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Why Nurse Delegation

Here’s the official explanation:

The Nurse Delegation Program, under Washington State law, allows nursing assistants working in certain settings to perform certain tasks--such as administration of prescription medications or blood glucose testing--normally performed only by licensed nurses. A registered nurse must teach and supervise the nursing assistant, as well as provide nursing assessments of the patient's condition.

That means a individual who needs nursing care, may be able to remain in their resident with support of qualified nurse delegator and certified caregiver. 

Where-does nurse delegation happen

  • Adult Family Homes ( 2 to 6 clients, no nurse on staff required) 
  • Assisted Living Facility (6 or more clients, may have a nurse on staff during some hours) 
  • In-Home (Clients live in their private homes) 
  • Supported Living (Clients live in their own home and may have roommates)  

What does the Nurse Delegator do

 The Nurse Delegator strives to assure delegation is safe and appropriate. 

 To do this the nurse delegator will :

  • Confirm caregiver has attend required training and has state required credentials 
  • Assess a client to determine appropriateness for nurse delegation  
  • Teach the caregiver the nursing task they will perform
  • Provide written instructions 
  • Evaluate the performance of the caregiver
  • Provide ongoing supervision of the client’s condition 
  • Provide ongoing supervision and evaluation of caregiver 

What about medication administration

  • Verify what medications are prescribed
  • Review the pharmacy record
  • Review the medication administration record
  • Verify medication changes 
  • Determine if there is a need to retrain the caregiver 
  • Update delegation instructions as needed

Insulin Delegation

Must verify caregiver once a week for the first four weeks of insulin delegation

Then every 90 day supervisor visits

In private homes RN will set up the client’s chart

  Nurse delegation forms 

  • Medication orders 
  • Medication administration records 
  • Credentials for all delegated caregivers
  • Progress notes

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