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<regulation prefix="Regulation" num=".03" citation="COMAR 10.27.11.03" title_num="10" subtitle_num="27" chapter_num="11" heading="Criteria for Delegation.">
  <paragraph num="A.">
    <text>The nurse may delegate the responsibility to perform a nursing task to an unlicensed individual, a certified nursing assistant, or a medication technician. The delegating nurse retains the accountability for the nursing task.</text>
  </paragraph>
  <paragraph num="B.">
    <text>A nursing task delegated by the nurse shall be:</text>
    <paragraph num="(1)">
      <text>Within the area of responsibility of the nurse delegating the act;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Such that, in the judgment of the nurse, it can be properly and safely performed by the unlicensed individual, certified nursing assistant, or medication technician without jeopardizing the client welfare; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>A task that a reasonable and prudent nurse would find is within the scope of sound nursing judgment.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>A nursing task delegated by the nurse may not require the unlicensed individual, certified nursing assistant, or medication technician to exercise nursing judgment or intervention except in an emergency situation.</text>
  </paragraph>
  <paragraph num="D.">
    <text>When delegating a nursing task to an unlicensed individual, certified nursing assistant, or medication technician the nurse shall:</text>
    <paragraph num="(1)">
      <text>Make an assessment of the patient's nursing care needs before delegating the task;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Either instruct the unlicensed individual, certified nursing assistant, or medication technician in the delegated task or verify the unlicensed individual's, certified nursing assistant's, or medication technician's competency to perform the nursing task;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Supervise the performance of the delegated nursing task in accordance with Regulation .04 of this chapter;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Be accountable and responsible for the delegated task;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Evaluate the performance of the delegated nursing task; and</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Be responsible for assuring accurate documentation of outcomes on the nursing record.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>The nurse shall be the primary decision maker when delegating a nursing task to an unlicensed individual, certified nursing assistant, or medication technician. Nursing judgment shall be exercised within the context of the employing facility's model of nursing practice which includes a mechanism for:</text>
    <paragraph num="(1)">
      <text>Identifying those individuals to whom nursing tasks may be delegated;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Reevaluation of the competency of those to whom nursing tasks may be delegated;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Recognizing that the final decision regarding delegation is within the scope of the nurse's professional judgment;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Determining the competency of the nurse to delegate; and</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Determining to whom nursing tasks may be delegated, which includes input by nurses employed in the facility.</text>
    </paragraph>
  </paragraph>
  <paragraph num="F.">
    <text>The registered nurse shall assume the role of case manager in delegating nursing tasks, including the administration of medications, only in accordance with Regulation .05G of this chapter in situations where the nurse has thoroughly assessed and documented that:</text>
    <paragraph num="(1)">
      <text>The client's health care needs are chronic, stable, uncomplicated, routine, and predictable;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The environment is conducive to the delegation of nursing tasks; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>The client is unable to perform his or her own care.</text>
    </paragraph>
  </paragraph>
</regulation>