What is Nurse Delegation?
Through Nurse Delegation a non-nurse is “delegated” by a registered nurse to provide tasks that are usually performed only by a licensed nurse. State law requires that when a task is “delegated” specific rules are followed both by the nurse delegating the care and by the caregiver (a long term care worker) who performs the task. The rules are written by the Nursing Commission to make sure the public is safe and that everyone who participates in Nurse Delegation does it in the same way.
The specific program where a non-nurse legally performs nursing tasks such as giving medication in a client’s home, an adult family home (AFH) or a boarding home (BH) is called the Community-Based Nurse Delegation Program and the rules are written in WAC 246-840-910 to 970.
Community-Based Nurse Delegation
How Does it Work?
For private pay clients, a state contracted delegating nurse will assess the client’s nursing care needs and whether the client is appropriate for the Nurse Delegation Program.
Caregivers who perform delegated tasks must be registered or certified in WA State as Nursing Assistants or Home Care Aide-C without restrictions on their license. In addition, they must have completed a basic caregiving class and some specific Nurse Delegation classes.
Once the training and registration is completed, the delegating nurse will teach them to perform the nursing task for the specific client, and leave written instructions. The instructions must include how to perform the task, how to document it in the client record, and who to call if some specific problems arise. The RND must also supervise the caregivers every 90 days, and re-evaluate the client’s physical and psychological condition, to be sure they remain “stable and predictable.”
Can Every Task Be Delegated?
No, certain tasks are prohibited from being delegated. The nurse may never delegate injectable medications, except for insulin injections (began 1/2009), procedures that are considered “sterile” or tasks that require nursing judgment. All other tasks can be delegated at the discretion of the delegating nurse.
Is The Program Expensive?
Private pay clients may pay for this service independently. On average, barring complicated medical tasks or frequent changes in the treatment orders, the Nurse Delegation Program can cost from $250 to $500 per year.
Does the Caregiver Need Special Training?
State law requires delegated caregivers to be registered or certified as nursing assistants or home care aides. They must also take a basic caregiving class and a special nurse delegation class. If the caregiver is giving insulin injections, there is an additional class on diabetes and insulin injections.
The RND will train each nursing assistant individually to perform the task for a specific client’s needs. There will also be written instructions left for the caregivers to follow, and a place for them to document when the task is done, and how the client responds to it.
How Does Nurse Delegation Get Started?
For a private-pay client, ask your provider to contact the person who did your admission assessment to see if they think you qualify for this service.
For more information, contact one of the DSHS Nurse Delegation Program Managers:
Doris Barret firstname.lastname@example.org
Erika Parada email@example.com