(a) When determining whether to delegate a nursing
task or those ADLs or HMAs requiring delegation, the RN, in addition
to the assessment under §225.6 of this title (relating to RN
Assessment of the Client), shall:
(1) determine that the task does not require the unlicensed
person to exercise nursing judgment;
(2) verify the experience and competency of the unlicensed
person to perform the task, including the unlicensed person's ability
to recognize and inform the RN of client changes related to the task.
The RN must have either:
(A) instructed the unlicensed person in the delegated
task; or
(B) verified the unlicensed person's competency to
perform the nursing task based on personal knowledge of the training,
education, experience and/or certification/permit of the unlicensed
person.
(3) determine, in consultation with the client or the
client's responsible adult, the level of supervision and frequency
of supervisory visits required, taking into account:
(A) the stability of the client's status;
(B) the training, experience and capability of the
unlicensed person to whom the nursing task is delegated;
(C) the nature of the nursing task being delegated;
(D) the proximity and availability of the RN to the
unlicensed person when the nursing task will be performed; and
(E) the level of participation of client or client's
responsible adult; and
(4) consider whether the five rights of delegation
can be met: the right task; the right person to whom the delegation
is made; the right circumstances; the right direction and communication
by the RN; and the right supervision.
(b) The RN or another RN qualified to supervise the
unlicensed person shall be available, in person or by telecommunications
when the unlicensed person is performing the task.
(c) The competency of the unlicensed person to whom
the nursing task is delegated must be adequately documented. The verification
of competency may be by an individual or, if appropriate, by experience,
training, education, and/or certification/permit of the unlicensed
person.
(d) If the RN is employed, the employing entity must
have a written policy acknowledging that the final decision to delegate
shall be made by the RN in consultation with client or client's responsible
adult.
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