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Question
Is the registered nurse (RN) allowed to delegate screening/diagnostic testing to the nursing assistant-registered/nursing assistant-certified (NA-R/NA-C) or home care aide-certified (HCA-C)?
Answer

It depends.  The RN is allowed to delegate simple, non-complex, and non-invasive screening and diagnostic testing to the NA-R/NA-C or HCA-C following the nurse delegation process. Examples include:

  • Electrocardiograms
  • Vision screening
  • Hearing screening
  • Spirometry

 

The RN must follow the nurse delegation process outlined in RCW 18.79.260 (3)(a) to determine if delegation is appropriate.

 

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 246-840-910: Purpose  

WAC 246-840-920: Definitions 

WAC 246-840-930: Criteria 

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 the statute and WACs 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

WAC 246-980-150: Standards of Practice

FAQ Category
Nursing Delegation
Audience