Aim To examine the delegation of medication administration, including the frequency of delegation, whether delegation was to a care worker or a registered nurse (RN) and whether care workers were directly supervised when administering medication.

Method Administration of 1,313 medication doses was observed on two inpatient psychiatric wards for older people.

Results Administration was delegated by the nurse preparing the medication for four out of every five doses, usually to another registered nurse (78% of delegated doses), but also to care workers (22%). Care workers were more likely to administer medications to confused and aggressive patients than were registered nurses.

Conclusion Care workers who undertake delegated medication administration should receive regular training to ensure safety. Nurses remain accountable for delegated medication administration.