Nurse Delegation is a service authorized by Washington State Law that is used to delegate certain nursing tasks to properly trained and licensed nursing assistants and home health aides at CareForce. Washington State Law allows CareForce Registered Nurses to provide this service if the following criteria are met:
- A nursing Assessment is done to determine if the client is in a stable and predictable state. This includes a history and a review of body systems.
- The client is admitted to CareForce home health services.
- The licensed nursing assistants/home health aides have taken proper Nurse Delegation course work as approved by the Washington State Department of Social and Health Services
- The licensed nursing assistants/home health aides are in good standing with the proper Washington State DSHS.
- The delegated tasks are allowable by law (examples include): Oral medication administration, Eye or ear drop administration, Rectal suppository administration, Tube feeding administration, Bowel training programs, Blood Glucose monitoring, Insulin injection administration, Simple, clean wound care, Application of prescription creams or lotions to the skin, Straight catheterization, Other tasks as deemed appropriate by the RN.
- A specific Plan of Care is developed for the client related to the delegated task(s).
- Physician orders are obtained and a documentation system is in place.
- The licensed nursing assistant/home health aide agrees to provide the delegated task(s).
- Each licensed nursing assistant / home health aide is taught how to do the delegated task(s) as it related to the client’s specific needs.
- Documentation of nurse delegation activities as required by law.
- The registered Nurse changes the documentation and delegation task(s) as Delegation is needed as determined by the Registered Nurse’s assessment.
- All insulin Delegation begins with licensed nurse visits to determine the stability of the client’s insulin needs; then delegation of caregivers must be done in person at the client’s place of residence with at least 3 supervision visits by a nurse for each delegated caregiver (as required by law).
- Ongoing supervision and evaluation of care is conducted and documented as required by law. At a minimum, an evaluation will be done every 90 days. Every 6 months an update will be completed with a review of systems and communication with the physician.
All Caregivers who are giving delegated care to the client must be delegated by the nurse. The RN makes a judgement about how that delegation will be done according to the law. While CareForce strives to have the fewest caregivers delegated to the clients care, sometimes circumstances are that we have to delegate other caregivers over the course of the client’s care. This must be done to provide consistent, quality care and is required by law.
Insulin Injection Nurse Delegation : Nurse Delegation has two components, the RN time to set up and delegate the qualified caregivers and then the caregiver’s costs. The RN will set up the delegation, supervise and teach the qualified caregivers, and monitor the insulin injections over the course of about 3-4 weeks to determine that the situation is stable and predictable and meets the WA state law for delegation of insulin injections. Cost savings occurs after about the first month when your delegated caregivers are providing the insulin injections after their training.
Delegated Diabetes Caregiver Visit – 90 minutes : Delegation of qualified caregivers to provide both blood glucose monitoring and insulin injections can be a cost effective solution to the person who is at home and can no longer administer their own insulin. Once the CareForce RN carefully evaluates your medical issues, communicates with your medical provider, sets up a system for insulin administration, and teaches/ observes each caregiver at least 3 times, your costs for insulin administration will be much more affordable than paying for a licensed nurse to administer the insulin.
Nursing Visit : RN or LPN comes to your home to provide skilled nursing procedures.
Live-In – Nurse Delegation : Nurse Delegated Live-In Service
Live-In Service – Nurse Delegation – Couples:
Your home care aide stays at your home for 3-4 days at a time to help you with all of your care and homemaking needs. Two aides share a 7 day cycle.
Nurse Delegated Daytime Personal Care Service – 12 hours : Qualified home health aide provides all aspects of care for 12 hours during the day including nurse delegated services.