Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-840 - Practical and registered nursing › DELEGATION OF NURSING CARE TASKS IN COMMUNITY-BASED AND IN-HOME CARE SETTINGS › Section 246-840-940 - Washington state board of nursing community-based and in-home care setting delegation decision tree

Current through Register Vol. 24-14, July 15, 2024
In community-based and in-home care settings, before
					 delegating a nursing task, the registered nurse delegator shall decide if a
					 task is appropriate to delegate based on the decision tree:
(1)
Does the patient reside in one of the following
								settings? A community-based care setting as defined by
								RCW
								18.79.260 (3)(e)(i)  or an
								in-home care setting as defined by
								RCW
								18.79.260 (3)(e)(ii).
No [RIGHT ARROW]
Do not delegate
Yes [DOWN ARROW]
(2)
Has the patient or authorized representative given
								consent to the delegation?
No [RIGHT ARROW]
Obtain the written, informed consent
Yes [DOWN ARROW]
No [RIGHT ARROW]
(3)
Is RN assessment of patient's nursing care needs
								completed?
No [RIGHT ARROW]
Do assessment, then proceed with a consideration of
								delegation
Yes [DOWN ARROW]
(4)
Does the patient have a stable and predictable
								condition?
No [RIGHT ARROW]
Do not delegate
Yes [DOWN ARROW]
(5)
Is the task within the registered nurse's scope of
								practice?
No [RIGHT ARROW]
Do not delegate
Yes [DOWN ARROW]
(6)
Is the nursing assistant or home care aide,
								registered or certified and properly trained in the nurse delegation for
								nursing assistants or home care aides? Is the nursing assistant or home care
								aide trained in diabetes care and insulin injections when delegating
								insulin?
No [RIGHT ARROW]
Do not delegate
Yes [DOWN ARROW]
(7)
Does the delegation exclude the administration of
								medications by injection other than insulin, sterile procedures or central line
								maintenance?
No [RIGHT ARROW]
Do not delegate
Yes [DOWN ARROW]
(8)
Can the task be performed without requiring
								judgment based on nursing knowledge?
No [RIGHT ARROW]
Do not delegate
Yes [DOWN ARROW]
(9)
Are the results of the task reasonably
								predictable?
No [RIGHT ARROW]
Do not delegate
Yes [DOWN ARROW]
(10)
Can the task be safely performed according to
								exact, unchanging directions?
No [RIGHT ARROW]
Do not delegate
Yes [DOWN ARROW]
(11)
Can the task be performed without a need for
								complex observations or critical decisions?
No [RIGHT ARROW]
Do not delegate
Yes [DOWN ARROW]
(12)
Can the task be performed without repeated nursing
								assessments?
No [RIGHT ARROW]
Do not delegate
Yes [DOWN ARROW]
(13)
Can the task be performed properly?
No [RIGHT ARROW]
Do not delegate
Yes [DOWN ARROW]
(14)
Is appropriate supervision available? With insulin
								injections, the supervision occurs at least every two weeks for the first four
								weeks.
No [RIGHT ARROW]
Do not delegate
Yes [DOWN ARROW]
(15)
There are no specific laws or rules prohibiting the
								delegation?
No [RIGHT ARROW]
Do not delegate
Yes [DOWN ARROW]
(16)
Task is delegable
Statutory Authority:
						RCW
						18.79.110,
						18.79.260, 18.88A 060
						[18.88A.060], and 18.88A.210. WSR 09-06-006, § 246-840-940, filed 2/18/09,
						effective 3/21/09. Statutory Authority:
						RCW
						18.79.110,
						18.79.260(3)(f),
						18.88A.210, 2003 c 140. WSR
						04-14-065, § 246-840-940, filed 7/2/04, effective 7/2/04. Statutory
						Authority: Chapters 18.79 and 18.88A RCW. WSR 02-02-047, § 246-840-940,
						filed 12/27/01, effective 1/27/02. Statutory Authority: Chapter 18.79 RCW. WSR
						97-13-100, § 246-840-940, filed 6/18/97, effective 7/19/97; WSR 96-05-060,
						§ 246-840-940, filed 2/19/96, effective
						3/21/96.