According to IDAPA 23.01.01.401 Board of Nursing Rules, “In addition to providing hands-on nursing care, licensed registered nurses work and serve in a broad range of capabilities including, but not limited to, regulation, delegation, management, administration, teaching and case management. Licensed registered nurses, also referred to as registered nurses or as “RN’s”, are expected to exercise competency in judgement, decision making, implementation of nursing interventions, delegation of functions or responsibilities, and administration of all medications and treatments prescribed by legally authorized persons.”
Nursing delegation is an integral component to delivering care to individuals in care settings where nursing services are limited.
This “Tool Kit” was designed to provide a framework for compliance with the regulations governing assisted living facilities in Idaho. The general concepts apply to multiple settings. There are multiple ways to document compliance with the regulations. These tools are offered as samples and are meant to be adapted to meet the unique needs of each care setting. They have not been endorsed by any State entity.
The tool kit contains the following forms:
- When to Delegate flow chart.
- Nurse Delegation Tool Kit – Introduction
- Nurse Delegation Policy and Procedure
This is a SAMPLE policy and procedure. We suggest that it be modified to include the tasks that will be delegated in the specific care setting.
- Nurse Delegation in Residential Care (Preparation Checklist)
Prior to delegating tasks, it is suggested that the RN gather and review specific documents to ensure an understanding of the governing regulations and expectations of employer. Organize these materials for easy reference and retrieval in the event of an audit or survey.
- Personnel Record Review for Delegation (Instructions and Data Collection Tool)
Prior to delegating tasks to Unlicensed Assistive Personnel, the nurse must be certain of the qualifications and training of the UAP. We have provided a data collection tool with instructions to help the facility keep track of UAP information.
- UAP Skills Checklist for Nurse Delegation
Prior to delegating tasks to Unlicensed Assistive Personnel, the nurse should validate the training and competence of staff. The checklist contains common knowledge and skills for staff typically delegated to assist with medications. We recommend that hands on skill demonstrations be completed by the UAP to confirm competence. The skills checklist can be maintained in the employee file.
- Nurse Delegation: Assumption of Delegation
As one nurse leaves and another is hired to oversee the care of clients in a residential care setting, the delegation of tasks must be assumed by the oncoming nurse. The outgoing nurse should rescind the delegation of tasks under their nursing license. The Assumption of Delegation form is a client specific form outlining tasks specifically delegated for that client to specific staff members. This form would be filed in the client’s record.
- Nurse Delegation: Instructions for Nursing Task
As new tasks are delegated for specific clients, the nurse must give written and verbal instructions to staff. This form is offered as an option for outlining care expectations. It has room available for all delegated staff to sign on the form. This form would be filed in the client’s record.
- RN Supervision and Evaluation of Unlicensed Assistive Personnel
The RN is required to periodically supervise and evaluate the UAP. This evaluation form should be completed according to the care center’s expectations. (ie. For a new hire, the expectation may be that they are to be evaluated after the first month, then every 90 days, then annually). This form would be filed in the employee’s record.
- RN Delegation Rescinded
In the event that there is a change in a client’s condition or the UAP’s ability to perform delegated tasks or a change in nurses the RN should re-evaluate and rescind delegation, as needed. This form is intended to include all staff having delegation rescinded for an individual client. This form should be filed in the client’s record.
- Additional Resources for Assisted Living Nurses
The forms included in this tool kit are offered to assist nurses in record keeping for the delegation process. While the State Board of Nursing and Rules for Assisted Living outline specific requirements that must be met, there are NO MANDATED FORMS available for delegation. Modify the tools to meet individual center needs.
- Medication Assistance Observation Checklist
- Nurse Assumption of Delegation form
The forms included in this tool kit are offered to assist nurses in record keeping for the delegation process. While the State Board of Nursing and Rules for Assisted Living outline specific requirements that must be met, there are NO MANDATED FORMS available for delegation. Modify the tools to meet your individual center needs.