Glossary of terms
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
A
Accountability: Being responsible and answerable or actions or inactions of self in providing nursing care or others in the context of delegation
Advanced Registered Nurse Practitioner (ARNP) Practice: Performance of the acts of the registered nurse and the performance of an expanded role in providing health care services as recognized by the medical and nursing professions, the scope of which is defined by rule by the Washington State Board of Nursing (WABON). Upon approval by the board, the APRN may prescribe legend drugs and controlled substances Schedule II-V.
Assistive Personnel (AP): Individuals health care providers trained to function in a supportive role by providing patient care activities through the nursing delegation process. The term applies to individuals who may have a health care credential (e.g., Nursing Assistant, Home Care Aide, Medical Assistant, and Surgical Technologist) or an individual without a credential. Also referred to as Unlicensed Assistive Personnel (UAP).
Assignment: The allocation of duties (e.g., responsibility for client care, interventions, or specific tasks as part of client care) to individuals whose scope of practice of a nurse or core competencies of assistance personnel.
Authorized Health Care Practitioner: A licensed health care practitioner who provides general direction to the registered nurse or licensed practical nurse within the health care practitioner's scope of practice:
- Advanced Registered Nurse Practitioner (ARNP);
- Physician and surgeon (MD);
- Physician assistant (PA) and Osteopathic PA;
- Dentist (DDS);
- Osteopathic physician and surgeon (DO);
- Naturopathic physician (ND);
- Podiatric physician and surgeon (DPM);
- Optometrist (OD); or
- Midwife.
C
Client-Specific/Patient-Specific: Refers to a specific individual who is receiving nursing care.
Clinical Lab Improvement Amendments (CLIA): Program that regulates laboratory testing and requires laboratories to be certified by the Center for Medicare and Medicaid Services (CMS) before they can accept human samples for diagnostic testing.
Clinical Lab Improvement Amendments (CLIA)-Waived Testing: Simple laboratory testing with a low risk of an incorrect result. These include some basic tests used for Point of Care (POC) testing and are often available over the counter for consumers. Examples include urine pregnancy tests, rapid strep tests, dipsticks for urine chemistry testing, blood glucose testing/glucometers, COVID-19 rapid tests, and fecal occult blood tests.
Clinical or Nursing Judgment: Observed outcome of critical thinking and decision making. It is an iterative process that uses nursing knowledge to observe and access presenting situations, identify and prioritize patient concerns, and generate the best possible evidence-based solutions in order to deliver safe patient care.
Community-Based Setting: Community residential programs for people with developmental disabilities, certified by the department of social and health services under chapter 71A.12 RCW; adult family homes licensed under chapter 70.128 RCW; and assisted living facilities licensed under chapter 18.20 RCW. Community-based care settings (Does not include acute care or skilled nursing facilities (Chapter 18.79 RCW)/
Complex Intervention, Activity, or Task: Require nursing judgment to safely alter standard procedures in accordance with the needs of the patient; or require nursing judgment to determine how to proceed from one step to the next; or require the multidimensional application of the nursing process. Complex interventions, activities or tasks may be more complicated because of the patient’s condition, the setting, the task or activity involved, and the skill level required to perform the intervention, activity, or task.
Competent: Demonstrated knowledge, skills, and ability in the practice of nursing or to perform a specific task.
Complex Nursing Situation: Patient's clinical and behavioral state is not predictable and rapid change in that state is reasonably anticipated.
Compounding: act of combining two or more ingredients in the preparation of a prescription.
Controlled Substance: Drugs and other substances that are considered controlled substances under the Controlled Substances Act (CSA) are divided into five schedules. An updated and complete list of the schedules is published annually in Title 21 Code of Federal Regulations (C.F.R.) §§ 1308.11 through 1308.15. Substances are placed in their respective schedules based on whether they have a currently accepted medical use in treatment in the United States, their relative abuse potential, and likelihood of causing dependence when abused. Controlled substances are a category of legend drugs.
Credentialing: Process of assessing and confirming the license or certification, education, training, and other qualifications or a licensed or certified healthcare practitioner.
