RN Delegation to Unlicensed Personnel
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.
About this policy
- Policy number
- TX-HH-DEL-02
- Version
- 1.0
- Main rule
- 26 TAC §558.298
- Library
- Texas home health · 56 policies
- Category
- Clinical tasks
- Sections
- 22
In short
- 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.
What's inside
22 sections. The full text comes with the One-time Policy Pack.
- 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
An inspector may ask
- 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?
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