21 NCAC 36 .0401. ROLES OF UNLICENSED PERSONNEL

(a)  Definitions.  As used in Section .0400:

(1)        "Nursing care activities" means activities performed by unlicensed personnel which are delegated by licensed nurses in accordance with paragraphs (b) and (c) of this Rule.

(2)        "Patient care activities" means activities performed by unlicensed personnel when health care needs are incidental to the personal care required.

(b)  The Board of Nursing, as authorized by G.S. 90-171.23(b)(1)(2)(3), shall be the determining authority to identify those nursing care activities which may be delegated to unlicensed personnel.  The licensed nurse, registered and practical, in accordance with 21 NCAC 36 .0224 and .0225 and G.S. 90-171.20(7)(8), may delegate nursing care activities to unlicensed personnel, regardless of title, that are appropriate to the level of knowledge and skill of the unlicensed personnel and are within the legal scope of practice as defined by the Board of Nursing for unlicensed personnel.

(c)  Those activities which may be delegated to unlicensed personnel are determined by the following variables:

(1)        knowledge and skills of the unlicensed personnel;

(2)        verification of clinical competence of the unlicensed personnel by the employing agency;

(3)        stability of the client's condition which involves predictability, absence of risk of complication, and rate of change, which thereby excludes delegation of nursing care activities which do not meet the requirements defined in 21 NCAC 36 .0221(b);

(4)        the variables in each service setting which include but are not limited to:

(A)       the complexity and frequency of nursing care needed by a given client population;

(B)       the proximity of clients to staff;

(C)       the number and qualifications of staff;

(D)       the accessible resources; and

(E)       established policies, procedures, practices, and channels of communication which lend support to the types of nursing activities being delegated, or not delegated, to unlicensed personnel.

 

History Note:        Authority G.S. 90‑171.20(2)(4)(7)d.,e.,g.; 90‑171.43(4); 90‑171.55;

42 U.S.C.S. 1395i‑3 (1987);

Eff. March 1, 1989;

Amended Eff. December 1, 1995; October 1, 1991.