Nurse delegation is a unique program in Washington State that allows certified nursing assistants (CNAs) and home care aides to perform specific skilled nursing tasks under the training and supervision of a registered nurse (RN). This program is designed for community-based healthcare settings, including in-home care, adult family homes, assisted living facilities, supported living agencies for individuals with mental health conditions or developmental disabilities, and other community residential settings.

A client requires nurse delegation when they are unable to complete the final step of a medication-related task, such as placing pills in their mouth, applying a topical treatment, or administering eye drops. Additionally, if a client is not consistently aware they are receiving medication or medical treatment, they also require delegation. If a client can perform these tasks and is aware of their treatment, the procedure qualifies as Medication Assistance and does not require delegation. However, for delegation to be approved, the client’s condition must be stable and predictable.

Many nursing tasks can be delegated under this program. Common examples include administering oral and topical medications, eye and ear drops, nasal sprays, insulin injections, ostomy care, non-sterile dressing changes, nebulizer treatments, rectal suppositories, and managing medication dispensers. 

However, some tasks cannot be delegated, including sterile procedures, most injectable medications (except insulin and certain diabetic injections), central line or IV maintenance, and any task requiring nursing judgment.

This information applies specifically to Washington State’s Community-Based Nurse Delegation program and does not extend to healthcare environments such as skilled nursing facilities or hospitals.