copy of the clinical notes at the office of the nurse registry;
  3. The licensed practical nurse shall be under the direction of a registered nurse, or a physician licensed pursuant to Florida Statutes, as required under Section 464.003(3)(b), F.S.

Specific Authority 400.497, 400.506 FS. Law Implemented 400.497, 400.506 FS. History–New 2-9-93, Amended 1-27-94, 12-24-00.

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Florida Rules & Statutes - CNA & HHA

59A-18.0081 Certified Nursing Assistant and Home Health Aide.

The certified nursing assistant (C.N.A.) and the home health aide shall:

  1. Be limited to assisting a patient in accordance with Section 400.506(10)(b), F.S.;
  2. Be responsible for documenting services provided to the patient or client and for filing said documentation with the nurse registry on a regular basis. These service logs will be stored by the nurse registry in the client's file. The service logs shall include the name of the patient or client and a listing of the services provided;
  3. Be responsible for observing appearance and gross behavioral changes in the patient and reporting these changes to the caregiver and the nurse registry or the registered nurse responsible for assessing the case when giving care in the home or to the responsible facility employee if staffing in a facility;
  4. Be responsible to maintain a clean, safe and healthy environment, which may include light cleaning and straightening of the bathroom, straightening the sleeping and living areas, washing the patient's dishes or laundry, and such tasks to maintain cleanliness and safety for the patient;
  5. Perform other activities as taught and documented by a registered nurse, concerning activities for a specific patient and restricted to the following:
    1. Assisting with the change of a colostomy bag, reinforcement of dressing;
    2. Assisting with the use of devices for aid to daily living such as a wheelchair or walker;
    3. Assisting with prescribed range of motion exercises;
    4. Assisting with prescribed ice cap or collar;
    5. Doing simple urine tests for sugar, acetone or albumin;
    6. Measuring and preparing special diets;
    7. Measuring intake and output of fluids; and
    8. Measuring temperature, pulse, respiration or blood pressure.

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Florida Rules & Statutes - Homemakers & Companions

59A-18.009 Homemakers or Companions

  1. The homemaker or companion shall have evidence of training in topics related to human development and interpersonal relationships, nutrition, shopping, food storage, use of equipment and supplies, planning and organizing of household tasks and principles of cleanliness and safety
  2. The homemaker shall have the following responsibilities:
    1. To maintain the home in the optimum state of cleanliness and safety depending upon the client's and the caregiver's resources;
    2. To perform the functions generally undertaken by the natural homemaker, including such duties as preparation of meals, laundry, and shopping;
    3. To perform casual, cosmetic assistance, such as brushing the client's hair, assisting with make-up, filing and polishing nails, with the exception of clipping nails for diabetic patients;
    4. To stabilize the client when walking, as needed, by holding the client's arm or hand; and
    5. To report any unusual incidents or changes in the patient's or client's behavior to the nurse registry administration and to the caregiver.
  3. The companion shall have the following responsibilities:
    1. To provide companionship for the patient or client;
    2. To provide escort services such as taking the patient or client to the doctor;
    3. To provide light housekeeping tasks such as preparation of a meal or laundering the client's personal garments;
    4. To perform casual, cosmetic assistance, such as brushing the client's hair, assisting with make-up, filing and polishing nails, with the exception of clipping nails for diabetic patients; and
    5. To stabilize the client when walking, as needed, by holding the client's arm or hand; and
    6. To report any unusual incidents or changes in the patient's or client's behavior to the nurse registry administration and to the caregiver.

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Medical Plan of Treatment Procedures

The licensed nurse responsible for delivering care to the patient is responsible for the medical plan of treatment which shall include, at a minimum, the following:

  1. Diagnoses;
  2. Activities permitted when indicated;
  3. Diet when indicated;
  4. Medication, treatments, and equipment required; and
  5. Dated signature of physician, physician assistant, or advanced ed nurse practitioner.

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Supervision of Self-Administered Medication in the Home

HHA / CNA RESPONSIBILITIES

CLIENT/PATIENT MUST BE ABLE TO TAKE OWN MEDICATION.

  1. Remind to take medication
  2. Prepare necessary items such as juice, water, cups, or spoons to assist the client/patient in the self administration of medication
  3. Open and close the medication container or tear the foil of prepackaged medications
  4. Observe the client/patient self-administering the medication
  5. Assist the client/patient in the self-administration process. Examples of such assistance include the steadying of the arm, hand or other parts of the client/patient body so as to allow the self-administration of medication
  6. If the client/patient removes too much medication you may assist the client/patient by placing unused doses of solid medication back into the medication container
  7. Reorder prescriptions from the pharmacy

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