1. A. The nurse may delegate the responsibility to perform a nursing task to an unlicensed individual, a certified nursing assistant, or a medication technician. The delegating nurse retains the accountability for the nursing task.

2. B. A nursing task delegated by the nurse shall be:

   1. (1) Within the area of responsibility of the nurse delegating the act;
   2. (2) Such that, in the judgment of the nurse, it can be properly and safely performed by the unlicensed individual, certified nursing assistant, or medication technician without jeopardizing the client welfare; and
   3. (3) A task that a reasonable and prudent nurse would find is within the scope of sound nursing judgment.
3. C. A nursing task delegated by the nurse may not require the unlicensed individual, certified nursing assistant, or medication technician to exercise nursing judgment or intervention except in an emergency situation.

4. D. When delegating a nursing task to an unlicensed individual, certified nursing assistant, or medication technician the nurse shall:

   1. (1) Make an assessment of the patient's nursing care needs before delegating the task;
   2. (2) Either instruct the unlicensed individual, certified nursing assistant, or medication technician in the delegated task or verify the unlicensed individual's, certified nursing assistant's, or medication technician's competency to perform the nursing task;
   3. (3) Supervise the performance of the delegated nursing task in accordance with Regulation .04 of this chapter;
   4. (4) Be accountable and responsible for the delegated task;
   5. (5) Evaluate the performance of the delegated nursing task; and
   6. (6) Be responsible for assuring accurate documentation of outcomes on the nursing record.

5. E. The nurse shall be the primary decision maker when delegating a nursing task to an unlicensed individual, certified nursing assistant, or medication technician. Nursing judgment shall be exercised within the context of the employing facility's model of nursing practice which includes a mechanism for:

   1. (1) Identifying those individuals to whom nursing tasks may be delegated;
   2. (2) Reevaluation of the competency of those to whom nursing tasks may be delegated;
   3. (3) Recognizing that the final decision regarding delegation is within the scope of the nurse's professional judgment;
   4. (4) Determining the competency of the nurse to delegate; and
   5. (5) Determining to whom nursing tasks may be delegated, which includes input by nurses employed in the facility.

6. F. The registered nurse shall assume the role of case manager in delegating nursing tasks, including the administration of medications, only in accordance with Regulation .05G of this chapter in situations where the nurse has thoroughly assessed and documented that:

   1. (1) The client's health care needs are chronic, stable, uncomplicated, routine, and predictable;
   2. (2) The environment is conducive to the delegation of nursing tasks; and
   3. (3) The client is unable to perform his or her own care.

Authority: : Health Occupations Article, §§8-102, 8-205, 8-6A-01, 8-6A-02, 8-6A-03, 8-6A-05(a)(4), and 8-6A-08(f)(5), Annotated Code of Maryland

Effective date: October 2, 1989 (16:19 Md. R. 2105)

Regulations .01—.06 amended as an emergency provision effective February 5, 1992 (19:4 Md. R. 468); emergency status expired August 7, 1992

Regulations .01—.06 amended permanently effective August 8, 1992 (19:11 Md. R. 1015)

Regulations .02—.06 amended effective July 4, 1994 (21:13 Md. R. 1158)

Regulations .01—.06 repealed and new Regulations .01—.06 adopted effective May 10, 2004 (31:9 Md. R. 712)

Regulation .01H adopted as an emergency provision effective July 8, 2015 (42:16 Md. R. 1053); adopted permanently effective July 20, 2015 (42:14 Md. R. 880)

Regulation .01I adopted effective August 4, 2025 (52:15 Md. R. 812)

Regulation .02B amended effective February 28, 2005 (32:4 Md. R. 411); January 26, 2009 (36:2 Md. R. 101); September 19, 2011 (38:19 Md. R. 1147); July 2, 2018 (45:13 Md. R. 667)

Regulation .03 amended effective June 29, 2009 (36:13 Md. R. 900)

Regulation .04 amended effective January 26, 2009 (36:2 Md. R. 101)

Regulation .04C, D amended effective September 19, 2011 (38:19 Md. R. 1147)

Regulation .05 amended effective February 28, 2005 (32:4 Md. R. 411); January 26, 2009 (36:2 Md. R. 101)

Regulation .05H amended effective September 19, 2011 (38:19 Md. R. 1147)

Regulation .06C, D amended effective January 26, 2009 (36:2 Md. R. 101)