SENATE BILL REPORT
SHB 1218
As Reported By Senate Committee On:
Health & Long-Term Care, February 23, 2000
Title: An act relating to department of health recommendations for improving nurse delegation in community settings.
Brief Description: Modifying provisions related to nurse delegation of tasks.
Sponsors: House Committee on Health Care (originally sponsored by Representatives Cody and Parlette; by request of Department of Health).
Brief History:
Committee Activity: Health & Long‑Term Care: 3/29/99, 4/1/99 [DPA]; 2/23/00 [DPA-WM].
SENATE COMMITTEE ON HEALTH
& LONG-TERM CARE
Majority Report: Do pass as amended and be referred to Committee on Ways & Means.
Signed by Senators Thibaudeau, Chair; Wojahn, Vice Chair; Costa, Deccio, Franklin, Johnson and Winsley.
Staff: Rhoda Jones (786-7198)
Background: In 1995 the Legislature authorized nurses to delegate specific nursing tasks to nursing assistants serving persons in community residential programs for the developmentally disabled, adult family homes, and boarding homes contracting with the Department of Social and Health Services to provide assisted living services to clients.
The nursing tasks that were authorized for delegation include oral and topical medications; nose, ear and eye drops; dressing changes and catheterization; suppositories, enemas, ostomy care; blood glucose monitoring; and gastrostomy feedings.
Summary of Amended Bill: The settings where nurse delegation may occur is expanded to include all boarding homes. Hospitals and skilled nursing homes are excluded.
A registered nurse is not limited to delegating specific tasks. Delegation may occur when the nurse decides it is in the best interest of the patient and after the nurse has evaluated the competency of the nursing assistant and ascertained that delegation is appropriate and safe.
Certain tasks may not be delegated, including acts requiring substantial skill, the administration of medications and piercing or severing of tissues except to nursing assistants providing care to individuals in community-based care settings. Medications by injection, sterile procedures, and central line maintenance may never be delegated. Acts requiring nursing judgment may not be delegated.
On or before June 30, 2001, the Nursing Care Quality Assurance Commission must by rule make needed revisions in the nurse delegation protocols, including standards for informed consent.
The prohibitions against coercing nurses to delegate and employer reprisal are transferred to the Nurse Practice Act, including the requirement of stable and predictable patient status, and the immunity of nurses from liability within the limits of the protocol.
Amended Bill Compared to Original Bill: The amended bill changes the date for the completion of rules from June 30, 2000 to 2001.
Appropriation: None.
Fiscal Note: Available.
Effective Date: Ninety days after adjournment of session in which bill is passed.
Testimony For: Nurse delegation has been very successful in its current settings and the practice should be expanded. This will allow more people to live in residential care, instead of nursing homes.
Testimony Against: None.
Testified: PRO: Nick Federici, WAHSA; Jerry Reilly, WHCA; Patty Hayes, DOH; Lauri St. Ours, Nor. ALFA.