Curriculum for registered nurse to bachelor's or master's in nursing education programs. BOX 47864, Olympia, WA 98504-7864, Location: 111 Israel Road SE, Tumwater, WA 98501, Subscribe to receive updates from the Nursing Commission, About | News| Meeting Schedule | Contact, Nursing Care Quality Assurance Commission, Washington Administrative Code (WAC) 246-840, Neonatal Intubation and Related Procedures Advisory Opinion, Standing Orders and Verbal Orders Advisory Opinion, WAC 246-320 Hospital Licensing Regulations, WAC 246-330 Ambulatory Surgical Facilities, WAC 388-112-0260 Adult Family Homes and Assisted Living Facilities, D20-010 Assessment and Person-Centered Service Planning Process during COVID-19 Outbreak Policy (March 17, 2020), D20-028 Delivery of Skilled Nursing, Nurse Delegation, and Private Duty Nursing Services during the COVID-19 Outbreak (April 10, 2020), Medical Quality Assurance Commission WAC 246-919-606 Nonsurgical Medical Cosmetic Procedures, Dentist Scope of Practice - Use of Botulinum Toxin Injections/Dermal Fillers Interpretive Statement, Medical Quality Assurance Commission WAC 246-919-605 Use of Laser, Light, Radiofrequency, and Plasma (LLRP) Devices as Applied to the Skin, Food and Drug Administration's website, Using Eye Cosmetics Safely, NCQAC Standing and Verbal Orders Advisory Opinion, WAC 246-870 Electronic Transmission of Prescription Information, Washington State Department of Health Pharmacies website, Compounding Medications by Licensed Practical Nurses, Registered Nurses, and Advanced Registered Nurse Practitioners Advisory Opinion, Washington State Tuberculosis Laws and Guidelines, Centers for Disease Control Guidelines for TB Screening and Follow-Up, Medication Organizer Device Letter from Secretary of Health (PDF), Food and Drug Administration Understanding Unapproved Use of Approved Drugs "Off-Label" website, Institute for Safe Medication Practices (ISMP), WAC 388-76 Adult Family Home Minimum Licensing Requirements, Washington State Department of Health Patient Rights Guidelines, Epinephrine Autoinjectors and Anaphylaxis Training and Reporting for Authorized Entities Frequently Asked Questions, NCQAC's Prevention and Treatment of Opioid-Related Overdoses Advisory Opinion, Frequently Asked Questions for Nursing Professionals of the Prevention and Treatment of Opioid-Related Overdoses for more information, WAC 246-865-060 Pharmaceutical Services-Extended Care Facility, WAC 246-874-050 Accountability Requirements for an Automated Drug Dispensing Device (ADDD), WAC 246-840 Practical and Registered Nursing, advisory opinions and interpretive statements, WAC 246-919-605 Use of Laser, Light, Radiofrequency, and Plasma (LLRP) Devices as Applied to the Skin. WebSee WAC 246-827-0240 for MA-certified. The patient must be in a stable condition. Established numerous primary care clinics. It may be within a licensed practical nurse's scope of practice to provide routine or basic training to UAP if the licensed practical nurse is competent under the direction of an authorized health care practitioner or under the direction and supervision of a registered nurse based on the nursing care plan. The registered nurse delegator ensures the task to be delegated can be properly and safely performed by the nursing assistant or home care aide. Suctioning of a non-established or established tracheostomy stoma. Washington state nursing care quality assurance commission community-based and in-home care setting delegation decision tree. It is within the scope of practice of an appropriately trained and competent licensed practical nurse to perform ostomy care under the direction of an authorized provider or under the direction and supervision of a registered nurse, following clinical practice standards. (6) The nurse shall only practice nursing in the state of Washington with a current Washington license; (7) The licensed nurse shall not permit their license to be used by another person; (8) The nurse shall have knowledge of the statutes and rules governing nursing practice and shall function within the legal scope of nursing practice; (9) The nurse shall not aid, abet or assist any other person in violating or circumventing the laws or rules pertaining to the conduct and practice of professional registered nursing and licensed practical nursing; or. The purpose of reconciliation is to avoid errors that include but are not limited to transcription, omissions, duplication, dosing errors, or drug interactions. The licensed practical nurse must work under the direction of an authorized health care practitioner or under the direction and supervision of a registered nurse. Provision for continuity of drug therapy for residents. The licensed practical nurse should use theScope of Practice Decision Treeto determine if these activities are within the nurse's legal and individual scope of practice. Competent practice may require the administration of first aid and/or CPR. Some settings may use the licensed practical nurse to manage calls after specialized training and under the supervision of the registered