Can the registered nurse delegator use telehealth services to initiate and provide ongoing evaluation, and supervision of delegated tasks to UAP in community-based or in-home care settings during the COVID-19 emergency?

The nursing and nursing assistant laws and rules do not prohibit the registered nurse delegator from using telehealth services to initiate or provide ongoing evaluation, or supervision of delegated tasks to UAP. The nurse must use nursing judgment and consider what aspects of the initial and ongoing assessment, supervision, and evaluation need to be done face-to-face. Telehealth may not be appropriate in some circumstances. The most important consideration is whether it is safe for the patient to perform the initial and ongoing assessment, evaluation, or supervision using telehealth services following the nursing and delegation laws and rules (RCW 18.79, WAC 246-840, RCW 18.88A, WAC 246-841).

The Washington State Department of Social and Health Services issued the following policies related to COVID-19, telehealth services, and delegation requirements:

• D20-010 Assessment and Person-Centered Service Planning Process during COVID-19 Outbreak Policy (March 17, 2020)
• D20-028 Delivery of Skilled Nursing, Nurse Delegation, and Private Duty Nursing Services during the COVID-19 Outbreak (April 10, 2020)