(a) This chapter does not apply to the following situations:

(1) Nursing services rendered during an epidemic or a state or national disaster;

(2) The rendering of assistance by anyone in the case of an emergency;

(3) Emergency services rendered by ambulance personnel trained in advanced life support under a licensed physician’s supervision as defined in Chapter 97 of Title 16. “Advanced life support” is defined in Chapter 97 of Title 16;

(4) The incidental care of the sick in private homes by members of the family, friends, domestic servants or persons primarily employed as housekeepers;

(5) Nursing services rendered by a student enrolled in a State Board of Nursing approved school of professional or practical nursing when these services are incidental to the course of study; or those nursing services rendered by a professional nurse or practical nurse enrolled in a State Board of Nursing approved refresher course pending reinstatement, reactivation or endorsement of licensure;

(6) The practice of nursing in this State by a nurse licensed in another state whose employment requires such nurse to accompany and care for a patient temporarily in this State, provided the nursing services are not rendered for more than 3 months within 1 year and such nurse does not claim to be licensed in this State;

(7) The practice of nursing by a nurse licensed in another state employed by the United States government or any bureau, division or agency thereof;

(8) The practice of nonmedical nursing in connection with healing by prayer or spiritual means in accordance with the tenets and practice of a well-recognized church or religious denomination, provided that persons practicing such nonmedical nursing do not claim to be licensed under this chapter;

(9) Auxiliary care services performed by nurse’s aides, attendants, orderlies and other auxiliary workers in medical care facilities, or elsewhere by persons under the direction and supervision of a person licensed to practice nursing, medicine, dentistry or podiatry, and performing those services which are routine, repetitive and limited in scope, and that do not require the professional judgment of a registered nurse or a licensed practical nurse; provided, however, that nothing contained herein shall limit the right of any person to act pursuant to [former] § 1703(e)(7) of this title [repealed], or persons employed in similar positions in the offices of podiatrists or dentists without being licensed under this chapter;

(10) The administration of prescription or nonprescription medication by child care providers who have successfully completed a state-approved medication training program and who administer the medication to a child in child day care homes or child day care centers regulated by the State under The Delaware Child Care Act, Chapter 30A of Title 14.

a. Medication may be administered under this paragraph (a)(10) if the child’s parent or legal guardian provides all of the following:

1. Written permission for the administration of the medication.

2. The medication in its original container, properly labeled.

b. Properly labeled medication must include instructions for administration of the medication;

(11) Nursing services rendered by a graduate of a State Board of Nursing approved school of professional or practical nursing working under supervision, pending results of the first licensing examination. The Board shall establish the procedure and extent to which subsequent examinations may be taken and the length of time and the character of nursing service which may be rendered pending subsequent examinations;

(12) The practice of any currently licensed registered nurse or licensed practical nurse of another state who provides or attends educational programs or provides consultative services within this State not to exceed 14 days in any calendar year. Neither the education nor consultation may include the provision of patient care, the direction of patient care or the affecting of patient care policies.

(13) Educators, coaches, or persons hired or contracted by schools serving students in kindergarten through grade 12 who assist students with medications that are self-administered during school field trips and approved school activities outside the traditional school day or off-campus that have completed a Board of Nursing approved training course developed by the Delaware Department of Education;

(14) Attendants providing basic and ancillary services defined and regulated by the Department of Health and Social Services in conformity with the Community-Based Attendant Services Act, Chapter 94 of Title 16;

(15) A competent individual who does not reside in a medical facility or a facility regulated pursuant to Chapter 11 of Title 16, may delegate to unlicensed persons performance of health-care acts, unless of a nature excluded by the Board through regulations, provided:

a. The acts are those individuals could normally perform themselves but for functional limitations; and

b. The delegation decision is entirely voluntary.

c. Nothing contained herein shall diminish any legal or contractual entitlement to receive health-care services from licensed or certified personnel;

(16) The limited lay administration of medications pursuant to § 1932 of this title.

