Wednesday Feature: Access to Health Care Through Nursing - New Jersey Nurse Delegation Pilot Project

Maggie Gossett, RN, Visiting Nurse Association of Central Jersey, pictured on the right, is delegating tube feeding and medication administration to a certified home health aide as part of New Jersey (NJ) Nurse Delegation Pilot Project, dubbed “There’s No Place Like Home,” because its purpose was to improve methods for providing skilled nursing care to patients in their homes so they would not have to be confined to institutions. RNs caring for patients in a community setting regularly encounter tasks where a home health aide or other unlicensed personnel can step in to provide care. A program that permits nurse delegation allows certified nurses to train unlicensed care providers on daily routine health activities such as administering routine medications and blood glucose monitoring. While nurse delegation regulations vary by state, these programs maximize consumer freedom, and for older adults, can help transition eligible patients from nursing homes relieving stress on family members.

The Robert Wood Johnson Foundation funded the NJ Nurse Delegation Pilot Project from 2007 to 2010 to study nurse delegation in home settings and found a potential for cost savings for Medicare and Medicaid. These types of programs support the IOM report’s The Future of Nursing: Leading Change, Advancing Health recommendation for nurses to practice to the full extent of their training and education. The importance of this, as outlined in a report by Susan Reinhard, Senior Vice President of AARP Public Policy Institute and Chief Strategist to the Center to Champion Nursing in America, is that “as states move more and more toward serving people in community settings, they may need to restructure the way nursing care is delivered and utilize nurses more in their teaching and consulting roles.”

Susan B. McDermott, who served as the director for this project had this to say about the program, "In my opinion, the RWJ grant that funded the nurse delegation project was some of the most well spent money ever for research in nursing practice. Although the sample was small, the preliminary results proved that nurses in the home care setting can make excellent decisions about practice and services provided to extremely vulnerable populations that result in excellent care in the home environment. It was a privilege to be part of this study."

Visit us here each week when we showcase the stories behind the photos that you submitted for our 2011 photo contest. Each Wednesday we will post pictures and share your stories. You were asked to identify one of four categories for entries that aligned with a recommendation area of the IOM future of nursing report as well as submit photos that highlighted health care in rural areas. As a result of these entries we are able to add more images to the CCNA public photo repository representing nurses, patients, and their families across health care, home, and education settings. Visit the CCNA public photo repository to view and use these images.