The Board proposes the rule amendments to update the rules due to legislation passed in 2023 (Ch. 2023-250. Laws of Fla.) and to increase clarity of the rules.

 

DEPARTMENT OF HEALTH

Board of Nursing

RULE NOS.:RULE TITLES:

64B9-14.001Definitions

64B9-14.002Delegation of Tasks or Activities

64B9-14.003Delegation of Tasks Prohibited

PURPOSE AND EFFECT: The Board proposes the rule amendments to update the rules due to legislation passed in 2023 (Ch. 2023-250. Laws of Fla.) and to increase clarity of the rules.

SUMMARY: Due to legislation passed in 2023, the rules will be updated.

SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION:

The Agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has not been prepared by the Agency.

The Agency has determined that the proposed rule is not expected to require legislative ratification based on the statement of estimated regulatory costs or if no SERC is required, the information expressly relied upon and described herein: During discussion of the economic impact of this rule at its Board meeting, the Board, based upon the expertise and experience of its members, determined that a Statement of Estimated Regulatory Costs (SERC) was not necessary and that the rule will not require ratification by the Legislature. No person or interested party submitted additional information regarding the economic impact at that time.

Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.

RULEMAKING AUTHORITY: 464.006 FS.

LAW IMPLEMENTED: 464.003(17), (18), (19), (20), 456.072(1)(p), 464.018(1)(h) FS.

IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE SCHEDULED AND ANNOUNCED IN THE FAR.

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Joe Baker, Jr., Executive Director, Board of Nursing, 4052 Bald Cypress Way, Bin #C02, Tallahassee, Florida 32399; [e-mail].

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

64B9-14.001 Definitions.

As used in this chapter, the following mean:

(1) “Unlicensed assistive personnel” (UAP) are persons who do not hold licensure from the Division of Medical Quality Assurance of the Department of Health but who have been assigned to function in an assistive role to registered nurses or licensed practical nurses in the provision of patient care services through regular assignments or delegated tasks or activities and under the supervision of a nurse. Unlicensed assistive personnel do not include certified nursing assistants.

(2) “Home health aide” (HHA) means a person defined in Section 400.462(15), F.S., and trained or qualified under subsection 59A-38.001(8), F.A.C., effective 7-1-19, hereby incorporated by reference, and may be obtained from http://www.flrules.org/Gateway/reference.asp?No=Ref-12509.

(3) “Assignments” are the normal daily functions of the UAP or CNA UAP’s based on institutional or agency job duties which do not involve delegation of nursing functions or nursing judgment.

(4) No change.

(5) “Validation” is the process of ascertaining the competency including psychomotor skills of the UAP, and verifying verification of education or training of the delegatee UAP by the qualified individual delegating or supervising the task based on preestablished standards. Validation may be by direct verification of the delegator or assurance that the institution or agency has established and periodically reviews performance protocols, education or training for the delegatee UAP’s.

(6) No change.

(7) “Delegator” is a the registered nurse or licensed practical nurse who delegates delegating authority to a competent individual the UAP.

(8) “Delegatee Delegate” is the individual UAP receiving the authority from the delegator. For purposes of this rule, a delegatee may be a QMA, CNA, or HHA.

(9) through (13) No change.

(14) “Certified Nursing Assistant” (CNA) is an individual certified pursuant to Chapter 464, Part II, F.S. “Education” means a degree or certification of the UAP in a specific practice area or activity providing background and experience in theoretical or clinical aspects of that practice or activity.

(15) “Qualified Medication Aide” (QMA) is a certified nursing assistant who meets the requirements in Sections 400.211(5) and 464.2035, F.S., and who has completed training and demonstrated competency to administer medications and perform associated tasks for residents of a nursing home facility. “Training” is the learning of tasks by the UAP through on the job experience or instruction by a nurse who has the education or experience to perform the task or activity to be delegated.

Rulemaking Authority 400.211(5), 464.006, 464.0156(3) FS. Law Implemented 400.211(5), 464.003(17), (18), (19), (20), 456.072(1)(p), 464.0156(3) FS. History–New 1-1-96, Amended 4-29-96, Formerly 59S-14.001, Amended 1-3-21,                        .

 

64B9-14.002 Delegation of Tasks or Activities.

In the delegation process, the delegator must use nursing judgment to consider the suitability of the task or activity to be delegated.

(1) No change.

(2) Factors to weigh in selecting and delegating to a specific delegatee delegate include:

(a) Normal assignments of the UAP or CNA.

(b) Validation or verification of the education and training of the delegatee delegate.

(3) The delegation process shall include communication to the delegatee UAP which identifies the task or activity, the expected or desired outcome, the limits of authority, the time frame for the delegation, the nature of the supervision required, verification of delegatee’s delegate’s understanding of assignment, verification of monitoring and supervision.

(4) Initial allocation of the task or activity to the delegatee delegate, periodic inspection of the accomplishment of such task or activity, and total nursing care responsibility remains with the qualified nurse delegating the tasks or assuming responsibility for supervision.

Rulemaking Authority 464.006 FS. Law Implemented 464.003(17),(18), (19), (20), 464.018(1)(h) FS. History–New 1-1-96, Formerly 59S-14.002, Amended                              .

 

64B9-14.003 Delegation of Tasks Prohibited.

The registered nurse or licensed practical nurse, under direction of the appropriate licensed professional as defined in Section 464.003(3)(b), F.S., shall not delegate:

(1) through (2) No change.

(3) Those activities for which the QMA, CNA, or UAP has not demonstrated competence.

Rulemaking Authority 400.211(5), 464.006, 464.0156 FS. Law Implemented 400.211(5), 464.003(17),(18), (19), (20), 464.0156, 464.018(1)(h) FS. History–New 1-1-96, Amended 4-29-96, Formerly 59S-14.003, Amended                     .

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Board of Nursing

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Board of Nursing

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: December 8, 2023

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: November 2, 2023