The Nevada Nurse Practice Act and Delegation

1. The Nevada  Nurse Practice Act  and  Delegation Chris Sansom, BSN, RN Director of Operations Nevada State Board of Nursing

2. The Nevada Nurse Practice Act Nevada Revised Statutes � NRS 632 ? Bill passed by the Assembly and Senate and signed into law by the Governor Nevada Administrative Code � NAC 632 ? Adopted by the Board of Nursing to carry out the intent of the law Practice Decisions Scope of Practice

3. Roles and Responsibilities Registered Nurse (RN) ? Independent, dependent and interdependent Licensed Practical Nurse (LPN) ? At the direction of RN, APN, licensed physician, licensed physician assistant, or licensed podiatric physician Certified Nursing Assistant (CNA) ? At the direction and under supervision of RN or LPN Unlicensed Assistive Personnel (UAP) ?

4. Delegation - What does it mean? NAC 632.047 Delegation defined. �Delegation� means entrusting the performance of a delegable nursing duty to a person who is qualified and competent to perform the duty.�

5. OK, so what does it mean?

6. No really � what does it mean? Nurses possess the knowledge, skill and ability to coordinate and supervise the delivery of nursing care, which includes the assignment of nursing tasks to others.

7. ANA�s Definition The transfer of responsibility for the performance of an activity from one individual to another while retaining accountability for the outcome. Example: The nurse, in delegating an activity to an unlicensed individual, transfers the responsibility for the performance of the activity but retains professional accountability for the overall care.

8. Still confused? Think assignment of tasks and supervision Case study: Right task � is it safe? Right circumstance � client condition/setting? Right person � is it within their scope of practice? Right direction/communication � clear, concise? Right supervision � follow-up? Nurses delegate tasks, not their scope of practice.

9. Delegation in Nevada Does the Nevada Nurse Practice Act permit delegation? Yes - NAC 632.222 Delegation and supervision of nursing care

10. RN � Delegation Regulations NAC 632.212 (1)(f-h) � RN duties NAC 632.220 (1)(b) � Medications and treatment NAC 632.224 (1)(c,d), (2)(a,b) - Supervision NAC 632.244 � Unauthorized acts prohibited NAC 632.248 � Assignment to UAPs NAC 632.340 (4,7,8) � Exemptions from required licensing or certification

11. LPN � Delegation Regulations NAC 632.230 � Limitations; Supervision; Delegation NAC 632.222 - Delegation and supervision NAC 632.450 - Procedures delegable to LPNs NAC 632.455 - Procedures not delegable to LPNs

12. Nurse Apprentices NAC 632.063 � Nursing student NAC 632.252 � Performance of tasks NAC 632.253 � Prohibited acts

13. Unlicensed Assistive Personnel NAC 632.226 (2-4)(8) � Employment as school nurse; Qualified person

14. Responsibility of the nurse Patient advocacy Maintain accountability Choose to delegate (assign) or not to delegate (assign) Know the skill level of the healthcare team to provide safe and competent care to your patients Evaluate outcomes

15. Unprofessional Conduct The following acts related to delegation are considered unprofessional conduct by the Board and are grounds for disciplinary action. NAC 632.890 (6-8), (15), (19), (24) (27-28), (30), (33)

16. Handouts Delegation Decision-making Tree, National Council of State Boards of Nursing *Graphics retrieved from: http://www.bing.com/images/search?q=Funny+Nursing+Cartoons&FORM=IGRE&qpvt=Funny+Nursing+Cartoons#

17. Questions ??????