Our Nurse Delegation Services
Seattle Nurse Delegation provides comprehensive nurse delegation services for adult family homes, assisted living facilities, and in-home care settings throughout the greater Seattle area. Our experienced RN delegators work with care facilities to enable safe, compliant medication administration and clinical task delegation.
Professional RN Delegation Services
Under Washington State law (WAC 246-840), registered nurses can delegate specific nursing tasks to qualified nursing assistants and home care aides in community-based settings. This allows patients to receive necessary care—including medication administration—while living in adult family homes, assisted living facilities, or their own residences rather than institutional settings.
According to the Centers for Medicare & Medicaid Services (CMS), community-based care alternatives play an increasingly important role in the healthcare system. Nurse delegation makes this care model possible by extending nursing oversight to non-institutional settings.
Our services cover the full spectrum of delegable nursing tasks, from standard medication administration to specialized services like insulin injection and G-tube feeding delegation. Each service is delivered by experienced registered nurses who understand both the clinical requirements and the regulatory framework governing delegation in Washington State.
Why Choose Professional Delegation Services?
- Compliance Assurance: Our delegation processes meet all WAC 246-840 requirements, ensuring your facility is prepared for state surveys
- Quality Training: Caregivers receive thorough, task-specific training with competency verification
- Complete Documentation: All required forms and records are provided, organized, and easy to access
- Ongoing Support: Regular reassessments and responsive support between scheduled visits
- Patient Safety Focus: Every decision prioritizes patient safety and appropriate care
The National Council of State Boards of Nursing (NCSBN) provides guidelines for safe delegation practices that inform our approach to every delegation we perform.
Medication Administration Delegation
Professional delegation for safe medication administration by nursing assistants and home care aides. Our RN delegators assess patients, train caregivers, and provide ongoing oversight per WAC 246-840 requirements. Includes oral, topical, ophthalmic, otic, nasal, inhaled, and rectal/vaginal medications.
Learn More →Insulin Injection Delegation
Specialized diabetes care delegation with focused training for insulin administration. Includes diabetes-focused education, blood glucose monitoring protocols, sliding scale management, hypoglycemia recognition and treatment, and proper injection technique training.
Learn More →Adult Family Home Services
Comprehensive nurse delegation services tailored specifically for adult family home environments. We understand AFH regulations, licensing requirements, and help you maintain compliance while serving residents with complex medication needs. Flexible scheduling to accommodate small facility operations.
Learn More →Assisted Living Facility Services
RN delegation services designed for assisted living facility operations. Support for medication management programs, staff training and competency verification, and regulatory compliance. We can work with your existing systems and processes.
Learn More →In-Home Care Delegation
Nurse delegation services for private in-home care settings and home care agency clients. Enable your caregivers to provide medication assistance in home environments while maintaining proper RN oversight and compliance with Washington State regulations.
Learn More →Top of License Training
Empower nurses, nurse practitioners, and healthcare professionals to practice at the full extent of their education, training, and licensure. Professional development for healthcare organizations seeking to optimize their nursing workforce capabilities.
Learn More →Nutrition & Hydration (G-Tube)
G-tube feeding delegation and basic tube care for patients requiring enteral nutrition support in community settings. Includes formula administration, water flushes, medication administration via tube, and recognition of complications.
Learn More →Wound & Skin Care
Simple dressing changes, pressure ulcer prevention protocols, and colostomy/ostomy care delegation for trained caregivers. Includes wound assessment training, proper dressing technique, and recognition of signs requiring RN intervention.
Learn More →Elimination Support
Urinary catheterization, bowel programs, and digital stimulation delegation for bladder and bowel management. Proper technique training, complication recognition, and hygiene protocols included.
Learn More →Respiratory Care
Oral and tracheal suctioning, cough-assist machine delegation for patients requiring respiratory support. Includes airway management training, equipment operation, and emergency response protocols.
Learn More →The Delegation Process
Our streamlined, WAC-compliant process ensures safe, effective delegation services while minimizing disruption to your facility operations.
Initial Assessment
Our RN delegator conducts a comprehensive assessment of the patient's condition, medical history, current medications, and care needs. We determine if delegation is appropriate per WAC requirements and identify any special considerations.
Caregiver Training
We verify caregiver qualifications (NA-R, NA-C, or HCA with core delegation training) and provide thorough task-specific training. Training includes demonstration, return demonstration, and competency verification for each delegated task.
Documentation
Complete documentation is provided, including informed consent, delegation records, medication/task protocols, and caregiver training verification. All documentation meets WAC requirements and is organized for easy access during surveys.
Ongoing Oversight
Regular reassessments are conducted at least every 90 days, or sooner if there are changes in patient condition, medications, or caregivers. We provide responsive support between scheduled visits for questions or concerns.
What Can Be Delegated?
