Washington State House of Representatives Office of Program Research | BILL ANALYSIS |
Health Care & Wellness Committee |
HB 2473
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: Creating a medication assistant endorsement for certified nursing assistants who work in nursing homes.
Sponsors: Representatives Green, Hinkle, Johnson, Van De Wege, Ryu and Roberts.
Brief Summary of Bill |
|
Hearing Date: 1/23/12
Staff: Chris Cordes (786-7103).
Background:
The Department of Health registers nursing assistants and certifies those who complete required education and training as determined by the state Nursing Care Quality Assurance Commission (Nursing Commission). Nursing assistants may assist in providing care to individuals under the direction and supervision of a licensed or registered nurse. Nursing assistants work in various health care facilities, such as hospitals, nursing homes, hospices, and other entities delivering health care services.
A registered nurse 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 level of the person to perform the delegated task, evaluate the appropriateness of the delegation, and supervise the person performing the delegated task. With some exceptions, registered nurses may not delegate tasks requiring nursing judgment, substantial skill, the administration of medications, or the piercing or severing of tissues.
In home and community-based care settings, registered nurses may delegate medication assistance and certain other nursing tasks to nursing assistants working with patients who are in a stable and predictable condition. The nursing assistant must first complete Department of Social and Health Services' basic core nurse delegation training. The assistance may not include assistance with intravenous or injectable medications except for prefilled insulin syringes.
Registered nurses working for a home health or hospice agency are allowed to delegate the application, instillation, or insertion of medications to a registered or certified nursing assistant under a plan of care.
Summary of Bill:
A program is established to allow certified nursing assistants (CNA) to receive a medication assistant endorsement to administer under registered nurse supervision certain medications and treatments in a nursing home.
Medication Assistant Endorsement. Beginning July 1, 2013, a CNA may seek a medication assistant endorsement from the Department of Health. To be issued the endorsement, a CNA must:
maintain his or her nursing assistant certification in good standing;
complete the hours of documented work as a CNA that is required by the Nursing Commission;
successfully complete an education and training program approved by the Nursing Commission;
pass an examination approved by the Nursing Commission; and
complete continuing competency requirements as defined by the Nursing Commission.
Permitted Additional Tasks. A CNA with a medical assistant endorsement may perform and document the following additional tasks:
administer medications orally, topically, and through inhalation; and
perform simple prescriber-ordered treatments, as defined by the Nursing Commission, which may include monitoring blood glucose and blood oxygen saturation, changing noncomplex clean dressings, and administering oxygen.
These tasks may be performed only in a nursing home and only if supervised by a designated registered nurse who is on site and immediately accessible. The registered nurse must assess the patient and determine whether it is safe for the CNA to administer the medications or treatment.
Prohibited Tasks. A medication assistant may not:
accept telephone or verbal orders from a prescriber;
calculate medication dosages;
inject any medications;
perform any sterile task;
administer medications through a tube;
administer Schedule I, II, or III controlled substances; or
perform any task that requires nursing judgment.
A medication assistant's employer may restrict, but not expand, the range of functions permitted for a medication assistant. The Nursing Commission may, by rule, limit the duties that a CNA may perform while functioning as a medication assistant.
Appropriation: None.
Fiscal Note: Requested on January 13, 2012.
Effective Date: The bill takes effect on July 1, 2013.