SECTION 748.575. In what circumstances may a physician or registered nurse (including an advanced practice registered nurse) delegate nursing tasks to unlicensed caregivers?


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  • The physician or registered nurse may delegate nursing tasks to unlicensed caregivers only if all delegation criteria are met for the task to be delegated, including, but not limited to:

    (1) The nursing task is one that a reasonable and prudent physician or registered nurse would find is within the scope of sound nursing judgment to delegate;

    (2) The physician or registered nurse determines that the nursing task can be properly and safely performed by the unlicensed caregiver without jeopardizing the child's welfare;

    (3) The operation employing or contracting with the unlicensed caregivers develops and follows a protocol, with input from a physician or registered nurse, for the instruction and training of unlicensed caregivers performing nursing tasks. The protocol must address:

    (A) An established mechanism for identifying those individuals to whom nursing tasks may be designated;

    (B) The manner in which the instruction addresses the complexity of the delegated task;

    (C) The manner in which the unlicensed caregivers demonstrate the competency of the delegated task; and

    (D) The mechanism for re-evaluation of the competency;

    (4) The training protocol recognizes that the final decision as to what nursing tasks can be safely delegated in any specific situation is within the specific scope of the physician's or registered nurse's judgment; and

    (5) A physician or registered nurse must instruct unlicensed caregivers in performing nursing tasks.

Source Note: The provisions of this §748.575 adopted to be effective January 1, 2007, 31 TexReg 7377; amended to be effective January 1, 2017, 41 TexReg 10393; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909