Under Washington State regulations, the following nursing tasks can be delegated to qualified nursing assistants and home care aides:
Medication Administration
- Oral medications (tablets, capsules, liquids)
- Topical medications (creams, ointments, patches)
- Eye drops and ointments (ophthalmic)
- Ear drops (otic)
- Nasal sprays and drops
- Inhalers and nebulizers
- Rectal and vaginal suppositories
- Insulin injections (with Special Focus on Diabetes training)
Clinical Tasks
- G-tube feedings and basic tube care
- Simple wound care and dressing changes
- Ostomy care
- Urinary catheter care
- Bowel programs and digital stimulation
- Oral and tracheal suctioning
- Cough-assist machine operation
What Cannot Be Delegated?
Per WAC 246-840-910, certain tasks cannot be delegated and must be performed by licensed nurses:
- Injections other than insulin (IM, subcutaneous, IV)
- Sterile procedures
- Central line maintenance and care
- Assessment and nursing judgment decisions
- Care planning and evaluation
- Tasks for patients who are not stable and predictable
Patient Eligibility
For tasks to be delegated, patients must be considered "stable and predictable." This means:
- Their condition is consistent and expected
- They respond predictably to care interventions
- No significant changes in condition are anticipated
- Emergency nursing intervention is unlikely to be needed
Our RN delegators carefully assess each patient to determine if delegation is appropriate. If a patient's condition is unstable or unpredictable, we will recommend alternative care arrangements.
Training Requirements for Caregivers
Before receiving delegation, caregivers must meet specific training requirements established by Washington State.
Required Credentials
Caregivers who can receive delegation include:
- Nursing Assistant - Registered (NA-R)
- Nursing Assistant - Certified (NA-C)
- Home Care Aide (HCA)
All caregivers must have current Washington State registration or certification without restrictions. You can verify caregiver credentials through the Washington State Department of Health Provider Credential Search.
Core Delegation Training
Before receiving any delegation, caregivers must complete Core Delegation Training through a DSHS-approved training provider. This training covers:
- Legal framework for delegation
- Scope of delegation
- Communication with the delegating nurse
- Documentation requirements
- When to contact the RN
Specialized Training
Some delegated tasks require additional training:
Special Focus on Diabetes (for Insulin Delegation)
Caregivers administering insulin must complete diabetes-focused training that covers:
- Diabetes disease process and types
- Blood glucose monitoring
- Insulin types and action
- Injection technique
- Hypoglycemia and hyperglycemia recognition
- Emergency response
Task-Specific Training
For each delegated task, we provide comprehensive training that includes:
- Step-by-step procedure demonstration
- Return demonstration by the caregiver
- Written protocols and instructions
- Signs and symptoms requiring RN notification
- Emergency procedures
- Documentation requirements
Frequently Asked Questions About Our Services
What nurse delegation services do you offer?
Seattle Nurse Delegation offers comprehensive services including medication administration delegation, insulin injection delegation, G-tube feeding delegation, wound care delegation, catheter and bowel program delegation, respiratory care delegation, and specialized services for adult family homes, assisted living facilities, and in-home care settings. Our RN delegators work with each facility to determine which services are needed based on patient care requirements.
How does the nurse delegation process work?
The delegation process involves four main steps: (1) Initial assessment where our RN evaluates the patient, reviews their medical history, and determines if delegation is appropriate; (2) Caregiver training where we verify qualifications and provide task-specific training with competency verification; (3) Documentation including consent forms, delegation records, and care protocols; and (4) Ongoing oversight with reassessments every 90 days or as needed.
What is the difference between medication administration and insulin delegation?
Standard medication administration delegation covers oral medications, topical medications, eye/ear/nasal drops, inhalers, and suppositories. Insulin delegation is a specialized service that requires additional training for caregivers (Special Focus on Diabetes) and includes comprehensive education on diabetes management, blood glucose monitoring, sliding scale protocols, hypoglycemia recognition and treatment, and proper injection technique.
Can you delegate nursing tasks for patients with feeding tubes?
Yes, we provide G-tube (gastrostomy tube) feeding delegation services. This includes delegation of formula administration according to prescribed rates and amounts, water flushes, medication administration through the tube, and basic tube site care. Caregivers receiving this delegation must demonstrate competency in tube feeding procedures and recognizing potential complications that require RN notification.
What documentation do you provide after delegation?
We provide complete WAC-compliant documentation including patient assessment forms, informed consent documentation, delegation records specifying exactly which tasks are delegated, caregiver training verification, medication or task-specific protocols with step-by-step instructions, and reassessment schedules. All documentation is designed to meet state survey requirements and is organized for easy reference.
Do you provide training for caregivers who need core delegation training?
While we provide comprehensive task-specific training as part of the delegation process, caregivers must complete Core Delegation Training through a DSHS-approved provider before they can receive any delegation. We can recommend local training providers and will verify training completion before proceeding with delegation. We do provide Special Focus on Diabetes training for caregivers who will be administering insulin.
Need Nurse Delegation Services?
Contact Seattle Nurse Delegation to discuss your specific needs. Our experienced RN delegators are ready to help your facility provide safe, compliant care.
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