<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".12" citation="COMAR 10.39.06.12" title_num="10" subtitle_num="39" chapter_num="06" heading="Criteria for Delegation.">
  <paragraph num="A.">
    <text>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.</text>
  </paragraph>
  <paragraph num="B.">
    <text>A dialysis-related 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 certified dialysis technician without jeopardizing patient 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 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.</text>
  </paragraph>
  <paragraph num="D.">
    <text>When delegating a dialysis-related nursing task to a certified dialysis technician, the nurse shall:</text>
    <paragraph num="(1)">
      <text>Make an assessment of the patient's nursing care needs related to the delegated task;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Either instruct the certified dialysis technician in the delegated task or verify the certified dialysis 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 .13 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 ensuring accurate documentation of outcomes on the medical record.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>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:</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 structured setting.</text>
    </paragraph>
  </paragraph>
</regulation>