The following standards must be met before the RN delegates
nursing tasks to unlicensed persons. These criteria apply to all instances
of RN delegation. Additional criteria, if appropriate to the particular
task being delegated, may also be found in §224.8(b)(1) of this
title (relating to Discretionary Delegation Tasks).
(1) The RN must make an assessment of the client's
nursing care needs. The RN should, when the client's status allows,
consult with the client, and when appropriate the client's family
and/or significant other(s), to identify the client's nursing needs
prior to delegating nursing tasks.
(2) The nursing task must be one that a reasonable
and prudent RN would find is within the scope of sound nursing judgment
to delegate. The RN should consider the five rights of delegation:
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 as determined by the RN.
(3) The nursing task must be one that, in the opinion
of the delegating RN, can be properly and safely performed by the
unlicensed person involved without jeopardizing the client's welfare.
(4) The nursing task must not require the unlicensed
person to exercise professional nursing judgment; however, the unlicensed
person may take any action that a reasonable, prudent non-health care
professional would take in an emergency situation.
(5) The unlicensed person to whom the nursing task
is delegated must be adequately identified. The identification may
be by individual or, if appropriate, by training, education, and/or
certification/permit of the unlicensed person.
(6) The RN shall have either instructed the unlicensed
person in the delegated task, or verified the unlicensed person's
competency to perform the nursing task. The verification of competence
may be done by the RN making the decision to delegate or, if appropriate,
by training, education, experience and/or certification/permit of
the unlicensed person.
(7) The RN shall adequately supervise the performance
of the delegated nursing task in accordance with the requirements
of §224.7 of this title (relating to Supervision).
(8) If the delegation continues over time, the RN shall
periodically evaluate, review, and when a change in condition occurs
reevaluate the delegation of tasks. For example, the evaluation would
be appropriate when the client's Nursing Care Plan is reviewed and
revised. The RN's evaluation of a delegated task(s) will be incorporated
into the client's Nursing Care Plan.
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