Wash. Admin. Code § 246-841A-405 - Registered nurse delegation to nursing assistants
In addition to the competencies identified in WAC 246-841A-400, nursing assistants may perform additional delegated tasks under the supervision of a registered nurse in accordance with RCW 18.79.260.
(1)
RCW
18.79.260 addresses general requirements for
registered nurse delegation as well as requirements specific to certain care
entities and settings, including home health or hospice agencies and
community-based or in-home care settings, as defined in the statute.
(2) General requirements for registered
nursing delegation that apply in all care settings include:
(a) In accordance with
RCW
18.79.260 (3)(f), registered
nurse delegation may include glucose monitoring and testing as a general
allowance, including in hospitals and nursing homes.
(b) Delegated nursing care tasks described in
this section are only for the specific patient receiving delegation.
(c) A nursing assistant may consent or refuse
to consent to perform a delegated nursing care task. The nursing assistant is
responsible for their own actions with the decision to consent or refuse to
consent and the performance of the delegated nursing care task.
(d) Nursing assistants shall not accept
delegation of, or perform, the following nursing care tasks:
(i) Administration of medication by
injection, except for insulin injections as authorized in
RCW
18.79.260 (3)(e);
(ii) Sterile procedures;
(iii) Central line maintenance;
(iv) Except as authorized in
RCW
18.79.260 (3)(e) and (f),
piercing or severing of tissues and acts requiring substantial skill;
and
(v) Acts requiring nursing
judgment.
(3)
RCW
18.79.260 (3)(e) defines
specific requirements for registered nurse delegation in community-based or
in-home care settings. WAC
246-840-910 through
246-840-970 provide additional
applicable requirements for compliance. Before performing any delegated task in
these care settings:
(a) Nursing
assistants-registered must show evidence as required by the department of
social and health services of successful completion of both the basic caregiver
training and designated nurse delegation core training from the department of
social and health services to the registered nurse delegator.
(b) Nursing assistants-certified must show
the registered nurse delegator evidence as required by the department of social
and health services of successful completion of required nurse delegation core
training. The training is provided by the department of social and health
services.
(c) All nursing
assistants registered and certified who may be completing insulin injections
must show to the registered nurse delegator evidence as required by the
department of social and health services of successful completion of nurse
delegation special focus on diabetes training.
(d) All nursing assistants must meet any
additional training requirements identified by the commission. Any exceptions
to additional training requirements must comply with
RCW
18.79.260
(3)(e)(v).
Notes
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