nurse or other authorized health care provider. The licensed practical nurse should use theScope of Practice Decision Treeto determine if performing compounding medications and preparing and administering allergenic extracts is within the licensed practical nurse's regulatory and individual scope of practice. Any changes to the standing order must be documented and communicated to an authorized health care practitioner or the registered nurse. The licensed practical nurse practices in an interdependent role when carrying out nursing care and a dependent role when carrying out medical regimens. The Washington State Department of Social and Health Services issued the following policies related to COVID-19, telehealth services, and delegation requirements: The nursing laws and rules allow a competent and appropriately trained licensed practical nurse to administer neuromodulators (such as Botox, Dysport, or Xeomin) or administering medications for sclerotherapy, asclerotherapy, or dermal fillers under the direction of an authorized health care practitioner or under the direction and supervision of a registered nurse. Internationally educated practical nurse program in an approved nursing education program. This does not mean the licensed practical nurse may not work in a pharmacy setting administering immunizations. An order is required from an authorized health care practitioner. Communication is defined as a process by which information is exchanged between individuals through a common system of speech, symbols, signs, and written communication or behaviors that serves as both a means of gathering information and of influencing the behavior, actions, attitudes, and feelings of others; and, (b) The registered nurse and licensed practical nurse shall document, on essential client records, the nursing care given and the client's response to that care; and. Chapter 28A.210.383 RCWprovides that the Office of the Superintendent of Public Instruction (OSPI) and school districts have the authority to develop anaphylactic policies for schools. The Nurse Delegation Program, under Washington State law, allows nursing assistants working in certain settings to perform certain tasks--such as administration of prescription medications or blood glucose testing--normally performed only by licensed nurses. Other examples include post-fall and pre-transfer assessments. The nursing laws and rules allow a competent and appropriately trained licensed practical nurse to perform phototherapy such as Type B Ultraviolet (UVB), Grenz Ray, or Psoralen and Long-Wave Ultraviolet Radiation (PUVA) under the direction of an authorized health care practitioner or under the direction and supervision of a registered nurse. Exceptions to nursing faculty degree requirements in prelicensure registered nurse nursing education programs. The law specifies that epinephrine autoinjectors may be prescribed to be maintained by schools for use when necessary. WebWe offer certification in two nurse delegation training topics; Nurse Delegation and Nurse Delegation Focus on Diabetes. SSB 6421was passed in 2016 allowing authorized entities to obtain epinephrine autoinjectors. Violations of standards of nursing conduct or practice. Licensure for ARNP applicants by interstate endorsement. The licensed practical nurse should use theScope of Practice Decision Treeto determine if these activities are within the nurse's legal and individual scope of practice. TheWashington State Department of Health COVID-19 Guidance for Home Care, Home Health, and Hospice Agenciesprovides guidance and resources for health care professionals providing services in these settings. Other laws may apply depending on the setting. The licensed practical nurse must be competent. The nursing law and rules do not prohibit the competent and appropriately trained licensed practical nurse from giving experimental drugs by any route under the direction of an authorized provider or under the direction and supervision of the registered nurse. The LPN should call the nursing supervisor, 911, or hospice for emergency help, and stay with the patient. For more information, see the Washington State Department of Health'sSuicide Prevention Training for Health Professionals Approved Courses. See theCompounding Medications by Licensed Practical Nurses, Registered Nurses, and Advanced Registered Nurse Practitioners Advisory Opinionfor more information. Use of alternative modalities for pain treatment. These people will be responsible for the storage, maintenance, and general oversight of the epinephrine autoinjectors. Extended or satellite nursing campus of nursing education programs approved in Washington state. Independently insert or remove a CVAD, arterial catheter, or intraspinal catheter; Insert a peripherally inserted midline catheter. Standing orders and verbal orders may include medical orders or nursing orders. The licensed practical nurse uses and applies nursing diagnosis (formulated by the registered nurse) as a foundation for implementing interventions. (a) The registered nurse and