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Delegation: What does the law say?

Posted on 09/04/2015 at 12:00 AM by MaryAnn Strawhacker

Good Morning,
Had a call from outside AEA 11 this am regarding nursing delegation that reminds me it never hurts to review the legal basics. Ultimately it is our nurse practice act in Iowa that allows us the freedom to determine what nursing tasks can and cannot be delegated. The only bright line, found in Chapter 6 of our Nurse Practice Act, is that we cannot delegate a task that is outside the scope of practice for an LPN (citation attached). With that said we all can think of factors related to the student, associate, or even our ability to provide direction and supervision that could change our mind regarding whether or not to delegate a task.

Once you make the decision to delegate, remember that you must document that decision as well as the factors you used to come to that decision. I teach new nurses how to write an initial delegation paragraph and what ongoing documentation is needed. The details of this are found in the Rules of Special Education (citation attached) but applied to all students who require health services.  Remember when you delegate to:

1. Write a summary paragraph(s) surrounding your decision to delegate (details regarding the student, associate, procedure...)
2. Included your delegation structure and plans for supervision ( Also include this in your IHP )
3. Document staff instruction provided, return demonstration, and ongoing provision of supervision in student's record (this can be a form or a narrative entry), and
4. Periodically reevaluate your decision to delegate and reevaluate delegation when condition(s) change.

Just for a refresher, read the two extracts I pasted on the front of the attached page. Remember that copies of staff training forms for  respiratory distress, diabetes management, diastat administration and a new one for seizures are all found on nurse train under the "Forms/Files" tab (Skills Documentation Header).

Also remember that the Medication Training Site found on the state AEA PD Online site contains training modules for:

Administering Glucagon to Students with Diabetes
Administering Rectal Diazepam for Seizures
Giving Insulin Injections
Insulin Pumps
Medication Administration by Gastrostomy Tube
Nebulizer Treatments at School

The site issues a training certificate after the paraprofessional completes the training. This certificate is your record that the individual was trained. Hope you find this information useful!

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