| (a) The RN, in consultation with the client if 16 or
older, and when appropriate the client's responsible adult, must make
an assessment to determine if the care:
(1) qualifies as an ADL or HMA not requiring delegation;
(2) can be delegated to an unlicensed person; or
(3) should not be delegated and only performed by a
nurse.
(b) In making this determination, the RN shall consider
each of the following elements of assessment to develop an overall
picture of the client's health status:
(1) the ability of the client or client's responsible
adult to participate in the health care decision and ability and willingness
to participate in the management and direction of the task;
(2) the adequacy and reliability of support systems
available to the client or client's responsible adult;
(3) the degree of the stability and predictability
of the client's health status relative to which the task is performed;
(4) the knowledge base of the client or client's responsible
adult about the client's health status;
(5) the ability of the client or client's responsible
adult to communicate with an unlicensed person in traditional or non-traditional
ways; and
(6) how frequently the client's status shall be reassessed.
(c) While each element must be assessed, strength in
one factor may compensate/offset a weakness in another factor. The
assessment under this section does not require the RN to know either
the specific unlicensed person who will perform the tasks or the specific
qualifications of the unlicensed person who will perform the tasks,
thus the RN is not required to determine the competency of the unlicensed
person.
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