SENATE BILL REPORT
HB 1753
As Reported By Senate Committee On:
Health & Long-Term Care, April 2, 2003
Title: An act relating to nursing practices in community-based and in-home care.
Brief Description: Concerning nursing practices in community-based and in-home care.
Sponsors: Representatives Cody, Pflug, Skinner, Clibborn, Morrell, Benson and Edwards; by request of Department of Social and Health Services and Department of Health.
Brief History:
Committee Activity: Health & Long-Term Care: 4/1/03, 4/2/03 [DPA].
SENATE COMMITTEE ON HEALTH & LONG-TERM CARE
Majority Report: Do pass as amended.
Signed by Senators Deccio, Chair; Winsley, Vice Chair; Brandland, Franklin, Keiser, Parlette and Thibaudeau.
Staff: Rhoda Donkin (786-7198)
Background: In 1995, legislation passed allowing registered nurses to delegate specific nursing tasks to nursing assistants in certain health care settings. The law limited delegation to situations where the patient's condition could be determined to be "stable and predictable," and where the patient provided informed consent to the delegation. Tasks were limited to such things as oral and topical medications, nose, ear and eye drops, ointments, and suppositories. The delegation was authorized between an individual nurse, one assistant and a specific patient, and only after the nursing assistant had completed several hours of core training.
In 2000, the Legislature expanded nurse delegation in response to recommendations from the Department of Social and Health Services and the Nursing Care Quality Assurance Commission. The task list was eliminated and replaced with language that allows registered nurses to delegate tasks at their discretion. Specific prohibitions were instituted, including delegating injections or doing sterile procedures among other tasks. More licensed community settings were included in the expanded delegation law.
Summary of Amended Bill: The practice of nurse delegation as permitted in statute is expanded to include in-home settings.
The standard of practice for home health and hospice agencies is affirmed.
Medication assistance statutes are simplified to reflect current practice. While provider involvement is maintained if a medication needs to be altered, the requirement for provider authorization for routine medication assistance is removed.
Amended Bill Compared to Original Bill: The amended bill permits assistance with pre-filled insulin syringes.
Appropriation: None.
Fiscal Note: Not requested.
Effective Date: The bill contains an emergency clause and takes effect immediately.
Testimony For: Nurse delegation has worked well. This will expand a very successful program.
Testimony Against: None.
Testified: Penny Black, Patty Hayes, DSHS, DOH (pro); Laurie St. Ours, NODALPHA (pro w/amendment); Terry Kohl, WA State Residential Case Council (pro w/amendment); Blanche Jones, Home Care Assn. of WA (pro).