!"# %&'%()# (* +",) )#-+,(. ,) +( "#/% +"# /#0'.

#'
&.1#')+0.1 +"# 20),-) (* 34 1#/#50+,(. 0.1 +"# '(/#
and responsibililies ol lhe AlH provider when a lask ol
.&'),.5 ,) 1#/#50+#16
!"# %"&'()
Lay caregiver
7#',(1,- ,.)%#-+,(.
3#)-,.1,.5
34 1#/#50+,(.
Supervisory visils
8',++#. ,.)+'&-+,(.)
*+,"-%./"()
9*+#' -(:%/#+,.5 +",) )#-+,(. +"# /#0'.#' ;,// 2# 02/# +(<
=.1#')+0.1 +"# 20),- 34 1#/#50+,(. %'(-#))>
Describe why an PN musl provide periodic
inspeclion and supervisory visils,
Describe lhe role and responsibilily ol lhe lay
caregiver once a lask ol nursing has been delegaled,
Lisl lhe lypes ol silualions/condilions when an PN
may rescind a delegaled lask,
?.(; ;"0+ 1(-&:#.+) +"# 34 :&)+ /#0@# 0+ +"#
adull losler home when a lask has been delegaled.
34 ABCBD9!EF4
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.0%&*12-%.*0
!"# %&'%()# (* +",) )#-+,(. ,) "#/% #I%/0,. +"# 20),- -(:%(.#.+) (* +"# '#5,)+#'#1
nurse (PN) delegalion process and lhe role and responsibilily ol lhe adull losler
"(:# J9KLM %'(@,1#'6
Adull losler home residenls lrequenlly require nursing lasks such as insulin
injeclions. PN delegalion is a lool lhal allows a caregiver lo perlorm a specilc
nursing lask. Nol all nursing lasks can be delegaled, and il is lhe sole responsibilily
ol lhe PN lo decide il a nursing lask can be delegaled.
PN delegalion will nol work in all silualions, lhe PN delegalion process
requires a leam approach belween lhe PN and lhe AlH caregiver(s). While lhe
34 ,) '#)%(.),2/# *(' &.1#')+0.1,.5 '&/#) (* 34 1#/#50+,(.N ,+ ,) ,:%('+0.+ +"#
9KL -0'#5,@#' &.1#')+0.1) +"# 34 1#/#50+,(. %'(-#)) 0.1 ;"0+ +( #I%#-+ *'(:
an PN when a nursing lask is delegaled.
345% .( &0 1"6"75%.*0
PN delegalion is a legally delned process lhal allows an PN lo aulhorize a
caregiver (non-licensed caregiver) lo perlorm a nursing lask lor a residenl wilhoul
lhe PN being in lhe losler home each lime lhe lask is perlormed. The Oregon
Nurse Praclice Acl only aulhorizes lhe PN lo delegale lhe perlormance ol lhe
physical lask. The PN cannol delegale assessmenl or evalualion ol lhe person's
"#0/+" )+0+&)6
&0 1"6"75%.*0
GO
&0 89:9;<=>?@ AB?C9DD
PN delegalion is a lask-, person- and selling-specilc process. Whal lhis means is
lhe PN musl provide delailed leaching and wrillen inslruclions lor each lask lor
#0-" '#),1#.+ ,. #0-" )#++,.5 0.1 (2)#'@# #0-" -0'#5,@#' %#'*(':,.5 +"# .&'),.5
lask on lhe residenl.
The PN can leach aboul lhe residenl's condilion and aboul lhe nursing lask lo
)#@#'0/ -0'#5,@#') 0+ +"# )0:# +,:#6 L(;#@#'N *(' 1#/#50+,(. +( (--&'N +"# 34 :&)+
#@0/&0+# #0-" ,.1,@,1&0/ -0'#5,@#' 0.1 (2)#'@# #0-" ,.1,@,1&0/ -0'#5,@#' %#'*(':
lhe nursing lask lrom slarl lo lnish lor each residenl. Depending on lhe lask, lhis
may mean lhe PN will need lo relurn several limes lo complele a delegalion lo
:&/+,%/# ,.1,@,1&0/)6
3E<= =<DFD ?G @HBD>@; IHD= J9 89:9;<=98
There is no lisl ol whal nursing lasks musl be delegaled. ll is lhe individual PN's
responsibilily lo delermine il a nursing lask can be delegaled. The lollowing lisl
,) 0 )0:%/# (* -(::(. 1#/#50+,(.) )##. ,. 9KL )#++,.5)<
P&2-&+0.#(&) ,.Q#-+,(.) )&-" 0) ,.)&/,.>
Providing nulrilion, luids and oral medicalions lhrough a gaslroslomy lube
J5R+&2#M (' (+"#' *##1,.5 +&2#)>
3(&+,.# +'0-" -0'# 0.1 )&-+,(.,.5>
Slraighl urinary calhelerizalion.
