| Program Name: | BadgerCare Plus and Medicaid | Handbook Area: | Personal Care | | 05/09/2024 | Covered and Noncovered Services : Covered Services and RequirementsTopic #2471 Delegation of Medically Oriented Tasks
Medically oriented tasks are covered personal care services when delegated by an RN under Wis. Admin. Code § DHS 107.112(2)(b) and ch. N 6.
Criteria for Delegation of Medically Oriented Tasks
According to Wis. Admin. Code § DHS 107.112(2)(b), a PCW of a Medicaid-enrolled personal care agency may perform a medically oriented task under the delegation of an RN according to Wis. Admin. Code ch. N 6 and the guidelines of the Board of Nursing. When delegating medically oriented tasks, the following conditions should be met:
- The agency has policies and procedures designed to provide for safe and accurate performance of the delegated tasks. These policies shall be followed by personnel assigned to perform these tasks.
- The RN provides written delegation of the nursing act.
- Documentation supports the educational preparation of the caregiver who performs delegated tasks.
- For medication administration, documentation should also include the name of the medication, the dose, the route of administration, the time of administration, and identification of the person administering the medication.
- Teaching and supervisory oversight is provided by the RN.
- Members are informed, prior to the delivery of service, that unlicensed personnel will administer their medications and other treatments/procedures.
- The supervision and direction of the delegated nursing act meets the requirements of Wis. Admin. Code ch. N 6.
- The member, parent, or responsible person is permitted to participate in the training and supervision of the PCW.
To assure that services are competently and safely provided, and the needs of the member are being met, an RN must provide the following supervision and direction of the delegated nursing acts:
- Delegate tasks commensurate with educational preparation and demonstrated abilities of the person supervised
- Provide direction and assistance to those supervised
- Observe and monitor the activities of those supervised
- Evaluate the effectiveness of acts performed under supervision
The supervising RN must document that the above requirements are met when medically oriented tasks are delegated to PCWs. Documentation must include that the PCW has been appropriately trained to provide the medically oriented task safely for the specific member and competency has been evaluated.
Responsibility for Delegation
Though agencies may suggest which nursing acts should be delegated, it is the supervising RN who makes the decision on whether and under what circumstances the delegation occurs. When an RN delegates another person to perform a task, the RN assumes responsibility and liability under their license for the proper performance of that task. The RN should only delegate tasks that can be performed appropriately or safely by the PCW.
The PCW is not required to accept a delegated act. However, the PCW should immediately inform the RN supervisor if he or she refuses to accept the delegation.
Questions Regarding Delegation
The Wisconsin DSPS standards in Wis. Admin. Code ch. N 6 define a nurse's responsibility when delegating nursing acts. Further questions regarding the interpretation of this code and the delegation of nursing acts, should be directed to:
Department of Safety and Professional Services
Board of Nursing
PO Box 8935
Madison WI 53708-8935
608-266-0145 |