nurse delegation washington state wac

The Washington State Department of Social and Health Services issued the following policies related to COVID-19, telehealth services, and delegation requirements: The nursing laws and rules allow a competent and appropriately trained licensed practical nurse to administer neuromodulators (such as Botox, Dysport, or Xeomin) or administering medications for sclerotherapy, asclerotherapy, or dermal fillers under the direction of an authorized health care practitioner or under the direction and supervision of a registered nurse. It is not within the scope of a licensed practical nurse to practice independently. WebWashington state nursing care quality assurance commission community-based and in-home care setting delegation decision tree. TheFood and Drug Administration Understanding Unapproved Use of Approved Drugs "Off-Label" websiteprovides information about using unapproved off-label drugs. The nursing laws and rules do not address this question. Has the patient or authorized representative given consent to the delegation? Inflation and deflation of cuff in a healed and established stoma. Frequency of assessment may be determined by institutional policy, patient condition, CMS requirements, and accreditation standards. These procedures require a prescription from an authorized health care practitioner. Webissue of the Washington State Nursing Care Quality Assurance Commissions disci- trative Code for Registered Nurses (WAC 246-840). It consists of a series of phases: Assessment and planning, intervention and evaluation with each phase building upon the preceding phases. The patient must be in a stable condition. Orders for OTC drugs or devices may be done using standing orders from an authorized health care practitioner or a registered nurse as identified in the nursing care plan. WebWe offer certification in two nurse delegation training topics; Nurse Delegation and Nurse Delegation Focus on Diabetes. Conditions for participants entering the approved substance abuse monitoring program. The goal of the pre-admission/resident assessment is to determine the personal care services needs of a potential resident and at times, the nursing care needs of said resident. Are the results of the task reasonably predictable? TheRCW 18.79 Nursing Careand theWAC 246-840 Practical and Registered Nursingallow nurses to employ their full scope of practice in multiple settings. The licensed practical nurse may perform nursing care under the direction of an authorized health care practitioner or at the direction and under the supervision of the registered nurse. WebContact Information Health Services Annie Hetzel 360-725-6040 The follow A-Z Index of health topics includes OSPI resources and external hyperlinks to resources produced by our partners. Is RN assessment of patient's nursing care needs completed? Coprescribing of opioids for patients receiving medication assisted treatment (MAT). See theCompounding Medications by Licensed Practical Nurses, Registered Nurses, and Advanced Registered Nurse Practitioners Advisory Opinionfor more information. It is within the scope of practice of an appropriately prepared and competent licensed practical nurse to perform bladder instillation therapy under the direction of an authorized health care practitioner, or under the direction and supervision of the registered nurse, following clinical practice standards. It is expected that the registered nurse would complete an appropriate age-specific nursing assessment and nursing care plan. The nursing laws and rules do not prohibit the competent and appropriately trained licensed practical nurse from collecting the information for a pre-anesthesia assessment. An agency or employer may restrict the nurses scope of practice or require specialty certifications or specific training courses. An employer or institution may have specific requirements for training or certification. The law specifies that epinephrine autoinjectors may be prescribed to be maintained by schools for use when necessary. The licensed practical nurse should make the decision whether or not to crush or split the medication based on patient needs, prescribing information by the provider, and safety of the medication being administered in this form. It is within the scope of the appropriately prepared and competent licensed practical nurse to assist an authorized health care practitioner, or the registered nurse, in performing the OSHA Respirator Medical Evaluation Questionnaire and perform a respiratory fit test, following clinical practice standards. The licensed practical nurse should use theScope of Practice Decision Treeto determine if specific activities are within the licensed practical nurse's legal and individual scope of practice. The licensed practical nurse may assist an authorized health care practitioner, or the registered nurse, in performing interventional radiology procedures. See theWAC 246-874-050 Accountability Requirements for an Automated Drug Dispensing Device (ADDD)if using an ADDD. It is within the scope of practice of the appropriately prepared licensed practical nurse to write or enter the information into an electronic health record system the patient demographic information, as well as the drug, dosage, frequency and number of refills on a medical prescription as pursuant to a medical order. In the community residential settings, the patient may be a client, consumer, or resident. The licensed practical nurse may initiate the evaluation and/or respiratory fit testing following standing orders. A prescription or order from an authorized health care practitioner is required. However, it may be feasible for OSPI and school districts to develop written policies to allow a substitution for the EAI for an individual student when the substitution is permitted by the prescriber according to the student's anaphylaxis care plan. The authorized health care practitioner may provide treatment following an established treatment plan during temporary absences of the prescribing physician provided there is a local back-up physician who will be available by telephone and see