Section 12 AAC 40.920 - Standards for delegation of routine duties(a) A physician, podiatrist, osteopath, or physician assistant licensed under AS 08.64 may delegate the performance of routine medical duties to an agent of the physician, podiatrist, osteopath, or physician assistant, if the following conditions are met: (1) the duty to be delegated must be within the scope of practice of the delegating physician, podiatrist, osteopath, or physician assistant; (2) a licensed physician, podiatrist, osteopath, or physician assistant must assess the patient's medical condition and needs to determine if a duty for that patient may be safely delegated; (3) the patient's medical condition must be stable and predictable; (4) the person to whom the duty is to be delegated has received the training needed to safely perform the delegated duty, and this training has been documented; (5) the delegating physician, podiatrist, osteopath, or physician assistant determines that the person to whom a duty is to be delegated is competent to perforin the delegated duty correctly and safely and accepts the delegation of the duty and the accountability for carrying out the duty correctly; (6) performance of the delegated duty would not require the person to whom it is delegated to exercise professional medical judgment oivknowledge of complex medical skills; (7) the delegating physician, podiatrist, osteopath, or physician assistant provides to the person, with a copy maintained on record, written instructions that include (A) a clear description of the procedure to follow to perform each task in the delegated duty;(B) the predicted outcomes of the delegated task; (C) Procedures For observing, reporting and responding to side effects, complications, or unexpected outcomes in the patient, and(D) the procedure to document the performance of the duty in the patient's record. (b) A physician, podiatrist, osteopath, or physician assistant who has delegated a routine duty to another person shall provide appropriate direction and supervision of the person, including the evaluation of patient outcomes. Another physician, podiatrist, osteopath, or physician assistant may assume delegating responsibilities from the delegating physician, podiatrist, osteopath, or physician assistant if the substitute physician, podiatrist, osteopath, or physician assistant has assessed the patient, the skills of the person to whom the delegation was made, and the plan of care. Either the original or substitute delegating physician, podiatrist, osteopath, or physician assistant shall remain readily available for consultation by the person to whom the duty is delegated, either in person or by telecommunication.(c) The delegation of a routine duty to another person under this section is specific to that person and for that patient, and does not authorize any other person to perform the delegated duty.(d) The physician, podiatrist, osteopath, or physician assistant who delegated the routine duty to another person remains responsible for the quality of the medical care provided to the patient.(e) Routine medical duties that maybe delegated to another person under the standards set out in this section means duties that (1) occur frequently in the daily care of a patient or group of patients;(2) do not require the person to whom the duty is delegated to exercise professional medical knowledge or judgment; (3) do not require the exercise of complex medical skills; (4) have a standard procedure and predictable results; and (5) present minimal potential risk to the patient. (f) Duties that require the exercise of professional medical knowledge or judgment or complex medical skills may not be delegated. Duties that may not be delegated include (1) the assessment of the patient's medical condition, and referral and follow-up; (2) formulation of the plan of medical care and evaluation of the patient's response to the care provided;(3) counseling of the patient and the patient's family or significant others regarding the patient's health;(4) transmitting verbal prescription orders, without written documentation, from the patient's health care provider; (5) duties related to pain management and opioid use and addiction;(6) the initiation, administration, and monitoring of intravenous therapy, including blood or blood products;(7) the initiation administration, and monitoring of procedural sedation; (8) assessing sterile wound or decubitus ulcer care; (9) managing and monitoring home dialysis therapy;(10) oral tracheal suction; (11) medication management for unstable medical conditions requiring ongoing assessment and adjustment of dosage or timing of administration; (12) placement and administration of nasogastric tubes and fluids;(13) initial assessment and management of newly-placed gastrostomy tubes and the patient's nutrition; and (14) the administration of injectable medications, unless (A) it is a single intramuscular, intradermal, or subcutaneous injection, not otherwise prohibited under 12 AAC 40.967(33); and(B) all other provisions of this section are met; and (C) the delegating physician, podiatrist, osteopath, or physician assistant is immediately available on site.(g) The provisions of this section apply only to the delegation of routine medical duties by a physician, podiatrist, osteopath, or physician assistant licensed under AS 08.64; they do not apply when duties have not been delegated, including when a person is acting (1) within the scope of the person's own license;(2) under other legal authority; or(3) under the supervision of another health care provider licensed under AS 08, who has authority to delegate routine dutiesEff. 12/25/2019, Register 232, January 2020 Authority:
AS 08.64.100
AS 08.64.106
AS 08.64.107
AS 08.64.170
AS 08.64.326
AS 08.64.336
AS 08.64.380