{"ref":"TX-HH-DEL-02","title":"RN Delegation to Unlicensed Personnel","category":"Clinical tasks","summary":"Requires every delegation of a nursing task to a home health aide or other unlicensed person to be made by an RN under the Texas Board of Nursing rules: Chapter 225 for stable and predictable conditions in an independent living environment, Chapter 224 for acute or unstable conditions. Sets out the RN’s assessment, the tasks that may and may not be delegated, the extra rules for pill reminder containers and insulin, written delegation, teaching, supervision, and re-evaluation.","inShort":["An aide may do a nursing task only if an RN has assessed the patient, taught or checked the aide, and delegated the task in writing.","A delegated task is for one patient only. Do not do it for anyone else.","Aides never take orders from a doctor, give injections other than delegated insulin, or calculate doses.","If the patient changes or you are unsure, stop and call the RN before you go on.","The final decision to delegate belongs to the RN. No one may pressure an RN to delegate."],"primaryCitation":"26 TAC §558.298","citations":["26 TAC §558.298","26 TAC §558.2","26 TAC §558.701","22 TAC ch. 224","22 TAC §224.6","22 TAC §224.7","22 TAC §224.8","22 TAC §224.11","22 TAC ch. 225","22 TAC §225.1","22 TAC §225.4","22 TAC §225.6","22 TAC §225.8","22 TAC §225.9","22 TAC §225.10","22 TAC §225.11","22 TAC §225.12","22 TAC §225.13","22 TAC §217.11"],"federalCitations":["42 CFR §484.80(g)","42 CFR §484.80(h)"],"surveyorAsks":["Show me the RN’s assessment and written delegation for this aide giving this patient’s medications.","Which Board of Nursing chapter applies to this patient, and how did the RN decide?"],"forms":[{"ref":"TX-HH-DEL-02-A","title":"RN Delegation Record"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (26 TAC §558.298)","5. Which Chapter Applies","6. Which Tasks May Be Delegated","7. Delegation Procedure","8. Additional Requirements for Specific Tasks","8.1 Health maintenance activities not requiring delegation (22 TAC §225.8)","8.2 Medications from a daily pill reminder container (22 TAC §225.11)","8.3 Insulin and other injectable diabetes medications (22 TAC §225.12)","8.4 Discretionary tasks under Chapter 224 (22 TAC §224.8(b))","9. Supervision of Delegated Tasks","10. Re-evaluation, Changes, and Withdrawal","11. Responsibilities","12. Records and Compliance Monitoring","13. Staff Training","14. References","15. Related Policies and Forms","16. Approval","17. Revision History"],"version":"1.0","sample":false,"pack":"tx-lhhs","state":"Texas","service":"Home health","guides":[{"path":"/guides/home-health-agency-policies/","h1":"What policies and procedures are required for home health agencies?"},{"path":"/guides/home-health-conditions-of-participation/","h1":"Home health Conditions of Participation: which policies each one needs"}],"agency":{"name":"Sample Home Health Agency","legalName":"Sample Home Health Agency, LLC","logo":null}}