Texas Registered Nurses (RNs) must adhere to delegation rules regarding tasks completed by unlicensed personnel. The fact is that it is not uncommon to have disagreement between a patient or client and a registered nurse as to what tasks can and should be properly delegated.
The practice of nursing requires substantial specialized judgment and skill, and every nurse licensed by the Texas Board of Nursing (BON) is responsible for applying the minimum standards of nursing regardless of the practice setting. Nurses who violate any part of the Nursing Practice Act or Board Rules, including rules pertaining to delegation, risk having their license restricted or revoked by the Board.
RN Delegation of Nursing Tasks to Unlicensed Personnel, Texas Rules
The BON offers a practice Delegation Resource Packet on their website here. The packet offers Delegation FAQs, information on the Conflict Resolution Model, Delegation Principles, Delegation Don'ts, and Links to Delegation Resources, among other information.
Delegation is an essential nursing skill that RNs use to maximize the nursing care that clients receive. The BON Rules contain a chapter on the delegation of nursing tasks by RNs to unlicensed personnel for patients with acute conditions or in acute care environments. 22 Tex. Admin. Code §224.
Under Board Rule 224, the general criteria for delegation are based upon:
- The needs of the patient and the stability of the patient’s condition;
- The RN assessment of the potential for patient harm;
- The complexity of the task;
- The predictability of the outcomes;
- The abilities of the unlicensed assistive personnel staff to whom the task is delegated; and
- The context of other patient needs to achieve the most benefit from nursing care since the RN is responsible and accountable for safe and appropriate delegation and delegation is utilized at the RN’s discretion.
22 Tex. Admin. Code §224.6. The delegation process is multifaceted, and it begins with decisions made at the administrative level and extends to the staff responsible for delegating and supervising the delegated tasks.
The BON Rules also have a chapter on RN delegation to unlicensed personnel and tasks not requiring delegation in independent living environments for patients with stable and predictable conditions. §Tex. Admin. Code §225. The BON also offers guidance specific to School RN's role in delegating tasks to unlicensed persons and supervising the tasks delegated.
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