5/9/2016

WAC246840700:Standardsofnursingconductorpractice.

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WACs>Title246>Chapter246840>Section246840700
246840583<<246840700>>246840705
https://wwu.instructure.com/courses/1010424/files/35979984

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5/9/2016

WAC246840700:Standardsofnursingconductorpractice.

246840583<<246840700>>246840705
Agencyfilingsaffectingthissection

WAC246840700
Standardsofnursingconductorpractice.
(1)ThepurposeofdefiningstandardsofnursingconductorpracticethroughWAC
246840700and246840710istoidentifyresponsibilitiesoftheprofessionalregistered
nurseandthelicensedpracticalnurseinhealthcaresettingsandasprovidedinthe
NursingPracticeAct,chapter18.79RCW.Violationofthesestandardsmaybegrounds
fordisciplinaryactionunderchapter18.130RCW.Eachindividual,uponenteringthe
practiceofnursing,assumesameasureofresponsibilityandpublictrustandthe
correspondingobligationtoadheretotheprofessionalandethicalstandardsofnursing
practice.Thenurseshallberesponsibleandaccountableforthequalityofnursingcare
giventoclients.Thisresponsibilitycannotbeavoidedbyacceptingtheordersor
directionsofanotherperson.Thestandardsofnursingconductorpracticeinclude,but
arenotlimitedtothefollowing
(2)Thenursingprocessisdefinedasasystematicproblemsolvingapproachto
nursingcarewhichhasthegoaloffacilitatinganoptimalleveloffunctioningandhealth
fortheclient,recognizingdiversity.Itconsistsofaseriesofphases:Assessmentand
planning,interventionandevaluationwitheachphasebuildinguponthepreceding
phases.
(a)Registered
(b)Licensed
Nurse:
PracticalNurse:
Minimumstandards Minimumstandards
forregistered
forlicensedpractical
nursesincludethe
nursesincludethe
following:
following:
(i)StandardI
Initiatingthe
NursingProcess:

(A)Assessment
andAnalysis:The
registerednurse
initiatesdata
collectionand
analysisthat
includespertinent
objectiveand
subjectivedata
https://wwu.instructure.com/courses/1010424/files/35979984

(i)StandardI
Implementingthe
NursingProcess:
Thepracticalnurse
assistsin
implementingthe
nursingprocess
(A)Assessment:
Thelicensed
practicalnurse
makesbasic
observations,
gathersdataand
assistsin
identificationof
needsandproblems
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WAC246840700:Standardsofnursingconductorpractice.

subjectivedata
regardingthehealth
statusoftheclients.
Theregistered
nurseisresponsible
forongoingclient
assessment,
including
assimilationofdata
gatheredfrom
licensedpractical
nursesandother
membersofthe
healthcareteam

needsandproblems
relevanttothe
clients,collects
specificdataas
directed,and,
communicates
outcomesofthe
datacollection
processinatimely
fashiontothe
appropriate
supervisingperson

(B)Nursing
Diagnosis/Problem
Identification:The
registerednurse
usesclientdataand
nursingscientific
principlestodevelop
nursingdiagnosis
andtoidentifyclient
problemsinorderto
delivereffective
nursingcare
(C)Planning:The
registerednurse
shallplannursing
carewhichwill
assistclientsand
familieswith
maintainingor
restoringhealthand
wellnessor
supportinga
dignifieddeath

(B)Nursing
Diagnosis/Problem
Identification:The
licensedpractical
nurseprovidesdata
toassistinthe
developmentof
nursingdiagnoses
whicharecentralto
theplanofcare

(D)
Implementation:
Theregistered
nurseimplements
theplanofcareby
initiatingnursing

(D)
Implementation:
Thelicensed
practicalnurse
carriesoutplanned
approachestoclient

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(C)Planning:The
licensedpractical
nursecontributesto
thedevelopmentof
approachestomeet
theneedsofclients
andfamilies,and,
developsclientcare
plansutilizinga
standardized
nursingcareplan
andassistsin
settingprioritiesfor
care

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WAC246840700:Standardsofnursingconductorpractice.

interventions
throughgivingdirect
careand
supervisingother
membersofthe
careteamand

careandperforms
commontherapeutic
nursingtechniques
and

(E)Evaluation:The
registerednurse
evaluatesthe
responsesof
individualsto
nursing
interventionsandis
responsibleforthe
analysisand
modificationofthe
nursingcareplan
consistentwith
intendedoutcomes

(E)Evaluation:The
licensedpractical
nurse,in
collaborationwith
theregistered
nurse,assistswith
makingadjustments
inthecareplan.The
licensedpractical
nursereports
outcomesofcareto
theregisterednurse
orsupervising
healthcareprovider

(ii)StandardII
Delegationand
Supervision:The
registerednurseis
accountableforthe
safetyofclients
receivingnursing
serviceby:

