What criteria should the school nurse consider in determining whether it is safe and appropriate to delegate asthma-related tasks to non-credentialed assistive personnel?

The school nurse should use professional judgment and consider the following criteria to determine safe and appropriate delegation of asthma-related tasks to non-credentialed assistive personnel in the kindergarten through twelve grade, public and private school setting (RCW 28A.210 Common School Provisions: Health-Screening and Requirements):

• A health care plan and emergency care plan written by the school registered nurse in collaboration with the parent/guardian should be in place.
• The school registered nurse has received written orders related to the frequency of administration of bronchodilators, or other asthma-related medications, and any emergency orders.
• The delegated non-credentialed assistive personnel is competent to perform delegated asthma-related tasks.
• The delegated non-credentialed assistive personnel is certified in cardiopulmonary resuscitation (CPR) and first aid (strongly recommended).
• The parents/guardians have provided the school/school nurse with the necessary equipment and supplies to perform delegated asthma-related tasks.
• The parents/guardians have provided the school/school nurse with the required authorization forms and emergency information.
• Consider the following when delegating non-credentialed assistive personnel to monitor or provide emergency assistance to a student prepared to perform some or all of the asthma-related tasks independently:
  • Documentation from the health care provider indicating the student’s level of independent functioning;
  • Nursing documentation that the student has demonstrated competence in determining the need for assistance and use of medication administration devices and/or bronchodilator use;
  • Assurance the student will follow school policies and safety procedures