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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

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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.

WHO CAN BE DELEGATED?

Qualified and credentialed caregivers who have taken the required certification courses. The caregiver is required to have one of the following active licenses:

 

- NAR (Nursing Assistant Registered)

- HCA (Home Care Aide)

- CNA (Certified Nursing Assistant)

  • Oral medication administration

  • Topical skin cream/ointment/powder

  • Topical patches

  • Blood glucose monitoring

  • Subcutaneous Insulin administration

  • Inhalation medications

  • Nebulizer treatments

  • Oxygen via nasal cannula or mask

  • Eye drops/ointments

  • Ear drops

  • Nose sprays/drops

  • Sublingual medications

  • Rectal suppository/Enema

  • Vaginal cream/suppository

  • Gastrostomy tube administration

  • Ostomy care (colostomy/ileostomy/urostomy)

  • In & Out Catheter/ Catheter Irrigation

  • Suprapubic catheter care

  • Hospice Comfort Kit

  • Simple ‘non-sterile’ dressing changes

WHAT CAN BE DELEGATED?

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WHAT CANNOT BE DELEGATED?

  • Sterile procedures or processes

  • Injectable medications (except insulin and non-insulin injections for Diabetes)

  • Central line or IV maintenance

  • Acts that require nursing judgement

  • The client is unable to perform the last step/get the medication where it needs to go 

  • The client is unaware that he/she is taking medication

  • The client has dementia or a cognitive impairment and does not know how/when to ask for the appropriate "as needed" medications

  • The client requires the caregiver to puncture the skin for blood sugar monitoring or insulin administration

NURSE DELEGATION IS REQUIRED WHEN...

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