Olher nursing lasks may be appropriale lo delegale. Addilionally, lhe PN
may delermine a commonly delegaled nursing lask cannol be delegaled in a
specilc silualion.
PN delegalion requiremenls do nol apply lo lamily members perlorming
nursing lasks lor lamily members.
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3E<= C<@@?= J9 89:9;<=98
Specilc lasks can never be delegaled lo a caregiver. An PN cannol delegale.
Assessmenl, evalualion or decision making,
Any nursing lask when lhe residenl's condilion is unslable or requires lhe PN
lo assess lhe residenl belore and/or aller lhe lask is perlormed,
!"# 01:,.,)+'0+,(. (* ,.+'0:&)-&/0' JETM ,.Q#-+,(.)>
!"# 01:,.,)+'0+,(. (* ,.+'0@#.(&) JEUM :#1,-0+,(.) #I-#%+ ;"#. +"# 34 ,)
an employee ol a licensed home heallh, home inlusion or hospice agency
providing services lor lhe residenl. Nole. Adull losler home (AlH) rules may
reslricl whal lasks ol nursing can be delegaled.
Cerlain nursing lasks used lor anlicipalory emergencies cannol be delegaled bul
are laughl by an PN, pharmacisl or lhe residenl's primary care praclilioner.
D/&-05(. *(' 1,02#+,-)>
B%,R%#.) *(' 0//#'5,#)6
&0 1"6"75%.*0 K&*-"((
The PN musl evaluale lve componenls ol lhe PN delegalion belore deciding il a
nursing lask can be delegaled. The inlormalion provided is general bul will give
you a beller underslanding ol why delegalion is a process and why a lask ol
nursing may nol be delegaled quickly.
V6 W#*('# +"# %'(-#)) (* 34 1#/#50+,(. -0. 2#5,.N +"# 34 :&)+ -(.),1#' ",) ('
her own experlise wilh lhe delegalion process and lhe nursing lask
2#,.5 -(.),1#'#16
The PN musl make lhe lnal decision il lhe delegalion ol a nursing lask can
salely occur in your AlH.
XY
Addilionally, lhe PN needs lo consider his or her own schedule. Does lhe
PN have lime lo complele lhe delegalion process in a limely manner? ls
lhe PN able lo provide lhe required ongoing supervision ol lhe delegaled
nursing lask?
Z6 !"# 34 :&)+ #@0/&0+# +"# '#),1#.+[) "#0/+" -(.1,+,(. '#/0+#1 +( +"# .&'),.5
lask being considered lor delegalion. The residenl's condilion musl be slable
0.1 %'#1,-+02/#6
!( 1#+#':,.# ,* +"# '#),1#.+ ,) )+02/# 0.1 %'#1,-+02/#N +"# 34 ;,// 1( 0
locused assessmenl ol lhe residenl relaled lo lhe nursing lask being
-(.),1#'#16 5 &0 C<@@?= 89:9;<=9 < @HBD>@; =<DF >G =E9 B9D>89@= E<D
<@ H@F@?L@ E9<:=E C?@8>=>?@6
\6 The PN musl delermine il lhe lask being considered lor delegalion is
appropriale in lhis specilc silualion.
An AlH provider may have had experience doing a nursing lask wilh anolher
residenl, bul lhe same lask may nol be appropriale lor a new residenl
because lhe person's heallh condilion requires an assessmenl belore and/or
aller lhe nursing lask is perlormed.
G6 The PN musl assess each caregiver individually and delermine il lhe caregiver
,) 02/#<
And willing lo perlorm lhe lask (includes physical abilily),
!( *(//(; ;',++#. ,.)+'&-+,(.) 0.1 +( -(::&.,-0+#>
To roulinely perlorm lhe lask.
The PN cannol delegale a nursing lask il lhe lay caregiver cannol perlorm
lhe nursing lask lrequenlly enough lo mainlain lhe necessary skills.
XV
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X6 The PN musl decide il lhe environmenl where lhe nursing lask will be
%#'*(':#1 ,) 0%%'(%',0+#6 K(' #I0:%/#N ,) +"#'# 0. 0'#0 *(' "0.1;0)",.5N (' 0
privale area where lhe nursing lask can be perlormed?
&0 1"6"75%.*0 +"7.0(
Once lhe PN has decided lo delegale a nursing lask, lhe PN musl leach lhe
caregiver lhe lollowing inlormalion belore delegaling lhe nursing lask.
