| (a) Registered Nurse: |
(b) Licensed Practical
Nurse: |
| Minimum standards for
registered nurses include
the following: |
Minimum standards for
licensed practical nurses
include the following: |
| (i) Standard I Initiating the
Nursing Process: |
(i) Standard I - Implementing the Nursing
Process: The practical
nurse assists in
implementing the nursing
process; |
| (A) Assessment and
Analysis: The registered
nurse initiates data
collection and analysis
that includes pertinent
objective and subjective
data regarding the health
status of the clients. The
registered nurse is
responsible for ongoing
client assessment,
including assimilation of
data gathered from
licensed practical nurses
and other members of the
health care team; |
(A) Assessment: The
licensed practical nurse
makes basic observations,
gathers data and assists in
identification of needs and
problems relevant to the
clients, collects specific
data as directed, and,
communicates outcomes of
the data collection process
in a timely fashion to the
appropriate supervising
person; |
| (B) Nursing
Diagnosis/Problem
Identification: The
registered nurse uses
client data and nursing
scientific principles to
develop nursing diagnosis
and to identify client
problems in order to
deliver effective nursing
care; |
(B) Nursing
Diagnosis/Problem
Identification: The
licensed practical nurse
provides data to assist in
the development of
nursing diagnoses which
are central to the plan of
care; |
| (C) Planning: The
registered nurse shall plan
nursing care which will
assist clients and families
with maintaining or
restoring health and
wellness or supporting a
dignified death; |
(C) Planning: The
licensed practical nurse
contributes to the
development of
approaches to meet the
needs of clients and
families, and, develops
client care plans utilizing a
standardized nursing care
plan and assists in setting
priorities for care; |
| (D) Implementation: The
registered nurse
implements the plan of care
by initiating nursing
interventions through
giving direct care and
supervising other members
of the care team; and |
(D) Implementation: The
licensed practical nurse
carries out planned
approaches to client care
and performs common
therapeutic nursing
techniques; and |
| (E) Evaluation: The
registered nurse evaluates
the responses of
individuals to nursing
interventions and is
responsible for the
analysis and modification
of the nursing care plan
consistent with intended
outcomes; |
(E) Evaluation: The
licensed practical nurse, in
collaboration with the
registered nurse, assists
with making adjustments in
the care plan. The licensed
practical nurse reports
outcomes of care to the
registered nurse or
supervising health care
provider; |
| (ii) Standard II Delegation
and Supervision: The
registered nurse is
accountable for the safety
of clients receiving nursing
service by: |
(ii) Standard II Delegation
and Supervision: Under
direction, the practical
nurse is accountable for
the safety of clients
receiving nursing care: |
(A) Delegating selected
nursing functions to
others in accordance with
their education,
credentials, and
demonstrated competence
as defined in WAC 246-840-010(10);
|
(A) The practical nurse
may delegate selected
nursing tasks to competent
individuals in selected
situations, in accordance
with their education,
credentials and
competence as defined in
WAC 246-840-010(10); |
| (B) Supervising others to
whom he/she has
delegated nursing
functions as defined in
WAC 246-840-010(10); |
(B) The licensed practical
nurse in delegating
functions shall supervise
the persons to whom the
functions have been
delegated; |
| (C) Evaluating the
outcomes of care provided
by licensed and other
paraprofessional staff; |
(C) The licensed practical
nurse reports outcomes of
delegated nursing care
tasks to the RN or
supervising health care
provider; and |
| (D) The registered nurse
may delegate certain
additional acts to certain
individuals in
community-based
long-term care and in-home
settings as provided by
WAC 246-840-910 through246-840-970
and WAC 246-841-405; and |
(D) In community based
long-term care and in-home
settings as provided by
WAC 246-840-910 through246-840-970
and WAC 246-841-405, the practical
nurse may delegate only
personal care tasks to
qualified care givers; |
| (E) In a home health or
hospice agency regulated
under chapter 70.127 RCW,
a registered nurse may
delegate the application,
instillation, or insertion of
medications to a registered
or certified nursing
assistant under a plan of
care pursuant to chapter 246-335 WAC; |
|
| (iii) Standard III Health
Teaching. The registered
nurse assesses learning
needs including learning
readiness for patients and
families, develops plans to
meet those learning needs,
implements the teaching
plan and evaluates the
outcome. |
(iii) Standard III Health
Teaching. The practical
nurse assists in health
teaching of clients and
provides routine health
information and instruction
recognizing individual
differences. |