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Practice Delegation

Frequently Asked Questions

Where are the regulations related to delegation to unlicensed assistive personnel (UAPs) located?

See: 12 AAC 44.950-975, Standards for Delegation of Nursing Duties to Other Persons.

Who are UAPs??

CMAs, CNAs, PCTs, PCAs, school secretaries, etc. Anyone not licensed as a health care provider.

To whom can nurses delegate the administration of medication?

  1. Home and community based services providers, and
  2. Residential supported living services providers.

Can nurses delegate injections to unlicensed assistive personnel (UAPs)?

No, 12 AAC 44.970 (13) states that the administration of injectable medications cannot be delegated to UAPs. A specific example is “can a nurse delegate insulin injections to a UAP?” NO.

I work in a doctor’s office as an appointment clerk. The nurse wants me to give out medication samples. Is this legal?

No, that is considered dispensing which falls under the realm of Advance Nurse Practitioner practice (12 AAC 44.447).

I’m a CMA in a doctor’s office. The nurse gave me a pill to take to the patient. Can I do that?

No, this practice does not fall under home or community based settings (AAC 44.965 (b)(1)&(2)). The nurse cannot delegate medication administration unless in these settings.

I am a nurse and have delegated obtaining blood glucose levels on Mrs. Evans to the UAP. The UAP took the reading and charted it, but did not tell me the reading was 250. Who is responsible?

The nurse is ultimately responsible for the tasks delegated to the UAP (12 AAC 44.950 (d). Also, if the patient is not stable and predictable, the task should not have been delegated (12 AAC 44.950 (a)(3) & 12 AAC 44.970 (10).

Can nurses delegate the administration of PRN controlled substances to a UAP?

No, PRN controlled substances are not delegatable under the regulation 12 AAC 44.964(e).

The doctor employs a CMA and wants the nurse to supervise the CMA starting an IV and giving IV push medications. Is this a proper role for the nurse?

No, this nursing duty is not delegatable by the nurse to a UAP. The nurse cannot be involved in supervising this activity. The delegation and supervision has to be by the doctor. This includes ANPs; they can not delegate this task or supervise the CMA.

But the doctor ordered it.

It does not matter. The delegation including supervision of the CMA performing this IV start and IV push by the RN or ANP violates the nurse practice act.