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Advisory Opinions

Overview

The broadly written laws and rules allow nurses to practice to their full scope of practice in any setting. It is impossible for the Nursing Care Quality Assurance Commission (NCQAC) to provide a comprehensive listing of the duties that licensed nurses are permitted to perform since nursing practice is reflective of the dynamic changes occurring in healthcare and society. The Revised Code of Washington (RCW) 18.79 and Washington Administrative Code (WAC) 246-840 provide the statutory and legal basis of nursing practice. The nursing commission provides advisory opinionsinterpretive statements, and guidance documents related to specific areas of nursing practice.

These documents are approved by the nursing commission and offer information and general guidance regarding the practice of professional nursing in the State of Washington. However, they do not constitute legal advice. You should contact your legal advisor to obtain advice with respect to any particular issue or problem.

If you have a question related to nursing practice in the state of Washington, please use the tools provided by the scope of practice decision tree and the approved documents below.

Other Guidance Documents

Additional Advisory Resources

For further guidance, please contact nursingpractice@doh.wa.gov or arnppractice@doh.wa.gov for advanced nursing practice questions.

Document ID Name Approved Date Nurse Type Nursing Group Type
NCAO 1.01 Perioperative Registered Nurse First Assistant (RNFA) RN, LPN, ARNP Surgical Settings, Perioperative Nursing, Surgical Nursing
NCAO 2.01 Camp Nursing RN, LPN, NA, UAP Camp Nursing, Non-Traditional Health Care Setting, School Nursing, Nursing Delegation
NCAO 3.00 Neonatal Intubation and Related Procedures RN, LPN, ARNP All Settings
NCAO 5.02 Portable Order for Life Sustaining Treatment (POLST) RN, LPN, ARNP, NA, UAP All Settings, POLST
NCAO 7.10 Administration of Sedating, Analgesic, and Anesthetic Agents RN, LPN All Settings, Medication Management, Medication Administration
NCAO 8.10 Prevention and Treatment of Opioid-Related Overdoses RN, LPN, ARNP, NA, UAP, NT All Settings
NCAO 9.00 Public Health Nurses: Dispensing Medications/Devices for Prophylactic and Therapeutic Treatment of Communicable Diseases and Reproductive Health RN, LPN All Settings, Public Health Nursing, Medication Management, Standing Orders
NCAO 10.00 Completion of Death Certificates by Advanced Registered Nurse Practitioners RN, LPN All Settings
NCAO 11.01 Compounding and Reconstituting Medications RN, LPN All Settings, General, Medication Management
NCAO 12.00 Medical Acupuncture ARNP All Settings, Holistic Nursing, Complementary Nursing, Alternative Nursing
NCAO 13.02 Registered Nurse and Licensed Practical Nurse Scope of Practice RN, LPN All Settings, General SOP
NCAO 14.10 Delegation of Blood Glucose Monitoring RN, LPN, NA, UAP Nursing Delegation, Community-Based Nursing, Home Care Nursing
NCAO 15.01 Registered Nurse Delegation in School Settings RN, LPN, NA, UAP School Nursing, Nursing Delegation, Non-Traditional Health Care Setting
NCAO 16.01 Opioid Use Disorder Medication Assisted Treatment – Nurse Care Managers and Scope of Practice RN, ARNP Nurse Case Managers, Nurse Care Coordinators, Behavioral Health Nursing, Medication Management, Substance Use Disorder, Controlled Substances, Mental Health, Medication Assisted Treatment Facilities, Behavioral Health Facilities, Psychiatric Hospitals, Mental Health Facilities, Substance Use Disorder Facilities
NCAO 17.01 Administration of Cannabis/Marijuana Products in School Settings RN, LPN School Nursing, Nursing Delegation, Non-Traditional Health Care Setting
NCAO 18.00 Advanced Registered Nurse Practitioner Scope of Practice: Repetitive Transcranial Magnetic Stimulation (rTMS) ARNP All Settings, Mental Health, Behavioral Health
NCAO 19.00 Role of the Nurse in Supervised Injection Services (SIS) Facilities RN, LPN, ARNP Nurse Case Managers, Nurse Care Coordinators, Behavioral Health Nursing, Medication Management, Substance Use Disorder, Controlled Substances, Mental Health, Medication Assisted Treatment
NCAO 20.03 Death with Dignity (Aid-in-Dying): Role of the Nurse RN, LPN, ARNP All Settings, POLST
NCAO 21.00 Mobile Anesthesia: Scope of Practice for Advanced Registered Nurse Practitioners ARNP
NCAO 22.00 Naloxone Prescribing Clarification RN, LPN, ARNP, NA, UAP All Settings
NCAO 23.01 Determining, Pronouncing, and Certifying Death RN, LPN, ARNP, NA, UAP All Settings, POLST
NCAO 24.00 Infusion Therapy Management RN, LPN, ARNP All Settings, Medication Management, Medication Administration
NCAO 25.00 Nursing Telehealth Practice: Registered Nurse, Licensed Practical Nurse, Nursing Technician, and Nursing Assistant RN, LPN, NA, UAP, NT All Settings
NCAO 26.00 Telehealth Advanced Practice Nursing Care Services ARNP All Settings
NCAO 27.00 Cosmetic/Aesthetic Dermatologic Procedures RN, LPN, ARNP All Settings
NCAO 28.01 Standing Orders RN, LPN, ARNP All Settings
NCAO 29.00 Verbal Orders RN, LPN, ARNP All Settings
NCAO 30.00 Seizure Disorder Management: Nursing Care Coordination RN, LPN, NA, UAP All Settings
NCAO 31.00 Endoscopy – Role of the Licensed Practical Nurse LPN All Settings