NURSE DELEGATION NORTH DAKOTA
FEBRUARY 17, 2010 ND BOARD OF NURSING
Constance B. Kalanek PhD, RNExecutive Director
1ND Board of Nursing
NDBON Overview NDCC Nurse Practice Act NDAC Rules Unlicensed Assistive Persons &
Medication AssistantsCollaboration with stakeholders
2ND Board of Nursing
ELEMENTS REQUIRED BEFORE DELEGATION CAN OCCUR1. Authority (legal)2. Role or job description3. Knowledge of responsibility4. Recognize accountability5. Trust
3ND Board of Nursing
CAN YOU DEFINE THE TERM “DELEGATION”?“Delegation" means: The authorization for the
performance of selected nursing interventions from a licensed nurse to an unlicensed assistive person NDAC 54-01-03(16).
4ND Board of Nursing
DEFINITIONS UNLICENSED ASSISTIVE PERSON
(UAP) – means an assistant to the nurse who regardless of title is authorized by the board to perform nursing interventions delegated and supervised by a licensed nurse. (NDCC 43-12.1-02(9).
5ND Board of Nursing
WHO ARE UAPs IN ND?-CNA in nursing home-HH & Hospice aide -Medical Assistant -Surgical Technician -NA in acute care-Workers in correctional facility, DD settings & home settings
6ND Board of Nursing
NURSE ACCOUNTABILITYSelfClientsEmployerNDBONProfession
7ND Board of Nursing
LIMITS ON DELEGATONAssessmentNursing DiagnosisPlan of CareTeachingCounselingTriageReceiving/transmitting orders
NDAC 54-05-04-05
8ND Board of Nursing
DESIRED DELEGATION OUTCOMES
Protection of client safetyAchievement of desired client
outcomesReduction of health care costsAccess to appropriate levels of
health careDecreased nursing liability
9ND Board of Nursing
KEYS TO DELEGATING EFFECTIVELY
Communicate continuouslyValue all team member
contributionsDevelop trust between co-
workersLearn from experience
10ND Board of Nursing
MEDICATION ASSISTANTSThree levels – I, II, IIIVariation in depth of programNDAC RulesDelegation process – not meant to
replace the nurse
11ND Board of Nursing
COLLABORATIVE EFFORTS - WORK GROUPS
Between state agenciesUnderstand the specifics of the
law & rulesAssist in the provision of care in
all settings.
12ND Board of Nursing
FAQI’m an RN who works with Quality
Service providers in a home setting. Can I delegate to the QSPs to assist the client in assistance with medication administration?
13ND Board of Nursing
APPROPRIATE/INAPPROPRIATE DELEGATION
Susan, a nurse works for a county social service , has delegated to Jane, the assistant, the task of assisting Mr. Jones with taking his medications. He is very shaky & can not open the bottle easily without spilling the contents. Did Susan do the right thing?
14ND Board of Nursing
APPROPRIATE/INAPPROPRIATE DELEGATION
Linda, a nurse working for the County Social Services has delegated to Bob, the assistant, the task of suctioning Mr. Clark. Mr. Clark has been on ventilator support for 15 years. Did Linda do the right thing?
15ND Board of Nursing
FAQI’m an RN who works in a self
directed cares program and I do not oversee the caregivers directly. What is my role in delegation?
16ND Board of Nursing
Questions
. Can I be sued if I make a mistake?
. If a UAP makes a mistake is my nursing license on the line?
17ND Board of Nursing