PREMIER NURSE DELEGATION
Bonnica Vuong began her healthcare journey in 2006. The first four years of her journey was spent at Seattle Children’s Hospital as a Certified Nursing Assistant. During this time, she attended Shoreline Community College to complete her pre-nursing prerequisites and eventually continued onto SCC’s rigorous Nursing Program. Bonnica was awarded her Registered Nurse License in 2010. Since then, she has gained a wide range of nursing experience. The foundation of her nursing skills and experience began at a skilled nursing facility specializing in Long Term Care and Dementia Care. Her passion and quality of care led to a promotion as a Resident Care Manager. During her role as the RCM of the Dementia Unit, she gained the skills of managing and overseeing resident care and team members, led in-service training, ensured medication accuracy and safety, and kept the unit organized and compliant to state regulations. After this management role, Bonnica sought to further her clinical nursing experience in a hospital setting. She found an excellent opportunity at Kindred Hospital in Seattle, where she was a staff nurse on the Medical/Surgical Unit. She further continued her hands-on nursing experience at a larger hospital, Providence Hospital in Everett, where she worked on the Medical Unit and Close Observation Unit. Extending her nursing experience, she enjoyed a few years as a Newborn ICU nurse. Bonnica left the hospital setting in the summer of 2017 to focus on her passion as a Washington State Contracted Nurse Delegator. Bonnica has been a Nurse Delegator since 2014. Under this role, she works with many adult family homes in Snohomish and King County. As a Nurse Delegator, she enjoys the ability to meet and collaborate with so many others who share a passion for caring and making a lasting impact on those we serve. Bonnica takes pride in her delegation services and through the years has continued to pour her passion into her work. She is very detail-oriented, organized, and always striving to be the best. Bonnica has great respect for AFH Providers and caregivers as she has walked in both those shoes before. Her experiences have taught her that having a great team and support from others really makes a big difference.
WHAT IS NURSE DELEGATION?
"The Nurse Delegation Program, under Washington State law, allows nursing assistants working in certain settings to perform certain tasks--such as administration of prescription medications or blood glucose testing--normally performed only by licensed nurses. A registered nurse must teach and supervise the nursing assistant, as well as provide nursing assessments of the patient's condition."
- WA State Department of Social Health and Services
PREMIER NURSE DELEGATION
As a Registered Nurse and a Washington State Contracted Nurse Delegator, I specialize in nurse delegation services, education and training to credentialed and certified caregivers. The Washington State Nurse Delegation Program first started in 1996 and through the years has come to include Adult Family Homes (AFHs), in-home settings, and Developmentally Disabled persons residing in group homes.
Nurse delegation services are services in compliance with WAC 246-840-910 through 246-840- 970 by a registered nurse to provide training and nursing management for nursing assistants who perform delegated nursing tasks. Services include the initial visit, care planning, competency testing of the nursing assistants, consent of the client, additional instruction and supervisory visits. Clients who receive nurse delegation services must be considered “stable and predictable” by the delegating nurse.
My approach to nurse delegation is as follows: after communication with the AFH Provider to discuss the client’s delegation needs, I review of the client’s assessment, current medications and orders, medical history, determine if the client is stable and predictable, then identify the nursing tasks that require delegation, (i.e. oral medication administration, topical medications, eye drops, inhalers, suppositories, blood sugar monitoring, insulin injections, etc.) The tasks that require nurse delegation are those that the resident cannot perform the last step (i.e. placing medication in the ordered route) or if the resident has an impairment in cognition/awareness (i.e. Alzheimer’s, Dementia, Confusion, Seizure disorders, etc.) or if the client does not know how to ask for the needed medication. After verifying the caregivers’ credentials and training certificates, I then delegate and teach the tasks to the caregivers. I delegate using various methods, including orally, written instructions, physical demonstration, visual job aids, videos, using actual medications/supplies, etc. The caregivers’ understanding and ability to carry out the delegated tasks accurately is verified by return demonstration and by their oral explanation of how to perform the tasks. As mentioned earlier, one of my responsibilities is to continue to provide ongoing supervision and evaluation of the tasks as needed and every 90 days or sooner.
As a Nurse Delegator, I do NOT provide emergency/on-call services or independent nursing duties. Nurse delegators cannot delegate injections (other than insulin injections), sterile procedures, central line maintenance, and acts that require nursing judgement. The client must be stable and predictable. The AFH Provider or Resident Manager is responsible to notify me of any changes in client’s condition, medications, or treatment plan.
A comprehensive assessment is required by law for residents moving into AFHs. This assessment is required to be updated annually, upon significant change in condition and after readmission from the hospital. For Medicaid clients, the state-appointed Case Manager has the responsibility of creating and updating the assessment, as well sending a referral to a nurse delegator when nurse delegation is needed. For private-paying clients, a RN Assessor creates and updates the assessment and the AFH Provider contacts the Nurse Delegator when nurse delegation services are needed.
Each Nurse Delegator determines his/her own fees for the above tasks. No insurance
company, long-term care policy or Medicare covers Nurse Delegation Services. (State Medicaid clients are the only clients whose fees are covered by their state insurance.)
I look forward to being a partner in your care. If you have any questions, please feel free to call or email me.
Bonnica Vuong, RN, RND Premier Nurse Delegation
"Alone we can do so little,
Together we can do so much."