(Nursing Care Quality Assurance Commission)
Date of Adoption: January 30, 2004.
Purpose: Adopt emergency rules to implement chapter 140, Laws of 2003, allowing nursing assistants to accept nurse delegation in the in-home care setting. Amends WAC 246-841-405 to make the rules consistent with the new laws.
These rules were already adopted by emergency rule which is about to expire. Due to extensive stakeholder work and legal advice on these issues there have been some delays. This rule needs to continue to be in place for public protection. The anticipated implementation date is within the next one hundred twenty days.
Citation of Existing Rules Affected by this Order: Amending WAC 246-841-405.
Statutory Authority for Adoption: Chapter 18.88A RCW and RCW 18.79.260 (3)(f).
Under RCW 34.05.350 the agency for good cause finds that immediate adoption, amendment, or repeal of a rule is necessary for the preservation of the public health, safety, or general welfare, and that observing the time requirements of notice and opportunity to comment upon adoption of a permanent rule would be contrary to the public interest.
Reasons for this Finding: RCW 18.79.760 (3)(d)(2) allows nurse delegation to nursing assistants in the in-home care setting. This law has an emergency clause which makes the law effective immediately.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 1, Repealed 0.
Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.
Number of Sections Adopted Using Negotiated Rule Making:
Pilot Rule Making:
or Other Alternative Rule Making:
Effective Date of Rule: March 4, 2004.
January 30, 2004
Frank Maziarski, RN, ARNP
Nursing Commission Chair
AMENDATORY SECTION(Amending WSR 96-06-029, filed 2/28/96, effective 3/30/96)
WAC 246-841-405 Nursing assistant delegation. Provision for delegation of certain tasks.
(1) Nursing assistants may perform the following tasks,
when delegated by a registered nurse, for residents in
certified community residential programs for the
developmentally disabled, residents in licensed adult family
and)) to residents of licensed boarding homes
contracting to provide assisted living services, and to
residents in an in-home care setting as defined by chapter
140, Laws of 2003:
(a) Oral and topical medications and ointments;
(b) Nose, ear, eye drops, and ointments;
(c) Dressing changes and urinary catheterization using clean techniques;
(d) Suppositories, enemas, and ostomy care in established and healed condition;
(e) Blood glucose monitoring; and
(f) Gastrostomy feedings in established and healed condition.
(2) Any nursing assistant who receives authority to perform such delegated nursing task must, before performing any delegated task:
(a) For nursing assistants-registered, complete both the basic caregiver training and core delegation training as established by the department of social and health services.
(b) For nursing assistants-certified, complete the core delegation training as established by the department of social and health services.
(c) Comply with requirements and protocol established by the nursing care quality assurance commission in WAC 246-840-910 through 246-840-980.
(3) Any nursing assistant performing a delegated nursing care task pursuant to this section, shall perform the task:
(a) Only for the specific resident who was the subject of the delegation;
(b) Only with the resident's consent; and
(c) In compliance with all requirements and protocols established by the nursing care quality assurance commission in WAC 246-840-910 through 246-840-980.
(4) A nursing assistant may consent or refuse to consent to perform a delegated nursing care task listed in subsection (1) of this section, and shall be responsible for their own actions with regard to the decision to consent or refuse to consent and the performance of the delegated nursing care task.
[Statutory Authority: Chapter 18.88A RCW. 96-06-029, § 246-841-405, filed 2/28/96, effective 3/30/96.]