(1)	Does the patient reside in one of the following settings? A community-based care setting as defined by RCW 18.79.260 (3)(e)(i) or an in-home care setting as defined by RCW 18.79.260 (3)(e)(ii).	No →	Do not delegate
	Yes ↓
(2)	Has the patient or authorized representative given consent to the delegation?	No →	Obtain the written, informed consent
	Yes ↓	No →
(3)	Is RN assessment of patient's nursing care needs completed?	No →	Do assessment, then proceed with a consideration of delegation
	Yes ↓
(4)	Does the patient have a stable and predictable condition?	No →	Do not delegate
	Yes ↓
(5)	Is the task within the registered nurse's scope of practice?	No →	Do not delegate
	Yes ↓
(6)	Is the nursing assistant or home care aide, registered or certified and properly trained in the nurse delegation for nursing assistants or home care aides? Is the nursing assistant or home care aide trained in diabetes care and insulin injections when delegating insulin?	No →	Do not delegate
	Yes ↓
(7)	Does the delegation exclude the administration of medications by injection other than insulin, sterile procedures or central line maintenance?	No →	Do not delegate
	Yes ↓
(8)	Can the task be performed without requiring judgment based on nursing knowledge?	No →	Do not delegate
	Yes ↓
(9)	Are the results of the task reasonably predictable?	No →	Do not delegate
	Yes ↓
(10)	Can the task be safely performed according to exact, unchanging directions?	No →	Do not delegate
	Yes ↓
(11)	Can the task be performed without a need for complex observations or critical decisions?	No →	Do not delegate
	Yes ↓
(12)	Can the task be performed without repeated nursing assessments?	No →	Do not delegate
	Yes ↓
(13)	Can the task be performed properly?	No →	Do not delegate
	Yes ↓
(14)	Is appropriate supervision available? With insulin injections, the supervision occurs at least weekly for the first four weeks.	No →	Do not delegate
	Yes ↓
(15)	There are no specific laws or rules prohibiting the delegation?	No →	Do not delegate
	Yes ↓
(16)	Task is delegable

[Statutory Authority: RCW 18.79.110, 18.79.260, 2012 c 164, and 2012 c 10. WSR 13-15-063, § 246-840-940, filed 7/15/13, effective 8/15/13. Statutory Authority: RCW 18.79.110, 18.79.260, 18.88A060 [18.88A.060], and 18.88A.210. WSR 09-06-006, § 246-840-940, filed 2/18/09, effective 3/21/09. Statutory Authority: RCW 18.79.110, 18.79.260 (3)(f), 18.88A.210, 2003 c 140. WSR 04-14-065, § 246-840-940, filed 7/2/04, effective 7/2/04. Statutory Authority: Chapters 18.79 and 18.88A RCW. WSR 02-02-047, § 246-840-940, filed 12/27/01, effective 1/27/02. Statutory Authority: Chapter 18.79 RCW. WSR 97-13-100, § 246-840-940, filed 6/18/97, effective 7/19/97; WSR 96-05-060, § 246-840-940, filed 2/19/96, effective 3/21/96.]

PDFWAC 246-840-940

Washington state nursing care quality assurance commission community-based and in-home care setting delegation decision tree.