(ii)StandardII
Delegationand
Supervision:Under
direction,the
practicalnurseis
accountableforthe
safetyofclients
receivingnursing
care:

(A)Delegating
selectednursing
functionstoothers
inaccordancewith
theireducation,
credentials,and
demonstrated
competenceas
definedinWAC
246840010(10)

(A)Thepractical
nursemaydelegate
selectednursing
taskstocompetent
individualsin
selectedsituations,
inaccordancewith
theireducation,
credentialsand
competenceas
definedinWAC
246840010(10)

(B)Supervising
otherstowhom
he/shehas
delegatednursing

(B)Thelicensed
practicalnursein
delegatingfunctions
shallsupervisethe

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functionsasdefined
inWAC246840
010(10)

personstowhom
thefunctionshave
beendelegated

(C)Evaluatingthe
outcomesofcare
providedbylicensed
andother
paraprofessional
staff

(C)Thelicensed
practicalnurse
reportsoutcomesof
delegatednursing
caretaskstotheRN
orsupervising
healthcareprovider
and

(D)Theregistered
nursemaydelegate
certainadditional
actstocertain
individualsin
communitybased
longtermcareand
inhomesettingsas
providedbyWAC
246840910
through246840
970andWAC246
841405and

(D)Incommunity
basedlongterm
careandinhome
settingsasprovided
byWAC246840
910through246
840970andWAC
246841405,the
practicalnursemay
delegateonly
personalcaretasks
toqualifiedcare
givers

(E)Inahomehealth
orhospiceagency
regulatedunder
chapter70.127
RCW,aregistered
nursemaydelegate
theapplication,
instillation,or
insertionof
medicationstoa
registeredor
certifiednursing
assistantundera
planofcare
pursuanttochapter
246335WAC

(iii)StandardIII
HealthTeaching.
Theregistered
nurseassesses
learningneeds
includinglearning
https://wwu.instructure.com/courses/1010424/files/35979984

(iii)StandardIII
HealthTeaching.
Thepracticalnurse
assistsinhealth
teachingofclients
andprovidesroutine

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includinglearning
andprovidesroutine
readinessfor
healthinformation
patientsand
andinstruction
families,develops
recognizing
planstomeetthose individual
learningneeds,
differences.
implementsthe
teachingplanand
evaluatesthe
outcome.
(3)Thefollowingstandardsapplytoregisterednursesandlicensedpractical
nurses:
(a)Theregisterednurseandlicensedpracticalnurseshallcommunicatesignificant
changesintheclient'sstatustoappropriatemembersofthehealthcareteam.This
communicationshalltakeplaceinatimeperiodconsistentwiththeclient'sneedforcare.
Communicationisdefinedasaprocessbywhichinformationisexchangedbetween
individualsthroughacommonsystemofspeech,symbols,signs,andwritten
communicationorbehaviorsthatservesasbothameansofgatheringinformationandof
influencingthebehavior,actions,attitudes,andfeelingsofothersand
(b)Theregisterednurseandlicensedpracticalnurseshalldocument,onessential
clientrecords,thenursingcaregivenandtheclient'sresponsetothatcareand
(c)Theregisterednurseandlicensedpracticalnurseactasclientadvocatesinhealth
maintenanceandclinicalcare.
(4)Otherresponsibilities:
(a)Theregisterednurseandthelicensedpracticalnurseshallhaveknowledgeand
understandingofthelawsandrulesregulatingnursingandshallfunctionwithinthelegal
scopeofnursingpractice
(b)Theregisterednurseandthelicensedpracticalnurseshallberesponsibleand
accountableforhisorherpracticebaseduponandlimitedtothescopeofhis/her
education,demonstratedcompetence,andnursingexperienceconsistentwiththescope
ofpracticesetforthinthisdocumentand
(c)Theregisterednurseandthelicensedpracticalnurseshallobtaininstruction,
supervision,andconsultationasnecessarybeforeimplementingneworunfamiliar
techniquesorprocedureswhichareinhis/herscopeofpractice.
(d)Theregisterednurseandthelicensedpracticalnurseshallberesponsiblefor
maintainingcurrentknowledgeinhis/herfieldofpracticeand
(e)Theregisterednurseandthelicensedpracticalnurseshallrespecttheclient's
righttoprivacybyprotectingconfidentialinformationandshallnotuseconfidentialhealth
careinformationforotherthanlegitimatepatientcarepurposesorasotherwiseprovided
intheHealthCareInformationAct,chapter70.02RCW.
[StatutoryAuthority:RCW18.79.110,18.79.260(3)(f),18.88A.210,2003c140.WSR
0414065,246840700,filed7/2/04,effective7/2/04.StatutoryAuthority:RCW
18.79.110.WSR0206117,246840700,filed3/6/02,effective4/6/02.Statutory
Authority:Chapter18.79RCW.WSR9713100,246840700,filed6/18/97,effective
7/19/97.]
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