1. (1) The registered nurse shall be accountable and responsible for the assignment of nursing activities and tasks to other health care workers based on, but not limited to:

   1. (a) Knowledge, skills, and experience.
   2. (b) Complexity of assigned tasks.
   3. (c) Health status of the patient.

2. (2) Assignments may not exceed the scope of an individual licensed nurse’s scope of practice, including, but not limited to:

   1. (a) Educational preparation, initial and continued.
   2. (b) License status.
   3. (c) State and federal statutes and regulations.
   4. (d) State and national standards appropriate to the type of practice.
   5. (e) Nursing experience.
   6. (f) Demonstrated competence.
   7. (g) Consideration for patient safety.
   8. (h) Knowledge, skills, and ability to manage risks and potential complications.

3. (3) The licensed nurse shall delegate only after considering various factors, including but not limited to:

   1. (a) Knowledge, skills, and experience of the person receiving the delegation.
   2. (b) Complexity of the delegated tasks.
   3. (c) Health status of the patient.

4. (4) Tasks delegated to unlicensed assistive personnel may not include tasks that require:

   1. (a) The exercise of independent nursing judgment or intervention.

   2. (b) Invasive or sterile procedures.

      1. 1. Finger sticks are not an invasive or sterile procedure within the meaning of these rules.
      2. 2. Peripheral venous phlebotomy for laboratory analysis is not an invasive or sterile procedure within the meaning of these rules.
   3. (c) Assistance with medications, except as provided in Chapter 610-X-7.
5. (5) Supervision shall be provided to individuals to whom nursing functions or responsibilities are delegated or assigned.
6. (6) The practice of licensed practical nursing shall be directed by a registered nurse, physician, or dentist.
7. (7) A licensed practical nurse or unlicensed individual may not supervise, direct, or evaluate the nursing care provided by the registered nurse.

Author: Alabama Board of Nursing

Statutory Authority: Code of Ala. 1975, §§34-21-1(3)(b), 34-21-2(a)(21), 34-21-2(c)(21).

History: New Rule: Filed November 23, 2009; effective December 28, 2009. Repealed and New Rule: Filed July 25, 2016; effective September 8, 2016.