the licensed practical nurse shall have knowledge and understanding of the laws and rules regulating nursing and shall function within the legal scope of nursing practice; (b) The registered nurse and the licensed practical nurse shall be responsible and accountable for his or her practice based upon and limited to the scope of their education, demonstrated competence, and nursing experience consistent with the scope of practice set forth in this document; and. The Nursing Care Quality Assurance Commission'sStanding Orders and Verbal Orders Advisory Opinionprovides additional guidance and recommendations. A licensed practical nurse does not require additional licensure as an esthetician to perform laser therapy for cosmetic purposes. See the Nursing Care Quality Assurance Commission'sStanding Orders and Verbal Orders Advisory Opinionfor additional information. A focused nursing assessment means recognizing patient characteristics that may affect the patient's health status, gathering and recording nursing assessment data and demonstrating attentiveness by observing, monitoring and reporting signs, symptoms, and changes in patient conditions in an ongoing manner to the registered nurse or other authorized medical provider. If a patient is deemed potentially dangerous to others, the licensed practical nurse may need to consult with the registered nurse cases are considered more complex and are often deferred to the registered nurse or other professional team member who is trained to handle the needs and complexities of the patient. Internationally educated nurse program approval criteria for nursing education programs approved in Washington state. Determination and pronouncement of death by a licensed registered nurse. The nurse should use theScope of Practice Decision Treeto determine if specific activities are within the nurse's legal and individual scope of practice. A prescription or order from an authorized health care practitioner is required. Continuing competency audit process and compliance. It is expected that the registered nurse would complete an appropriate age-specific nursing assessment and nursing care plan. The Licensed Practical Nurse should use theScope of Practice Decision Treeto determine if specific activities are within the registered nurse's legal and individual scope of practice. The SNF may allow the licensed practical nurse to initiate the admission assessment within licensed practical nurse's scope of practice including collecting information and data without a registered nurse on the premises with the intent that the registered nurse will complete the comprehensive assessment and care planning. The licensed practical nurse may assist an authorized provider or the registered nurse in performing these procedures following clinical practice standards. The nursing diagnosis drives interventions and patient outcomes, enabling the registered nurse to develop the nursing care plan. Ongoing evaluation and approval of nursing education programs located in Washington state. The licensed practical nurse must be competent to do these activities. It is recommended that medication orders be patient/condition specific even if prescribed pro re nata (PRN), when needed. Functions of a registered nurse and a licensed practical nurse. It is within the scope of practice of an appropriately prepared and competent licensed practical nurse to perform peritoneal dialysis under the direction of an authorized health care practitioner, or under the direction and supervision of the registered nurse, following clinical practice standards. The nursing commission provides advisory opinions and interpretive statements about specific areas of nursing practice. The registered nurse delegator determines the patient does not require frequent nursing presence and evaluation. TheInstitute for Safe Medication Practices (ISMP)is a good resource for determining whether a medication is safe to crush. The licensed practical nurse may assist an authorized health care practitioner, or the registered nurse, in performing a sterile speculum examination, including obtaining cytology specimens, following clinical practice standards. Standards and evaluation of nursing education programs. For more information, go to theWashington State Department of Health Overdose Education and Naloxone Distribution Website. With insulin injections, the supervision occurs at least weekly for the first four weeks. Examples include theInfusion Nurses Society (INS)and theNational Infusion Center Association (NICA)practice, training, and competency standards for the licensed practical nurse. This procedure requires a prescription from an authorized health care practitioner. Nurse administrator qualification requirements in nursing education programs located in Washington state. There must be an order from an authorized provider. (c) Writing prescriptions for drugs unless authorized to do so by the commission; (a) Appropriating for personal use medication, supplies, equipment, or personal items of the client, agency, or institution. The RN must be