AGING AND DISABILITY SERVICES ADMINISTRATION
March 15, 2002
AASA: AFH #2002-006
SUBJECT: NEW NURSE DELEGATION WACS
Dear Adult Family Home Provider:
The requirements for Nurse Delegation were changed during the 2000 legislative session. The statutory authority that governs Nurse Delegation now includes both Chapter 18.79 RCW and Chapter 18.88A RCW. As a result, the Washington Administrative Code (WAC) for Nurse Delegation that was established in 1996 has been revised by the Department of Health (DOH). The new Nurse Delegation WAC 246-840-910 through 970 (enclosed) became effective on January 27, 2002. This letter is to provide you with an overview of the revisions.
1. What are the major changes in the Nurse Delegation WAC?
This new WAC:
- eliminates the task list for Nurse Delegation
- allows the registered nurse delegator to determine what tasks can be delegated
- extends the time-frame for re-evaluation and documentation to every 90 days
2. How does the registered nurse determine what tasks can be delegated?
The registered nurse is required to use the elements of the nursing process (assessing, planning, implementing, and evaluating) and an established protocol for making the decision about what tasks can be delegated. The patient must be in a stable and predictable condition at the time tasks are delegated.
3. Who can do nurse delegated tasks?
A nursing assistant who is either a nursing assistant-certified (CNA) or nursing assistant-registered (NAR) per chapter 18.88A RCW. The NAR must have successfully completed both the basic caregiver training and core delegation training. Both the CNA and NAR must have a certificate of completion for nurse delegation issued by DSHS.
4. What tasks are prohibited?
The new WAC still prohibits delegation of sterile procedures, injections, and central line maintenance.
5. What type of consents must be in place?
The nursing assistant must be willing to perform delegated tasks. The resident or authorized representative must give written informed consent. Documented verbal consent of the resident and/or representative is acceptable if written consent is obtained within 30 days. Electronic consent is acceptable.
6. What do I do if I am having problems with nurse delegation in my home?
Report any complaints with nurse delegation to the Complaint Resolution Unit (CRU) toll-free hotline at 1-800-562-6078. All complaints will be referred to the nursing care quality assurance commission for investigation.
7. Is nurse delegation mandatory?
Nurse delegation is not mandatory. However, if you provide any type of nursing service in your home, consult with your registered nurse as to whether nurse delegation would be appropriate.
Should you have any further questions about the new Nurse Delegation WAC,
please contact the DOH Nursing Care Quality Assurance Commission by telephone
at
(360) 236-4700, or online at http://www.doh.wa.gov/Nursing/default.htm.
Sincerely,
Patricia K. Lashway, Director
Residential Care Services
