Ala. Admin. Code r. 610-X-7-.02

Current through Register Vol. 42, No. 8, May 31, 2024

Section 610-X-7-.02 - Delegation By School Nurses

(1) The school nurse is accountable and responsible for the nursing care delivered to students under the nurse's jurisdiction.

(2) Over-the-counter (OTC) medications may be administered to school children by the school nurse with a parent's written authorization and without a physician's authorization, unless the school system policy requires a physician authorization. Parental authorization requirements require the following documentation:

(a) The purpose of the OTC medication.

(b) The circumstances under which the over-the-counter medication can be administered.

(3) Licensed nurses who provide nursing care in the school setting through the twelfth grade may delegate specific tasks to unlicensed assistive personnel.

(4) The registered nurse is accountable for determining the tasks that may be safely performed by the unlicensed assistive personnel following appropriate training and demonstration of competency.

(5) Delegation of the use of the vagal nerve stimulator (VNS) in selected cases is not prohibited.

(6) The specific delegated tasks shall not require the exercise of independent nursing judgment or intervention. Specific tasks that require independent nursing judgment or intervention that shall not be delegated include, but are not limited to:

(a) Catheterization, clean or sterile.

(b) Administration of injectable medications, other than premeasured medication for allergic reactions, premeasured injection for opioid-related drug overdose and treatment of diabetes symptoms with insulin and glucagon, as described in Alabama Administrative Code 610-X-7-.10.

(c) Administration of rectal or vaginal medications.

(d) Calculation of medication dosages other than measuring a prescribed amount of liquid medication or breaking a scored tablet.

(e) Tracheotomy care, including suctioning.

(f) Gastric tube insertion, replacement, or feedings.

(g) Invasive procedures or techniques.

(h) Sterile procedures.

(i) Ventilator care.

(j) Receipt of verbal or telephone orders from a licensed prescriber.

(7) The task of providing prescribed oral, topical, ear, eye, nasal, and inhalation medications to a student through twelfth grade may be delegated to unlicensed assistive personnel by the school nurse only when the following conditions are met:

(a) The school nurse identifies the appropriate individual(s) to assist in providing prescribed medications.

(b) The unlicensed assistive personnel selected by the school nurse shall attend a minimum seven-hour course of instruction that includes a curriculum approved by the Board and have demonstrated competency to perform the delegated task.

(c) The school nurse shall provide periodic and regular evaluation and monitoring of the individual performing the delegated tasks.

(d) The school nurse shall routinely and periodically conduct quality monitoring of the tasks performed by the unlicensed assistive personnel, including but not limited to:

1. Training.

2. Competency.

3. Documentation.

4. Error reporting.

5. Performance of the seven (7) rights of medication administration.

(8) The school nurse delegating the task may, at any time, suspend or withdraw the delegation of specific tasks to unlicensed assistive personnel.

(9) The School Nurse Administrator, or his or her designee, shall conduct on-site compliance monitoring no less than once every three (3) years.

(10) The School Nurse Consultant or School Nurse Administrator shall submit a report(s) to the Alabama Board of Nursing in a format specified by the Board upon request. The report shall include, but not be limited to, the results of all compliance monitoring conducted during the designated reporting period.

Ala. Admin. Code r. 610-X-7-.02

Filed September 29, 1982. Repealed: Filed October 29, 2001; effective December 3, 2001. New Rule: Filed November 23, 2009; effective December 28, 2009.

Adopted by Alabama Administrative Monthly Volume XXXIV, Issue No. 10, July 29, 2016, eff. 9/8/2016.

Amended by Alabama Administrative Monthly Volume XXXV, Issue No. 10, July 31, 2017, eff. 9/3/2017.

Amended by Alabama Administrative Monthly Volume XXXIX, Issue No. 12, September 30, 2021, eff. 11/14/2021.

Author: Alabama Board of Nursing

Statutory Authority:Code of Ala. 1975, § 34-21-2(c)(21).