SECTION 225.9. Delegation Criteria

(a) When determining whether to delegate a nursing task or those ADLs or HMAs requiring delegation, the RN, in addition to the assessment under §225.6 of this title (relating to RN Assessment of the Client), shall:

(1) determine that the task does not require the unlicensed person to exercise nursing judgment;

(2) verify the experience and competency of the unlicensed person to perform the task, including the unlicensed person's ability to recognize and inform the RN of client changes related to the task. The RN must have either:

(A) instructed the unlicensed person in the delegated task; or

(B) verified the unlicensed person's competency to perform the nursing task based on personal knowledge of the training, education, experience and/or certification/permit of the unlicensed person.

(3) determine, in consultation with the client or the client's responsible adult, the level of supervision and frequency of supervisory visits required, taking into account:

(A) the stability of the client's status;

(B) the training, experience and capability of the unlicensed person to whom the nursing task is delegated;

(C) the nature of the nursing task being delegated;

(D) the proximity and availability of the RN to the unlicensed person when the nursing task will be performed; and

(E) the level of participation of client or client's responsible adult; and

(4) consider whether the five rights of delegation can be met: the right task; the right person to whom the delegation is made; the right circumstances; the right direction and communication by the RN; and the right supervision.

(b) The RN or another RN qualified to supervise the unlicensed person shall be available, in person or by telecommunications when the unlicensed person is performing the task.

(c) The competency of the unlicensed person to whom the nursing task is delegated must be adequately documented. The verification of competency may be by an individual or, if appropriate, by experience, training, education, and/or certification/permit of the unlicensed person.

(d) If the RN is employed, the employing entity must have a written policy acknowledging that the final decision to delegate shall be made by the RN in consultation with client or client's responsible adult.

Source Note: The provisions of this §225.9 adopted to be effective February 19, 2003, 28 TexReg 1386; amended to be effective February 24, 2014, 39 TexReg 1154