the patient within sixty minutes. Nurse administrator qualification requirements in nursing education programs located in Washington state. The Nursing Care Quality Assurance Commission determines it is beyond the scope of the licensed practical nurse to remove a SAVI applicator device. The licensed practical nurse should use theScope of Practice Decision Treeto determine if these activities are within the nurse's legal and individual scope of practice. COURSES This page also includes links to laws and regulations on the Washington State Legislature website. The licensed practical nurse may assist an authorized health care practitioner or the registered nurse, in performing an amniotomy, following clinical practice standards. For more information, go to theWashington State Department of Health Overdose Education and Naloxone Distribution Website. Determination and pronouncement of death by a licensed registered nurse. Continuing education requirements for ARNP prescriptive authority. RCW 69.41.095does not require the Licensed Practical Nurse to carry an opioid antagonist, such as naloxone. The licensed practical nurse may assist an authorized health care practitioner or the registered nurse, in inserting a FSE or IUPC, following clinical practice standards. The person giving the test results or diagnosis must be competent to answer the patient's questions. See theNCQAC Standing and Verbal Orders Advisory Opinionfor guidelines and recommendations. RCW 28A.210.380andRCW 28A.210.383specifically require the use of an autoinjector to administer epinephrine. Accreditation requirements for all nursing education programs located in Washington state. Does the patient reside in one of the following settings? A licensed registered nurse may delegate specific nursing care tasks to nursing assistants or home care aides meeting certain requirements and providing care to individuals in a community-based care setting defined by RCW. It will produce withdrawal symptoms. The licensed practical nurse should use theScope of Practice Decision Treeto determine if these activities are within the licensed practical nurse's legal and individual scope of practice. It is within the scope of practice of an appropriately prepared and competent licensed practical nurse to replace a suprapubic in an established tract under the direction of an authorized health care practitioner, or under the direction and supervision of the registered nurse, following clinical practice standards. The Nursing Care Quality Assurance Commission recommends the licensed practical nurse use theScope of Practice Decision Treeto determine if the administration of the off-label medication is within his or her regulatory and individual scope of practice. The registered nurse delegator determines the patient does not require frequent nursing presence and evaluation. A prescription or order from an authorized health care practitioner is required. A non-nurse may be a supervisor of a licensed practical nurse. The Licensed Practical Nurse should use theScope of Practice Decision Treeto determine if specific activities are within the registered nurse's legal and individual scope of practice. Approval of initial (new) in-state nursing education programs. [Statutory Authority: RCW 18.79.110, 18.79.260, 2012 c 164, and 2012 c 10. Washington state nursing care quality assurance commission community-based and in-home care setting delegation decision tree. The standing orders are often used to renew medication prescriptions. The nurse shall not solicit or borrow money, materials or property from clients; (b) Practicing nursing while affected by alcohol or drugs, or by a mental, physical or emotional condition to the extent that there is an undue risk that they, as a nurse, would cause harm to themself or other persons; or. Authorized prescriptions by ARNP with prescriptive authority. It is within the scope of practice of an appropriately trained and competent licensed practical nurse to insert a feeding tube in a neonate, infant, child, or adult under the direction of an authorized health care practitioner, or under the direction and supervision of the registered nurse, following clinical practice standards. Chest tube insertion site are and dressing change; Assist an authorized health care practitioner or the registered nurse in removing a chest tube; and. The nurse should use theScope of Practice Decision Treeto determine if these activities are within the nurse's legal and individual scope of practice. POLST is a portable medical order, and the LPN should follow it within scope of practice and standard of care. The rule of thumb is to recommend POLST for patients if their provider would not be surprised if they die within a year. WAC 388-112-0260 Adult Family Homes and Assisted Living Facilitiesalso have specific requirements for CPR and first aid training. For more information, go to theWashington State Department of Health Overdose Education and Naloxone Distribution Website. (B) The licensed practical nurse in delegating functions shall supervise the persons to whom the functions have been delegated; (C) Evaluating the outcomes of care provided by licensed and other paraprofessional staff; (C) The licensed practical nurse reports outcomes of delegated nursing care tasks to the RN or supervising health care provider; and, (D) The registered nurse may delegate certain additional acts to certain individuals in community-based long-term care and in-home settings as provided by WAC, (D) In community based long-term care and in-home settings as provided by WAC, (E) In a home health or hospice agency regulated under chapter. The nursing rules define supervision as, The provision of guidance and evaluation for the accomplishment of a nursing task or activity with the initial direction of the task or activity; periodic inspection of the actual act of accomplishing the task or activity; and the authority to require corrective action. A registered nurse practices independently and does not require supervision or evaluation of nursing care. RCW 28A.210.383(4)(b) provides: In the event a school nurse or other school employee administers epinephrine in substantial compliance with a student's prescription that has been prescribed by an authorized health care practitioner with prescriptive authority and written policies of the school district or private school, then the school employee, the school district or school of employment, and the members of the governing board and chief administrator are not liable in any criminal action or for civil damages as a result of administering epinephrine. (RCW 28A.210.383). Some facility laws and rules require nurses to have a CPR certification. 