| Washington State House of Representatives Office of Program Research |
BILL ANALYSIS |
| Health Care & Wellness Committee | |
HB 2667
This analysis was prepared by non-partisan legislative staff for the use of legislative members in
their deliberations. This analysis is not a part of the legislation nor does it constitute a
statement of legislative intent.
Brief Description: Allowing the delegation of nursing tasks to care for persons with diabetes.
Sponsors: Representatives Morrell, McCoy, Green, Hunt, Wallace, Cody, Pedersen and Kenney.
Brief Summary of Bill |
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Hearing Date: 1/23/08
Staff: Chris Blake (786-7392).
Background:
Nursing assistants may either be registered or certified by the Department of Health depending
on their education and training. Nursing assistants may assist in providing care to individuals as
delegated by and under the supervision of a registered nurse. Nursing assistants working in
community-based or in-home care settings may provide additional nursing care tasks upon
completion of the Department of Social and Health Service's (DSHS) basic core nurse delegation
training.
Registered nurses may delegate nursing care tasks that are within the nurse's scope of practice to
other individuals where the nurse finds it to be in the patient's best interest. Before delegating a
nursing care task, the registered nurse must determine the competency of the person to perform
the delegated task and evaluate the appropriateness of the delegation. The registered nurse must
supervise the person performing the delegated task.
Registered nurses may not generally delegate acts requiring substantial skill or the
administration of medications unless the delegation is to a nursing assistant working in a
community-based or in-home care setting. The administration of medications by injection,
sterile procedures, and central-line maintenance may never be delegated to a nursing assistant in
a community-based or in-home care setting.
Summary of Bill:
The set up of diabetic insulin devices and verbal verification of insulin dosage for sight-impaired
individuals are considered "simple care tasks" which do not require delegation from a registered
nurse.
Upon delegation by a registered nurse, a nursing assistant may administer insulin by injection to
people with diabetes in community-based or in-home care settings. The delegating nurse must
provide instruction and a demonstration to the nursing assistant in the use of insulin and proper
injection procedures. The delegating nurse must provide regular supervision and evaluation of
each nursing assistant's performance.
Prior to providing care to individuals with diabetes who may require the administration of
insulin, nursing assistants must, in addition to other delegation training and credentialing
requirements, submit a certificate to the delegating nurse that documents completion of
specialized diabetes nurse delegation training approved by the DSHS. The training must include
instruction regarding diabetes, insulin, and proper injection procedures.
Legislative findings are made stating that over 15 percent of people over 65 years old have
diabetes and that current limitations on delegation authority limit the ability of people to remain
in their homes or in home-like settings. The stated legislative intent is to authorize registered
nurses to delegate the administration of insulin injections for elderly persons so that they may
continue to reside in their homes or home-like settings.
Appropriation: None.
Fiscal Note: Not requested.
Effective Date: The bill takes effect 90 days after adjournment of session in which bill is passed.