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Question
Is the registered nurse (RN) allowed to delegate suprapubic catheter care and suprapubic ostomy care to the nursing assistant-registered/nursing assistant-certified (NA-R/NA-C) or home care aide-certified (HCA-C)?
Answer

It depends. The RN may delegate to the NA-R/NA-C or HCA-C suprapubic catheter care and suprapubic ostomy care to the NA-R/NA-C or HCA-C using clean technique of an established (well-healed) urostomy. Examples include cleaning the urostomy site and changing the pouch. The statute and WACs prohibit RN delegation of tasks that use sterile technique in all settings. When nurse delegation is allowed, the RN must follow the 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 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

WAC 246-980-150: Standards of Practice

FAQ Category
Nursing Delegation
Audience