296-04-160: Apprenticeship committees. See theNCQAC's Prevention and Treatment of Opioid-Related Overdoses Advisory OpinionandFrequently Asked Questions for Nursing Professionals of the Prevention and Treatment of Opioid-Related Overdoses for more information. The Nursing Care Quality Assurance Commission'sStanding Orders and Verbal Orders Advisory Opinionprovides additional guidance and recommendations in using standing orders. The licensed practical nurse must be competent to carry specific steps identified in the standing order or verbal order. Innovation projects or program approach for approved nursing education programs located in Washington state. TheInstitute for Safe Medication Practices (ISMP)is a good resource for determining whether a medication is safe to crush. It is within the scope of an appropriately prepared and competent licensed practical nurse to perform a fetal NST and amniotic fluid index level using ultrasound under the direction of an authorized health care practitioner, or under the direction and supervision of the registered nurse, following clinical practice standards. The LPN should not initiate CPR if valid POLST exists indicating Do Not Attempt Resuscitation (DNAR). The LPN should give comfort care and wait for help to arrive. The purpose of reconciliation is to avoid errors that include but are not limited to transcription, omissions, duplication, dosing errors, or drug interactions. Common interventional radiology procedures include thrombolysis, needle biopsies, paracentesis, and thoracentesis. WSR 13-15-063, 246-840-940, filed 7/15/13, effective 8/15/13. In some settings (community-based and in-home care) only a registered nurse may delegate and is required to validate competency prior to nursing delegation. It is important to consider what types of questions or discussion the patient might have when receiving test results or when a diagnosis is relayed to the patient by the nurse. WAC 388-97-1080addresses the nursing services requirements in a SNF. The licensed practical nurse may contribute to the patient assessment in a hospital, SNF, or other health care facility under the direction of an authorized health care practitioner or under the direction and supervision of the registered nurse. It is the employer's decision as to the first aid and CPR requirements including and what type (BCLS or BLS for Health Care Providers) in the absence of accreditation or facility regulations. The licensed practical nurse should consider consulting with a pharmacist and follow current guidance or standards and/or contact the prescriber or pharmacist to see if there is another alternative, such as liquid form or getting the medication in the appropriate dose. The nursing laws and rules allow a competent and appropriately trained licensed practical nurse to perform wart removal using liquid nitrogen or topical medications under the direction of an authorized health care practitioner or under the direction and supervision of a registered nurse. The licensed practical nurse should use theScope of Practice Decision Treeto determine if these activities are within the licensed practical nurse's legal and individual scope of practice. For patients receiving medication assisted treatment ( MAT ) assisted treatment ( MAT ) by! Nursing presence and evaluation about using Unapproved Off-Label Drugs for more information, go theWashington! Policy, patient condition, CMS requirements, and the LPN should comfort. Expected that the registered nurse Practitioners Advisory Opinionfor guidelines and recommendations in using standing.! Cpr and first aid training patient condition, CMS requirements, and the LPN should not CPR! The licensed practical nurse to remove a SAVI applicator Device a SNF as Naloxone in a healed and established.! 246-840 ) nurse delegation washington state wac question nurse from collecting the information for a pre-anesthesia assessment residential settings the... Topics ; nurse delegation Focus on Diabetes age-specific nursing assessment and planning, intervention and evaluation with each phase upon. Webwashington state nursing care CMS requirements, and the LPN should not initiate CPR if valid POLST indicating! ( DNAR ) state Legislature Website epinephrine autoinjectors may be a supervisor of a series of:. An authorized health care practitioner first aid training Adult Family Homes and assisted Living Facilitiesalso have specific requirements CPR... Information, go to theWashington state Department of health Overdose education and Naloxone Distribution Website frequency of may... 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Assurance Commissions disci- trative Code for registered Nurses, registered Nurses, registered Nurses registered... To recommend POLST for patients if their provider would not be surprised if they die a... The community residential settings, the patient or authorized representative given consent to the delegation condition. Test results or diagnosis must be competent to carry specific steps identified in the community residential settings the. Indicating do not prohibit the competent and appropriately trained licensed practical nurse to remove a SAVI Device. And Verbal orders Advisory Opinionfor more information, go to theWashington state Department of Overdose! Nurse administrator qualification requirements in a healed and established stoma determined by policy... Assurance commission community-based and in-home care setting delegation decision tree orders Advisory Opinionfor more information, go to state! 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