Wash. Admin. Code § 246-840-940

Current through Register Vol. 24-23, December 1, 2024

Section 246-840-940 - Washington state board of nursing community-based and in-home care setting delegation decision tree

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

Amended by WSR 24-13-079, Filed 6/17/2024, effective 7/18/2024

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.