Is the registered nurse (RN) allowed to delegate to the nursing assistant-registered/nursing assistant-certified (NA-R/NA-C) or home care aide-certified (HCA-C) the task of performing routine, non-complex screening tests, such as growth and developmental screening, vision screening, and hearing screening?
It depends. The RN may delegate to the NA-R/NA-C or HCA-C the performance of routine, non-complex screening tests, such as growth and developmental screening, vision screening, and hearing screening, if the screening does not require nursing judgment, puncturing of the skin, or sterile procedure. In all settings, the RN must follow the delegation process outlined in RCW 18.79.260 (3)(a) to make that determination.
In addition, the following statute and WACs are applicable to nurse delegation in community-based* and in-home care settings:
RCW 18.79.260: Registered Nurse—Activities Allowed—Delegation of Tasks
WAC 246-840-940: Community-Based and In-Home Care Nursing Delegation Decision Tree
WAC 246-840-950: How to Make Changes to Delegated Tasks
WAC 246-840-960: Rescinding Delegation
WAC 246-840-970: Accountability, Liability, and Coercion
*Community-based settings include adult family homes, assisted living facilities, and residential homes for individuals with developmental disabilities (RCW 18.79.260).
The HCA-C is allowed to work only in community-based*, in-home care settings, and enhanced service facilities. The following statutes and WACs are applicable to nurse delegation to the HCA-C, in addition to those noted above:
RCW 18.88B.070: Nurse Delegated Tasks
WAC 246-980-130 Provision of Delegation of Certain Tasks to the HCA-C
WAC 246-980-140: Scope of Practice for Long-Term Care Workers