Is the registered nurse (RN) allowed to delegate the task of “reading” (measuring the induration) of a tuberculosis (TB) skin test to the nursing assistant-registered/nursing assistant-certified (NA-R/NA-C) or home care aide-certified (HCA-C) in community-based* and in-home care settings?
Yes. The RN may delegate the “reading” of a TB skin test to the NA-R/NA-C or HCA-C to allow for measuring the induration of the TB screening site in community-based*or in-home care settings. The RN is not allowed to delegate interpretation of the TB skin test.
Fact Sheets | Testing & Diagnosis | Fact Sheet - Tuberculin Skin Testing | TB | CDC
The RN must follow the nurse delegation process. 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 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