D
Delegatee: One who is delegated a nursing responsibility by an advanced practice registered nurse, registered nurse, is competent to perform it, and accepts the responsibility. Examples include Nursing Assistants, Home Care Aides, Medical Assistants, Surgical Technologists, or non-credentialed individuals.
Delegation: Transferring the performance of a nursing task (that the person would not normally be allowed to do) to a competent individual in selected situations following the delegation process.
Delegator: One who delegates a nursing responsibility/task.
Direction: Instructions or orders to provide nursing services or carry out a medical regimen under the direction of an authorized health care practitioner.
Dispense: Interpretation of a prescription or order for a legend drug and, pursuant to that prescription or order, the proper selection, measuring, compounding, labeling, or packaging necessary to prepare the prescription or order for delivery.
E
Enhanced Services Facility (ESF): Facility that provides support and services to persons for whom acute inpatient treatment is not medically necessary (Chapter 70.97 RCW).
H
Health care facility: Any land, structure, system, machinery, equipment or other real or personal property or appurtenances useful for or associated with delivery of inpatient or outpatient health care service or support for such care or any combination thereof which is operated or undertaken in connection with hospital, clinic, health maintenance organization, diagnostic or treatment center, extended care facility, or any facility providing or designed to provide therapeutic, convalescent or preventive health care services, and shall include research and support facilities of a comprehensive cancer center, but excluding any facility which is maintained by a participant primarily for rental or lease to self-employed health care professionals or as an independent nursing home or other facility primarily offering domiciliary care (RCW 70.37.020).
Health care setting: Any setting in which health care nursing services are provided, licensed or unlicensed. Examples include (but not limited to) a nursing home, community-based facility (adult family home, assisted living facility, residential home for individuals with developmental disabilities), hospital, hospice care facility, home care agency, hospice agency, community behavioral health program, enhanced service facilities, private clinic, foster home, group home, medical spa, school setting, daycare setting, head start/pre-school setting, correction facility/jail, juvenile detention center, residential treatment center, psychiatric hospital, homeless shelter, supervised injection site, laboratory/diagnostic facility, ambulatory surgical facility, dialysis center, urgent care facility, and mobile clinic.
I
Individual Provider (IP): An individual working under contract or agreement with the Washington State Department of Social and Health Services.
In-home Care Settings: An individual's place of temporary or permanent residence (Does not include acute care or skilled nursing facilities, or community-based care settings (Chapter 18.79 RCW).
Intervention: Any act or action, based on clinical judgment and knowledge, that a nurse performs to enhance the health outcome of a patient.
L
Legend Drug or Prescription Drug: Any drugs which are required by state law or regulation of the pharmacy quality assurance commission to be dispensed on prescription only or are restricted to use by practitioners only. Controlled substances are a category of legend drugs.
Licensed Practical Nurse (LPN) Practice: The performance of services requiring the knowledge, skill, and judgment necessary for carrying out selected aspects of the designated nursing regimen under the direction and supervision of an authorized health care practitioner or under the direction and supervision of a RN.
Long-Term Care Worker (LTCW): Persons who provide paid, hands-on personal care services for the elderly or persons with disabilities, including individual providers of home care services, direct care workers employed by home care agencies or a consumer directed employer, and providers of home care services to persons with developmental disabilities under Title 71A RCW. RCW 70.127.010.
M
Medication Administration: When a nurse or other health care provider prepares, gives, and evaluates the effectiveness of prescription and non-prescription drugs. It means the direct application of a drug or device, whether by injection, inhalation, ingestion, or any other means, to the body of a patient or research subject. It also refers to guidelines in medication management, ensuring that drugs are administered safely and legally.
Medication Assistance: Assistance rendered by a nonpractitioner to an individual residing in community-based care settings and in-home care settings to facilitate the individual’s self-administration of legend drug or controlled substance. It includes reminding or coaching the individual, handing the medication container to the individual, opening the individual, handing the medication container to the individual, using an enabler, or placing the medication in an individual’s hand. This also includes help in preparing legend drugs or controlled substances for self-administration where a practitioner has determined and communicated that medication preparation assistance is necessary and appropriate. Medication assistance does not include assistance with intravenous medications or injectable medications, except prefilled insulin syringes (RCW 69.41.010) (RCW 69.41.085)
Medication Assisted Treatment (MAT): Use of the Food and Drug Administration (FDA) and approved opioid agonist medications for the maintenance treatment of opioid use disorders and opioid and opioid antagonist medication to prevent relapse to opioid use. MAT is only one aspect of substance use disorder management and is intended to be used in conjunction with evidence based behavioral health interventions.
