<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".04" citation="COMAR 10.27.11.04" title_num="10" subtitle_num="27" chapter_num="11" heading="Supervision.">
  <paragraph num="A.">
    <text>The nurse shall determine the required degree of supervision after an evaluation of appropriate factors including, but not limited to the:</text>
    <paragraph num="(1)">
      <text>Stability of the condition of the client;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Training of the individual to whom the nursing task is being delegated;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Nature of the nursing task being delegated;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Orientation of the unlicensed individual, certified nursing assistant, or medication technician to the specific patient environment;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Ability of the unlicensed individual, certified nursing assistant, or medication technician to perform the delegated nursing task in a safe and competent manner; and</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Reevaluation of the client's health status.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>The delegating nurse shall be readily available when delegating a nursing task to an unlicensed individual, certified nursing assistant, or medication technician.</text>
  </paragraph>
  <paragraph num="C.">
    <text>For the client whose health status meets the criteria as stated in Regulation .03F of this chapter, the registered nurse managing the case shall make a supervisory on-site visit to the client at a minimum of every 45 days to:</text>
    <paragraph num="(1)">
      <text>Evaluate the client's health status;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Evaluate the nursing acts to be delegated;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Determine whether health goals are being met;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Evaluate the continued competence of the certified nursing assistant, unlicensed individual, or medication technician to perform the delegated nursing task; and</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Evaluate the environment in which the delegated task is performed.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>For the client whom the registered nurse has determined does not meet the criteria as stated in Regulation .03F of this chapter, the registered nurse shall:</text>
    <paragraph num="(1)">
      <text>Make a supervisory on-site visit to the client at least every 2 weeks to evaluate the criteria described in §C of this regulation; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Determine whether the:</text>
      <paragraph num="(a)">
        <text>Nursing tasks may be safely delegated in that setting and given the client's clinical status; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Nursing assistant, unlicensed individual, or medication technician is competent to perform the nursing tasks to be delegated.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>