8asic inlormalion aboul lhe residenl's chronic condilion including why lhe
residenl needs a parlicular nursing lask perlormed,
Any polenlial risks associaled wilh lhe nursing lask and possible side ellecls
lhe residenl may experience when perlorming lhe nursing lask,
Any signs and symploms you need lo observe or any aclion you need lo lake
0.1 1(-&:#.+>
How lo perlorm lhe lask.
The PN musl observe lhe caregiver perlorm lhe nursing lask lrom slarl lo lnish.
While lhe PN can provide leaching aboul lhe lask lo several caregivers al one lime,
lhe PN musl observe each caregiver perlorm lhe lask lrom slarl lo lnish on lhe
residenl. Depending on lhe lrequency ol lhe nursing lask, lhe PN may need lo
relurn lo lhe AlH lo lnish delegaling lo all caregivers.
The PN is responsible lor providing clear wrillen slep-by-slep inslruclions including
;"#. +( -0// SRVRVN +"# '#),1#.+[) "#0/+" -0'# %'0-+,+,(.#' 0.1 +"# 34 ;"( "0)
delegaled lhe nursing lask.
The PN is nol on call lor emergencies. However, il is lhe AlH's responsibilily
lo nolily lhe PN anylime lhere is a change in lhe residenl's medical orders or
-(.1,+,(.6 !"# 34 ;,// .##1 +( 1#+#':,.# ,* +"# -"0.5#) 0**#-+ +"# 1#/#50+#1
nursing lask.
XZ
The PN is also required lo documenl in lhe residenl's record lhe name ol each
caregiver lhe PN has aulhorized lo perlorm lhe nursing lask. The PN musl provide
a nursing plan ol care lhal idenliles lhe delegalion and when lhe PN will relurn lo
'#@,#; +"# 1#/#50+,(.6
ll is your responsibilily lo lalk wilh lhe PN il you are unable lo read her or his
handwriling, il any ol lhe inslruclions are unclear, or il inslruclions do nol malch
whal lhe PN laughl you.
K"&.*1.- .0(K"-%.*0M (2K"&/.(.*0 501 "/5625%.*0
Once a nursing lask has been delegaled, lhe PN has mandaled ongoing supervision
responsibililies lor lhe delegaled nursing lask. Supervision ol PN delegalion is
limiled lo lhe delegaled lask and is nol general supervision ol lhe caregiver(s).
Oregon's Nurse Praclice Acl requires lhe lollowing lrequencies.
A new delegalion requires lhe PN lo evaluale lhe lay caregiver and residenl
belween one and 60 days lrom lhe dale lhe nursing lask was delegaled.
Therealler, lhe PN is required lo evaluale each lay caregiver and residenl no
less lhan every !80 days lrom lhe lasl visil.
The PN may decide lo evaluale lhe caregiver more lrequenlly. The decision
lo review more lrequenlly is based on lhe complexily ol lhe nursing lask, lhe
residenl's needs, and lhe skill and conldence ol lhe caregiver.
lrequency ol lhe PN's supervisory visils should be documenled in lhe nurse's plan
(* -0'#6 E. 011,+,(.N ,* +"# '#),1#.+[) "#0/+" )&%%('+ .##1) "0@# -"0.5#1 (' :#1,-0/
orders have changed, lhe PN may need lo relurn and review lhe delegalion lo
assure il is slill appropriale or make any necessary changes lo lhe inslruclions.
When lhe PN relurns lo your AlH lor lhe supervision visil, he or she will.
9))#)) +"# -&''#.+ -(.1,+,(. (* +"# '#),1#.+>
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3#@,#; +"# %'(-#1&'#) 0.1 ;',++#. 1,'#-+,(.) #)+02/,)"#1>
B.)&'# +"# 9KL 1(-&:#.+0+,(. 1#:(.)+'0+#) +"# 34[) ;',++#. ,.)+'&-+,(.)
0'# 2#,.5 *(//(;#1>
F2)#'@# #0-" -0'#5,@#'J)M ;"(: +"# 34 "0) 1#/#50+#1 +( %#'*(': +"#
nursing lask.
34"0 50 &0 &"(-.01( 5 1"6"75%.*0
ll any ol lhe lve componenls are nol mel, lhe PN cannol delegale a nursing lask.
Addilionally, il lhere are changes lo any one ol lhe lve componenls aller lhe lask
has been delegaled, lhe PN may be required lo rescind a delegalion. Common
'#0)(.) *(' '#)-,.1,.5 0 1#/#50+,(.<
!"# '#),1#.+[) -(.1,+,(. "0) -"0.5#1 0.1 ,) .( /(.5#' )+02/#6
The nursing lask is no longer needed.
