9613.1 A registered nurse, licensed practical nurse, nurse practitioner, clinical nurse specialist or physician may assign or delegate tasks to a CNA that are among the authorized tasks listed in § 9615.1.

9613.2 A CNA shall not practice independently but shall work under the supervision of an RN or LPN or other authorized licensed health care professional.

9613.3 The delegation or assignment shall comply with the standards for delegation listed in 17 DCMR § 5415 (Registered Nurse) and assignments listed in 17 DCMR § 5515 (Licensed Practical Nurse). Nursing care tasks that may be delegated or assigned shall be determined by:

1. (a) The knowledge and skills of the CNA;
2. (b) Verification of the clinical competence of the CNA by the employing agency;
3. (c) The stability of the client's condition, including factors such as predictability, absence of risk of complication, and rate of change in health status; and
4. (d) The variables in each health care setting which include, but are not limited to:
5. (1) The accessible resources and established policies, procedures, practices, and channels of communication that lend support to the type of nursing tasks being delegated;
6. (2) The complexity and frequency of care needed by a given client population; and
7. (3) The accessibility of an RN or LPN.

9613.4 Nursing tasks that inherently involve on-going assessment, interpretation, or decision making that cannot be logically separated from one or more procedures shall not be delegated to the CNA.

SOURCE: Final Rulemaking published at 66 DCR 11404 (August 23, 2019).