appropriately trained and competent to provide nursing telehealth services. Nursing preceptors, interdisciplinary preceptors, and proctors in clinical or practice settings for nursing students located in Washington state. Do assessment, then proceed with a consideration of delegation. It is not within the LPNs scope of practice to certify death. Some facility laws and rules require nurses to have a CPR certification. Nursing assistant (CNA or NAR) (chapter 18.88A RCW) May administer in community-based care settings or in-home care settings under nurse delegation. The focused assessment may include obtaining health care history information and physical assessment. Philosophy governing voluntary substance abuse monitoring programs. The employer may have policies or guidelines about crushing or splitting medications. The Nursing Care Quality Assurance Commission determines it is beyond the scope of the licensed practical nurse to perform pulmonary artery pressure monitoring procedures due to the complexity of the procedure. Dispensing of medication is outside the scope of practice of the licensed practical nurse. The nurse must use nursing judgment and consider what aspects of the initial and ongoing assessment, supervision, and evaluation need to be done face-to-face. RCW 28A.210.383(2)(a). However, the Nursing Care Quality Assurance Commission (NCQAC) recommends licensed nurses complete the telemedicine training if they provide services such as; telephone triage, remote patient monitoring (RPM, which enables recording and monitoring health data remotely), asynchronous telehealth (such as Store and Forward technology that allows patient data to be collected, stored, and later retrieved by another professional), Mobile Health (mHealth, using smart devices such as smartphones and smart wearables that allow continuous data collection about a person's behavior or condition) or other types of telehealth. The nursing law and rule does not prohibit the competent and appropriately trained licensed practical nurse from administering any medication legend or controlled substance (Schedule II-IV) or over-the-counter medications. Nurses must follow the delegation process following the RCW 18.79.260. Discussions should include a review of the patient's or residents medical history and recommendations from treating providers. WebIf the home identifies that a resident has a need for nursing care and the home is not able to provide the care per chapter 18.79 RCW, the home must contract with a nurse currently licensed in the state of Washington to provide the nursing care and service, or hire or contract with a nurse to provide nurse delegation. EMTALA requires the assessment of a patient for the existence of an emergency medical condition before the patient can be transferred or released from the emergency department. (4) "Direct supervision" means the registered nurse delegator on the premises, quickly and easily available and the patient assessment by the registered nurse delegator occurs prior to the delegation of the duties to any care giver. It may be within the scope of practice of the licensed practical nurse to hand a patient a pre-packaged sample that is properly labeled by an authorized health care practitioner or pharmacist. The nursing laws and rules do prohibit the competent and appropriately trained licensed practical nurse from assisting in performing a sports physical examination under the direction of an authorized provider or under the direction and supervision of the registered nurse. In no case, may administration of medications by injection with the exception of insulin injections, sterile procedures and central line maintenance be delegated. The licensed practical nurse should use theScope of Practice Decision Treeto determine if these activities are within the nurse's legal and individual scope of practice. It is within the scope of practice of the appropriately prepared and competent licensed practical nurse to apply and operate a TENS for chronic and acute pain, following clinical practice standards. It is within the scope of practice of the appropriately prepared and competent licensed practical nurse to assist an authorized health care practitioner, or a registered nurse, to perform needle decompression for a tension pneumothorax, following clinical practice standards. The licensed practical nurse should use theScope of Practice Decision Treeto determine if any of the activities the licensed practical nurse is assisting with, is within the nurse's legal and individual scope of practice. The Nursing Care Quality Assurance Commission recommends following theWAC 246-919-606for physicians. The nurse must follow Federal and State blood-borne pathogen andClinical Laboratory Improvement Amendments (CLIA)regulations. These are legend drugs, and not categorized as a controlled substance. The licensed practical nurse should use theScope of Practice Decision Treeto determine if these activities are within the nurse's legal and individual scope of practice. 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