22 Tex. Admin. Code § 224.7 - Supervision
The registered professional nurse shall provide supervision of all nursing tasks delegated to unlicensed persons in accordance with the following conditions. These criteria apply to all instances of RN delegation and supervision of delegation for clients with acute conditions or in acute care environments.
(1) The degree of
supervision required shall be determined by the delegating RN or the RN who
assumes supervisory responsibilities after an evaluation of appropriate factors
involved including, but not limited to, the following:
(A) the stability of the client's status in
relation to the task(s) to be delegated;
(B) the training, experience, and capability
of the unlicensed person to whom the nursing task is delegated;
(C) the nature of the nursing task being
delegated; and
(D) the proximity
and availability of the RN to the unlicensed person when the nursing task will
be performed.
(2) The RN
or an RN who assumes supervisory responsibilities under this section shall be
available in person or by telecommunications, and shall make decisions about
appropriate levels of supervision using the following examples as guidelines:
(A) In situations where the RN's regularly
scheduled presence is required to provide nursing services, including
assessment, planning, intervention and evaluation of the client whose health
status is changing and/or to evaluate the client's health status, the RN must
be readily available to supervise the unlicensed person in the performance of
delegated tasks. Settings include, but are not limited to acute care, long term
care, rehabilitation centers, and/or clinics providing public health
services.
(B) In situations where
nursing care is provided in the client's residence but the client's status is
unstable and unpredictable and the RN is required to assess, plan, intervene,
and evaluate the client's unstable and unpredictable status and need for
skilled nursing services, the RN shall make supervisory visits at least every
fourteen calendar days. The RN shall assess the relationship between the
unlicensed person and the client to determine whether health care goals are
being met. Settings include, but are not limited to group homes, foster homes
and/or the client's residence.
(C)
In situations where the RN assumes supervision of UAPs performing tasks that
have been delegated by another RN, if performance of the tasks by the UAP poses
a risk of patient harm, the supervising RN must intervene as required to
stabilize a patient's condition and prevent complications and then communicate
with the delegating RN.
Notes
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