(a) The licensed nurse delegates tasks based on the needs and condition of the client, potential for harm, stability of the client's condition, complexity of the task, predictability of the outcomes, ability of the staff to whom the task is delegated, and the context of other client needs.
(b) CNA may complement the APRN, RN, or LPN in the performance of nursing functions but shall not substitute for the APRN, RN, or LPN.
(c) Delegation shall be task-specific, client-specific, and CNA specific.
(d) The CNA role evolves from the performance of delegated nursing related tasks and services regardless of an individual's title or care setting.
(e) Delegation shall be directed by a APRN, RN, or LPN. - (i) The delegating APRN, RN, or LPN must delegate only those tasks which:
- (A) Are within his/her area of responsibility and scope of practice;
- (B) A reasonable, prudent APRN, RN, or LPN would find, within his/her sound nursing judgment, appropriate to delegate;
- (C) In the opinion of the APRN, RN, or LPN, shall be properly and safely performed by the CNA without jeopardizing the client's welfare;
- (D) Does not require the CNA to exercise nursing judgment, complex observations or nursing assessments, critical decision making or interventions except in an emergency situation; and
- (E) Are client specific, task specific, and CNA specific and outcomes are predictable.
- (ii) When delegating a nursing task, the APRN, RN, or LPN shall:
- (A) Make an initial assessment of the client's nursing care needs before delegating the task;
- (B) Verify the CNA's competence to perform any nursing task prior to delegation;
- (C) Verify appropriate continuing education for each CNA for each task to be performed;
- (D) Communicate with CNA allowing the opportunity to ask questions, provide feedback, or clarification;
- (E) Inform the client of the decision to delegate;
- (F) Provide appropriate direction or supervision;
- (G) Remain accountable for the delegated tasks;
- (H) Evaluate client outcomes and make adjustments accordingly; and
- (I) Make clear to the CNA that the delegated task cannot be re-delegated.
- (iii) Delegation is unnecessary if the particular activity or task is already within the legally recognized scope of practice or role of the individual who is to perform the activity or task;
- (A) An element of assignment exists in all delegation; however, for the purpose of these rules, assignment means that an individual designates another to be responsible for specific clients or selected nursing functions for specifically identified clients;
- (B) Both "assignment" and "delegation" decisions must be made by the licensed nurse on the basis of the skill levels of the care givers, the care needs of clients, and other considerations.