Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 11 - TEXAS BOARD OF NURSING › Chapter 225 - RN DELEGATION TO UNLICENSED PERSONNEL AND TASKS NOT REQUIRING DELEGATION IN INDEPENDENT LIVING ENVIRONMENTS FOR CLIENTS WITH STABLE AND PREDICTABLE CONDITIONS › Section 225.3 - Purpose

Current through Reg. 49, No. 28; July 12, 2024
(a) The Texas Board of Nursing (BON or Board)
				recognizes that public preference in the provision of health care services
				includes a greater opportunity for clients to share with the RN in the choice
				and control for delivery of services in the community based setting. The Board
				also appreciates that the provision of health care is dynamic in nature and
				continually evolving. As professional nurses, regardless of practice setting,
				RNs are obligated to assess the nursing needs of the client, develop a plan of
				nursing actions, implement this plan, and evaluate the outcome. These are
				essential components of RN practice that identify professional nursing as a
				process discipline. Professional nursing while inclusive of tasks is not
				focused on tasks but rather on interventions or client-centered actions
				initiated to assist the client in accomplishing the goals defined in the
				nursing care plan.
(b) In the
				independent living environment, RNs encounter clients across the spectrum of
				health to illness. The primary goal is to assist the choice of the client to
				achieve the most integrated setting/least restrictive environment throughout
				the life span. This is regularly accomplished, in part, through the assistance
				of unlicensed personnel who work with the client to complete a variety of tasks
				on a daily basis. Some tasks that are considered nursing tasks in the acute
				care setting are considered support services necessary to assist the client to
				maintain client health, and thus the highest degree of independence and quality
				of life possible, in the independent living environment.
(c) The purpose of this chapter is to provide
				guidance to RNs which includes advanced practice registered nurses practicing
				in independent living environments in incorporating the use of unlicensed
				personnel to achieve optimal health benefits for the client. Clients in these
				settings have needs that may be categorized as activities of daily living
				(ADLs), health maintenance activities (HMAs), or nursing tasks. For some
				clients, ADLs and HMAs may be of a routine and supportive nature that minimizes
				the need for RN involvement.
(d)
				The RN shall collaborate with the client and/or the client's responsible adult
				in pursuit of the highest possible degree of independent living for the client.
				By adequately and accurately assessing the needs of the client in this setting,
				and considering the inter-related factors impacting the client's environment,
				the RN can effectively make decisions in utilizing unlicensed personnel to
				accomplish quality supportive services and care.
(e) The RN nurse administrator or the RN who
				is responsible for nursing services in settings that utilize RN delegation in
				independent living environments shall be responsible for knowing the
				requirements of this rule and for taking reasonable steps to assure that
				registered nurse delegation is implemented and conducted in compliance with the
				Texas Nursing Practice Act and this chapter.