Aging and Long-Term Support Administration Information for Professionals

AGING AND DISABILITY SERVICES ADMINISTRATION

HANDOUTS FOR Nurse Delegation Classes for Registered Nurses

The following are the class materials used for the Nurse Delegation Class. Download, print, and put these files in a ring binder in the order they appear below. Bring the ring binder with you to class.

Table of Contents

TAB 1 Nurse Delegation Handout – Required
TAB 2 Nurse Delegation Law - Required (RCW 18.79.260(3)(e) Please scroll to and print section (3)(e)
TAB 3 Nurse Delegation Rules - Required (WAC 246-840-910 to 970) Please print from section 910 through 970
TAB 4 Medication Assistance Rules – Required (WAC 246-888)
TAB 5 Sample Nursing Task Instruction Sheets – (20 pages) Optional
- Additional Task Sheets/Job Aids for delegating insulin may be found on the previous page
TAB 6 Self Directed Care Law – Required (RCW 74.39.050)
TAB 7 Nurse Delegation Forms - Required

10-217 Nurse Delegation: Credentials and Training Verification
- Word Format
- PDF format
13-678, Nurse Delegation: Consent for Delegation Process (page 1)
- Word Format
- PDF Format
13-678, Nurse Delegation: Instructions for Nursing Task (page 2)
- Word Format
- PDF Format
13-678A Nurse Delegation: PRN Medication
- Word Format
- PDF Format
13-678B Nurse Delegation: Assumption of Delegation
- Word Format
- PDF Format
13-680 Nurse Delegation: Rescinding Delegation
- Word Format
- PDF Format
13-681 Nurse Delegation: Change in Medical Orders
- Word Format
- PDF Format
14-484 Nurse Delegation: Nursing Visit
- Word Format
- PDF Format

TAB 8a Client Scenarios - Required
TAB 8b CARE Assessment for Client Scenarios - Required
Tab 9 Referral Form - Required
TAB 10 Adult Family Home Rules - Optional (WAC 388-76-1000 to 10995)
TAB 11 Boarding Home Rules - Optional (WAC 388-78A-2010 to 3230)
TAB 12 Adult Family Home or Boarding Home Assessment Form – Optional
TAB 13 DDD Rules - Optional
1. Supported Living WAC 388-101-3000
2. Group Homes WAC 388-101-3230
3. Certified Settings WAC 388-101-3010
4. DD Staff Training Requirements for Delegation WAC 388-101-3375
5. Voluntary Placement Program WAC 388-826-001 to 0250
6. Waiver Programs in DDD WAC 388-845-001-4015
TAB 14 Additional Documents For RN’s With A State Contract – Optional
- Skin Observation Protocol Forms
  - SOP Pressure Sore Assessment
  - SOP Basic Skin Assessment
- Request for Additional Units forms
- Contract Monitoring
  - Contract Monitoring Chart Audit Form
TAB 15 Certified Nursing Assistant Rules WAC 246-841
TAB 16 Home Care Aide WAC 246-980

OTHER REFERENCES TO BE DISTRIBUTED AT TRAINING

RND Statewide Report
Sample Chart and Sample Client Assessment