# COMAR Title 10 — Maryland Department of Health

## Subtitle 39 — Board of Nursing — Certificate Holders

### Chapter 06 — Certified Dialysis Technicians

#### Regulation .12 Criteria for Delegation.

*COMAR 10.39.06.12*

A. The nurse may delegate the responsibility to perform a dialysis-related nursing task to a certified dialysis technician. The delegating nurse retains the accountability for the dialysis-related nursing task.

B. A dialysis-related nursing task delegated by the nurse shall be:

  (1) Within the area of responsibility of the nurse delegating the act;

  (2) Such that, in the judgment of the nurse, it can be properly and safely performed by the certified dialysis technician without jeopardizing patient welfare; and

  (3) A task that a reasonable and prudent nurse would find is within the scope of sound nursing judgment.

C. A dialysis-related nursing task delegated by the nurse may not require the certified dialysis technician to exercise nursing judgment or intervention except in an emergency situation.

D. When delegating a dialysis-related nursing task to a certified dialysis technician, the nurse shall:

  (1) Make an assessment of the patient's nursing care needs related to the delegated task;

  (2) Either instruct the certified dialysis technician in the delegated task or verify the certified dialysis technician's competency to perform the nursing task;

  (3) Supervise the performance of the delegated nursing task in accordance with Regulation .13 of this chapter;

  (4) Be accountable and responsible for the delegated task;

  (5) Evaluate the performance of the delegated nursing task; and

  (6) Be responsible for ensuring accurate documentation of outcomes on the medical record.

E. The nurse shall be the primary decision maker when delegating a dialysis-related nursing task to a certified dialysis technician. Nursing judgment shall be exercised within the context of the employer’s model of nursing practice which includes a mechanism for:

  (1) Identifying those individuals to whom nursing tasks may be delegated;

  (2) Reevaluation of the competency of those to whom nursing tasks may be delegated;

  (3) Recognizing that the final decision regarding delegation is within the scope of the nurse's professional judgment;

  (4) Determining the competency of the nurse to delegate; and

  (5) Determining to whom nursing tasks may be delegated, which includes input by nurses employed in the structured setting.