(17) a. The administration of prescription or nonprescription medications by a direct care worker to an adult individual who resides in the adult individual’s own residence if the administration is authorized by a responsible caregiver and all of the following apply:

1. The responsible caregiver prepackages the medication to be given by the direct care worker by date and time and provides the direct care worker with written instructions regarding the administration procedure. Each medication must be packaged separately and labeled with the medication name and dosage. The responsible caregiver may decide which medication is to be given by the direct care worker to the adult individual.

2. The responsible caregiver and a personal assistance services agency enter into an agreement regarding the administration of medication under this paragraph (a)(17). The agreement must include confirmation by the responsible caregiver that both the medication to be administered and the process for administering the medication are safe and appropriate.

b. For purposes of this paragraph (a)(17):

1. “Direct care worker” means an individual employed by or under contract to a personal assistance services agency to provide a consumer with personal care services, companion services, homemaker services, transportation services, and those services authorized by this paragraph (a)(17).

2. “Residence” means a dwelling considered to be home by an adult individual. “Residence” does not include any facility licensed by the Department of Health and Social Services under Title 16 or Title 29.

3. “Responsible caregiver” means an individual 18 years old or older who is the primary caretaker for an adult individual.

c. This paragraph (a)(17) applies to the administration of prescription or nonprescription medications by any route except the following:

1. Injection.

2. Intravenous therapy.

3. Through the rectum or vagina.

4. Through a catheter.

5. Through a feeding tube, including nasogastric, gastrostomy, or jejunostomy tubes.

d. This paragraph (a)(17) does not apply to the administration of a controlled substance listed on Schedule II or IV under subchapter II of Chapter 47 of Title 16.

e. A direct care worker may administer medication under this paragraph (a)(17) only if the worker has successfully completed an administration of medications training program approved by the Secretary of Department of Health and Social Services.

f. A direct care worker who administers medication under this paragraph (a)(17) shall document, in writing, the medications administered by the worker and provide the documentation to the personal assistance services agency that employs the worker. The personal assistance services agency shall retain the documentation and make it available to the Secretary of Department of Health and Social Services for inspection on request.

g. A personal assistance services agency, or its employees or authorized agents, is not liable for the death of or injury to an adult individual caused by an act or omission of a direct care worker under this paragraph (a)(17), unless the adult individual’s death or injury was caused in part or solely by the negligence of the personal assistance services agency, or its employees or authorized agents.

h. In any action for negligence based upon a claim of a failure to adequately train or instruct a direct care worker, it is a defense that the direct care worker was given and following instructions provided under this paragraph (a)(17) of this section.

(b) Persons involved in the rendering of electrolysis treatments shall be eligible for licensing under this chapter regardless of whether the applicant is in compliance with § 1910(6) of this title, or § 1914(6) of this title, so long as such applicants are in compliance with either § 1910(1)-(5) or § 1914(1)-(5) of this title.

24 Del. C. 1953, § ?1920; 54 Del. Laws, c. 153; 57 Del. Laws, c. 634; 57 Del. Laws, c. 668, §§ ?9, 10; 64 Del. Laws, c. 26, § ?1; 65 Del. Laws, c. 466, § ?1; 66 Del. Laws, c. 21, §§ ?1, 2; 68 Del. Laws, c. 93, §§ ?1-3; 68 Del. Laws, c. 162, § ?2; 71 Del. Laws, c. 478, § ?2; 73 Del. Laws, c. 32, § ?1; 73 Del. Laws, c. 41, § ?1; 73 Del. Laws, c. 193, § ?3; 74 Del. Laws, c. 260, § ?1; 77 Del. Laws, c. 220, § ?1; 78 Del. Laws, c. 340, § ?1; 80 Del. Laws, c. 83, § ?2; 81 Del. Laws, c. 299, § 1; 82 Del. Laws, c. 42, § 1; 82 Del. Laws, c. 184, §§ ? 2, 3;