Utah Admin. Code 156-31b-701a

Current through Bulletin 2024-08, April 15, 2024

Section R156-31b-701a - Delegation of Nursing Tasks in a Non-school Setting

Under Subsections 58-31b-102(12)(g) and R156-31b-102(14), the delegation of nursing tasks in a non-school setting is as follows:

(1) Under Section 58-1-307.1, the nursing tasks that an unlicensed individual may perform without delegation by a health care provider are listed on the Division's website at https://dopl.utah.gov/nurse.

(2) A delegator retains accountability for the appropriate delegation of tasks and for the nursing care of the patient.

(3) Tasks that are appropriate for delegation with prior assessment are as follows:

(a) a delegator may not delegate to unlicensed assistive personnel a task requiring the specialized knowledge, judgment, or skill of a licensed nurse;

(b) a delegator may not delegate a task that is:

(i) outside the area of the delegator's responsibility;

(ii) outside the delegator's personal knowledge, skills, or ability; or

(iii) beyond the ability or competence of the delegatee to perform:

(A) as personally known by the delegator; and

(B) as evaluated according to generally accepted nursing practice standards of health, safety, and reasonable prudence; and

(c) a nursing task may be delegated if it meets the following criteria, as applied to each specific patient situation:

(i) it is considered routine care for the specific patient;

(ii) it poses little potential hazard for the patient;

(iii) it is generally expected to produce a predictable outcome for the patient;

(iv) it is administered according to a previously developed plan of care; and

(v) it does not inherently involve nursing judgment that cannot be separated from the procedure; and

(d) before determining which, if any, nursing tasks may be delegated, the delegator shall make a focused nursing assessment of the circumstances, and evaluate the following factors to determine the degree of supervision required to ensure safe care:

(i) the stability and condition of the patient;

(ii) the training, capability, and willingness of the delegatee to perform the delegated task;

(iii) the nature of the task being delegated, including the complexity, irreversibility, predictability of outcome, and potential for harm inherent in the task;

(iv) the proximity and availability to the delegatee of the delegator or other qualified nurse during the time when the task will be performed; and

(v) any immediate risk to the patient if the task is not carried out; and

(e) if a delegator, upon review of the criteria established in this subsection, determines that a proposed delegatee cannot safely provide the requisite care, the delegator may not delegate the task to the proposed delegatee.

(4) Requirements for instruction and demonstration of competency before the delegation of tasks are as follows:

(a) in delegating a nursing task, the delegator shall:

(i) provide instruction and direction necessary to allow the delegatee to safely perform the specific task;

(ii) explain the delegation to ensure that the delegatee understands which patient is to be treated, and according to what time frame; and

(iii) instruct the delegatee how to intervene in any foreseeable risks that may be associated with the delegated task; and

(b)

(i) if the employing facility or agency requires initial and ongoing demonstration of competency of direct patient care tasks, and makes competency documentation available to the delegator, the delegator may use that competency documentation;

(ii) if the employing facility or agency does not require demonstration of competency or does not provide competency documentation that is satisfactory to the delegator, or if a task falls outside tasks in which the proposed delegatee has previously been proven competent, the delegator or qualified educator shall:

(A) require the proposed delegatee to provide to the delegator or qualified educator a physical or verbal demonstration of the delegated task; and

(B) document the observed or spoken demonstration; and

(iii) teaching of a task, demonstration of competency, and documentation may be conducted per individual or in a group training session.

(5) Requirements for a delegator during the supervision and monitoring of a task are as follows:

(a) provide ongoing appropriate supervision and evaluation of the delegatee;

(b) ensure that the delegator or another qualified nurse is readily available, either in person or by telecommunication, to:

(i) evaluate the patient's health status;

(ii) evaluate the performance of the delegated task;

(iii) determine whether goals are being met; and

(iv) determine the appropriateness of continuing delegation of the task; and

(c) if the delegated task is to be performed more than once, establish a system for ongoing monitoring of the delegatee.

(6) A delegatee is prohibited from the following without express permission from the delegator:

(a) further delegate to another person a delegated task, or any part of a delegated task; or

(b) expand the scope of the delegated task.

(7) A medical facility's internal policies or practices required or allowed to be performed by an unlicensed person shall not be deemed to have been delegated by a licensee.

Utah Admin. Code R156-31b-701a

Amended by Utah State Bulletin Number 2017-2, effective 12/22/2016

Amended by Utah State Bulletin Number 2018-1, effective 12/11/2017

Amended by Utah State Bulletin Number 2021-02, effective 1/8/2021

Amended by Utah State Bulletin Number 2022-01, effective 12/27/2021

Amended by Utah State Bulletin Number 2023-03, effective 1/24/2023