Medication Organizer Device: Container with separate compartments for storing medications organized in daily doses. The device may include automated features, such as timed reminders, automatic dispensing, and remote monitoring.
Medication Self-Administration: patient manages and takes their own medications, identifies times and methods of administration, places the medication internally in or externally on their own body without assistance and without required supervision.
N
Nursing Assistant (NA): Individual, regardless of title, who, under the direction and supervision of a registered nurse or licensed practical nurse, assists in the delivery of nursing and nursing-related activities to patients in a health care facility. The two levels of nursing assistants are nursing assistant-certified (NA-C) and nursing assistant-registered (NA-R) (RCW 18.88A.020).
Non-Complex Interventions: Can be safely performed according to exact directions, does not require alteration of the standard procedure, and for which the results and patient responses are predictable.
Nurse Delegation Decision-Making Tool: Decision-making tool to determine if it is safe to delegate a task to unlicensed assistive personnel (UAP).
Nursing Judgment: Logical and systematic cognitive process of identifying pertinent information and evaluating data in the clinical context to produce informed decisions, which guide nursing actions and the delegation of nursing tasks.
Nursing Jurisprudence: In the context of nursing, it refers to the philosophy that guides the laws and rules governing nursing in Washington state and the actual laws and rules themselves. The guiding philosophy is to protect the public by regulating the competency and quality of nurses under its jurisdiction by establishing, monitoring, and enforcing qualifications for licensing, consistent standards of practice, continuing competency mechanisms, and discipline.
Nursing Scope of Practice Decision Tree: Decision-making tool to determine if an activity is within the nurse's legal boundaries and competency.
Nursing Task: Activities that constitute the practice of nursing as a licensed nurse and may include, but are not limited to, assistance with activities of daily living that are performed to maintain or improve the patient’s well-being when the patient is unable to perform that activity for themselves.
O
Opioid Treatment Program (OPT): Licensed program engaged in treatment of opioid addicted patients with approved schedule II opioids. Medication is ordered and dispensed from the OTP. Must be certified by the Substance Abuse and Mental Health Services Administration (SAMSHA) and assigned a Drug Enforcement Administration (DEA) registration identification.
Office Based Opioid Treatment (OBOT): Engaged in treatment of opioid addicted patients with approved narcotics less than Schedule II. Stand-alone clinic-based provider whose primary service is Medication Assisted Treatment (MAT), who employs or contracts with a provider who holds a current waiver with the Substance Abuse and Mental Health Services Administration (SAMSHA) and assigned a Drug Enforcement Administration (DEA) number for Buprenorphine prescribing for opioid use disorders.
Opioid Maintenance Therapy (OMT): Can be provided under any level of care. May be provided in an Outpatient Treatment Program (OTP).
P
Personal Aide: Individual, working privately or as an individual provider as defined in RCW 74.39A.240, who acts at the direction of an adult person with a functional disability living in their own home to assist with the physical performance of a health care task, as described in RCW 74.39.050, that persons without a functional disability can perform themselves (RCW 74.39.007).
Personal Care Services: Physical or verbal assistance with Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) due to functional limitations.
Practice Standards: Established practice that is accepted as correct within the nursing profession. These standards change as new methods and technology change. They are based on the most recent scientific data available and through the contribution of administrative, academic, and clinical experts.
Privileging: Process of authorizing a health care practitioner's specific scope of content and patient care services.
Professionalism: The conduct, aims, or qualities that characterize a profession or a member of the profession; competence or skills expected of a professional.
R
Reconstitution of Medications: Preparing medications in accordance with directions contained in approved labeling provided by the product’s manufacturer direction consistent with the labeling.
Registered Nurse (RN) Practice: Performance of acts requiring substantial specialized knowledge, judgment, and skill based on the principles of the biological, physiological, behavioral, and sociological sciences in either:
- The observation, assessment, diagnosis, care or counsel, and health teaching of individuals with illnesses, injuries, or disabilities, or in the maintenance of health or prevention of illness of others.