The caregiver(s) is nol able lo lollow lhe inslruclions lor any reason.
The PN is nol able lo provide adequale supervision ol a caregiver.
The caregiver quils.
There are lrequenl changes in caregivers and lhe PN is unable lo evaluale
new caregivers in a limely manner.
!"# '#),1#.+ :(@#) +( 0.(+"#' )#++,.5 (' 1,#)6
9KL %'(@,1#') )(:#+,:#) -(:%/0,. ,* +"# 34 ;0.+) +( -(:# +( +"# 9KL
during busy limes such as meals or during lhe morning. ll lhe delegaled
nursing lask is scheduled during a busy lime, lhe PN musl visil during lhe
lime lhe nursing lask will be perlormed.
XG
No maller why lhe PN needs lo rescind a delegalion, il musl be documenled in
+"# '#),1#.+[) '#-('16 A(-&:#.+0+,(. .##1) +( ,.-/&1# +"# 10+# +"# 1#/#50+,(. ;0)
'#)-,.1#1> +"# .0:# (* #0-" -0'#5,@#' *(' ;"(: +"# 1#/#50+,(. ,) '#)-,.1#1> 0.1
lhe reason why lhe PN needs lo rescind lhe delegalion.
4*'" 4"56%4 501 4*(K.-"
A residenl receiving home heallh services or on hospice may have delegalion needs
lor a chronic ongoing condilion such as diabeles. ln lhis case, you musl discuss
+"# '#),1#.+[) .##1) ;,+" #0-" 34 +( 1#+#':,.# ;"( ,) 1(,.5 ;"0+ 0.1 ;"#.6 !",)
)"(&/1 0// 2# 1(-&:#.+#1 ,. +"# '#),1#.+[) '#-('16 ]/#0' -(::&.,-0+,(. ,. +"#
beginning will assure lhe residenl's heallh care needs are lully supporled.
'.(-"6650"*2( 72.150-"
lnlormalion regarding oral medicalions may need lo be laughl by a qualiled heallh
prolessional bul does nol require PN delegalion. The PN consullanl, lhe residenl's
pharmacisl or primary care praclilioner can also provide addilional inlormalion
'#50'1,.5 ('0/ :#1,-0+,(.)6
9. ,.*(':0+,(.0/ 1(-&:#.+ 02(&+ +"# 1'&5 ,) %'(@,1#1 *(' #0-" :#1,-0+,(.
dispensed lrom lhe pharmacy. ll conlains imporlanl inlormalion aboul lhe
medicalion. Once you have read lhrough all lhe inlormalion, be sure lo ask aboul
anylhing you do nol undersland.
PNs who have delegaled a nursing lask are nol responsible lor lhe general
supervision ol lhe caregiver. An PN may need lo rescind a delegalion il a caregiver
does nol lollow inslruclions or is unable lo perlorm lhe lask lor any reason,
however, il is lhe responsibilily ol lhe AlH provider lo address perlormance issues
;,+" +"# )+0**6
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PN delegalion is nol lranslerable. Whal lhis means is you cannol perlorm lhe same
lask on anolher residenl wilhoul lhe nursing lask being delegaled lor lhal residenl.
You cannol perlorm a nursing lask prior lo having il delegaled even il a nurse is
scheduled lo delegale lhe lask laler.
AlH rules require lhal you have all lhe necessary supporls in place belore accepling
a residenl. ll a hospilal, nursing home or anyone else wanls you lo admil a residenl
who has PN delegalion needs, you cannol accepl lhe residenl unless you have
made arrangemenls lor PN delegalion. ll an PN is unavailable, consider asking.
lor a relerral lor home heallh lo eilher perlorm lhe lask or lo delegale
lhe lask,
ll a lamily member has experience perlorming lhe nursing lask and il lhal
person is willing lo perlorm lhe nursing lask unlil an PN is available lo
delegale lhe lask lo lhe AlH caregiver,
The residenl's primary care praclilioner lo perlorm lhe lask.
The PN is responsible lor any lorms or documenls needed lo delegale a nursing lask.
Any slall member wilh a medicalion aide or nursing assislanl cerlilcale musl have
nursing lasks delegaled by an PN.
511.%.*056 &"(*2&-"(
The PN can provide you wilh addilional delailed inlormalion on everyone's role in
lhe PN delegalion process. Conlacl lhe PN who has delegaled a nursing lask lo
you and your slall il you have any queslions.
A sell-sludy course lilled "PN Delegalion lor Lay Caregivers" is available. Co lo
www.oreon.ov/||5/spd/prov|oo|s/|ra|n|n/se||-s|udy.sh|m| *(' 0.
('1#' *(':6