- The performance of such additional acts requiring education and training and that are recognized by the medical and nursing professions as proper and recognized by the commission to be performed by registered nurses licensed under this chapter and that are authorized by the commission through its rules.
- The administration, supervision, delegation, and evaluation of nursing practice. However, nothing in this subsection affects the authority of a hospital, hospital district, in-home service agency, community-based care setting, medical clinic, or office, concerning its administration and supervision.
- The teaching of nursing.
- The executing of medical regimen as prescribed by a licensed physician and surgeon, dentist, osteopathic physician and surgeon, podiatric physician and surgeon, physician assistant, osteopathic physician assistant, or advanced registered nurse practitioner, or as directed by a licensed midwife within his or her scope of practice what constitutes a permanent or temporary home.
Responsibility: Reliability, dependability, the obligation to accomplish work, and the obligation to perform at an acceptable level of the nurse's education.
Routine Nursing Situations: Relatively free of complexity, and the clinical and behavior state of the patient is relatively stable, requires care based upon a comparatively fixed and limited body of knowledge.
S
Self-Directed Care: Process in which an adult person, who is prevented by a functional disability from performing a manual function related to health care that an individual would otherwise perform for himself or herself, chooses to direct and supervise a paid personal aide to perform those tasks. Self-directed care under chapter 74.39 RCW must be directed by an adult client for whom the health-related tasks are provided. The adult client is responsible to train the individual provider in the health-related tasks which the client self-directs (RCW 74.39.007).
Stable and Predictable: Patient's clinical and behavior status is non-fluctuating and consistent. Stable and predictable may also include a terminally ill patient whose deteriorating condition is expected.
Supervision: Providing guidance and evaluation for the accomplishment of a nursing task or activity with the initial direction of the task or activity; periodic inspection of the actual act of accomplishing the task or activity; and the authority to require corrective action.
T
Telehealth Host Site: The location of the practitioner providing telehealth services. (Also referred to as Consulting Site, Originating Site, Physician Site, Provider Site, or Referral Site).
Telehealth – Mobile Health (mHealth): Health care and public health information provided through mobile devices. The information may include general educational information, targeted texts, and notifications about disease outbreaks. Examples include health care supported by mobile devices such as mobile phones, tablets, personal digital assistant (PDA), and wireless infrastructure. Within digital health, mHealth encompasses all applications of telecommunications and multimedia technologies for the delivery of healthcare and health information.
Telehealth Nursing: Method of delivering nursing care remotely using technology, including mobile devices, tablets, and computers.
Telehealth – Store-and-Forward (Asynchronous): the use of a camera (e.g., audio clips, video clips, still images) to record (store) an image that is transmitted (forwarded) to another site for review later. Examples include remote patient monitoring using devices to remotely collect and send data to a health care practitioner, agency, or diagnostic testing facility for interpretation. Examples include vital signs, electrocardiograms, continuous positive airway pressure, monitoring, and blood glucose monitoring.
Telehealth – Remote Patient Monitoring (RPM): The use of connected electronic tools to record personal health and medical data in one location for review by a provider in another location, usually at a different time.
Telehealth Remote Site: The location of the client/patient receiving telehealth services. (Also referred to as Client/Patient Site, Request Site, Distant Site, Participating Site, or Referring Site).
Telehealth – Telemedicine (Synchronous): The delivery of health care services using interactive audio and video technology, permitting real-time communication between the patient at the originating site and the provider, for the purpose of diagnosis, consultation, or treatment. It does not include the use of audio-only telephone, facsimile, or email.
Telepresenter: A health care professional at the originating site that presents a patient to the primary health care practitioner at the distant site who facilitates the visit including supporting communications, clinical, and technical workflows through the tele-encounter process.
U
Unlicensed Assistive Personnel (UAP): Individuals health care providers trained to function in a supportive role by providing patient care activities through the nursing delegation process. The term applies to individuals who may have a health care credential (e.g. Nursing Assistant, Home Care Aide, Medical Assistant, and Surgical Technologist) or an individual without a credential. Also referred to as Assistive Personnel (AP).