Washington Administrative Code

Voluntary Closure(1) When a governing institution decides to close a nursing education program it shall immediately notify the commission in writing, stating the reason, plan, and date of intended closing. The governing institution may choose one of the following closing procedur…

The commission may consider reinstatement of withdrawn approval of a nursing education program after one year and upon submission of satisfactory evidence that the program will meet the standards of nursing education, WAC 246-840-511 through 246-840-556. The commission may conduc…

A nursing education program wishing to contest a decision by the commission that affects the program's approval status shall have the right to appeal the commission's decision in accordance with the provisions of chapter 18.79 RCW, chapter 34.05 RCW, the Administrative Procedure …

(1) A program making application to the commission for approval of a refresher course for LPNs and RNs in Washington state shall submit a commission approved application at least three months before expected date of implementation.(2) For in-state refresher course programs, the r…

For practical nurse refresher course programs, the course content must consist of a minimum of sixty hours of theory content and one hundred twenty hours of clinical practice.(1) The theory course content must include, but not be limited to, a minimum of sixty hours in current ba…

For registered nurse refresher course programs, the course content must consist of a minimum of forty hours core course content, forty hours of specialty course content, and one hundred sixty hours of clinical practice in the specialty area.(1) The core course content must includ…

(1) A college or university approved by the commission and located in the state of Washington to offer a graduate level nursing education program preparing students for advanced registered nurse licensure may apply to offer an ARNP refresher course program on a commission approve…

(1) Refresher courses located outside the state of Washington shall be reviewed individually for approval by the commission and must meet curriculum and clinical practice standards identified in WAC 246-840-563 and 246-840-564, or 246-840-566.(2) The nurse administrator shall hol…

(1) The commission may:(a) Approve a refresher program for no longer than five years;(b) Deny approval of a refresher program;(c) Withdraw approval of a refresher program;(d) Place a program on warning or conditional approval status;(e) Make on-site visits to determine compliance…

(1) The commission may approve out-of-state distance learning nursing education programs for the purpose of placing student in clinical or practice experiences in the state of Washington. The out-of-state distance learning nursing education program shall:(a) Complete and submit a…

WAC 246-840-582 and 246-840-583 establish the early remediation program and its eligibility criteria and procedures. The intent of this program is to effectively and efficiently protect patients by resolving allegations of practice deficiencies of a less serious nature through a …

The definitions in this section apply throughout WAC 246-840-581 and 246-840-583 unless the context clearly requires otherwise.(1) "Action plan" means a documented agreement between the nurse named in the complaint(s) and the commission listing remedial steps to be taken by the n…

(1) In any complaint where the commission identifies practice deficiencies, the commission may resolve the matter through the early remediation program.(2) The commission shall use the following criteria to determine eligibility for early remediation:(a) The identified practice d…

(1) The purpose of defining standards of nursing conduct or practice through WAC 246-840-700 and 246-840-710 is to identify responsibilities of the professional registered nurse and the licensed practical nurse in health care settings and as provided in the Nursing Practice Act, …

(1) Registered Nurses:(2) Licensed Practical Nurses:The registered nurse performs acts that require substantial knowledge, judgment and skill based on the principles of biological, behavioral, health, and nursing sciences. Such acts are grounded in the elements of the nursing pro…

The following conduct may subject a nurse to disciplinary action under the Uniform Disciplinary Act, chapter 18.130 RCW:(1) Engaging in conduct described in RCW 18.130.180;(2) Failure to adhere to the standards in WAC 246-840-700 which may include, but are not limited to:(a) Fail…

The commission recognizes that there may be circumstances inherent to various practice settings that may affect the commission's decision whether to issue a statement of charges, to make a finding of unprofessional conduct, or to determine a sanction.[Statutory Authority: Chapter…

Any person including, but not limited to, a registered nurse, a licensed practical nurse, advanced registered nurse practitioner, health care facility, or governmental agency shall always report in compliance with the uniform mandatory reporting rules found in WAC 246-16-200 thro…

(1) Sexual misconduct. A nurse or nursing technician shall not engage, or attempt to engage, in sexual misconduct with a current patient, client, or key party, inside or outside the health care setting. Sexual misconduct shall constitute grounds for disciplinary action. Sexual mi…

The commission adopts the model procedural rules for adjudicative proceedings as adopted by the department of health and contained in chapter 246-11 WAC, including subsequent amendments.[Statutory Authority: Chapter 18.79 RCW. WSR 97-13-100, § 246-840-745, filed 6/18/97, effectiv…

All persons appearing in proceedings before the commission in a representative capacity shall conform to the standards of ethical conduct required of attorneys before the courts of Washington. If any such person does not conform to such standards, the commission may decline to pe…

The Washington state board of nursing (board) recognizes the need to establish a means of providing early recognition and treatment options for licensed practical nurses or registered nurses whose competency may be impaired due to the use of drugs or alcohol. The board intends th…

The definitions in this section apply throughout WAC 246-840-750 through 246-840-790 unless the text clearly requires otherwise.(1) "Continuing care" means the phase of treatment following acute treatment. Common elements of continuing care include relapse prevention and self-hel…

The board uses WHPS as the approved monitoring program.(1) WHPS will:(a) Employ staff with the qualifications and knowledge of both substance use and the practice of nursing as defined in this chapter to be able to evaluate:(i) Clinical laboratories;(ii) Laboratory results;(iii) …

(1) Any nurse participating in the substance use monitoring program must:(a) Undergo a complete substance use disorder evaluation. This evaluation will be performed by health care professional(s) with expertise in chemical dependency.(b) Enter into a monitoring contract with WHPS…

(1) Applicants must meet the requirements in RCW 18.79.440 to be eligible for the substance use disorder monitoring stipend program (stipend program). All disbursements of stipend program funds are subject to availability of budgeted funds.(2) To be eligible for the stipend progr…

(1) The commission may issue advisory opinions in response to questions put to it by professional health associations, nursing practitioners and consumers concerning the authority of various categories of nursing personnel to perform particular acts. Such questions must be presen…

When a resident of a long-term care facility has the opportunity for an unscheduled therapeutic leave that would be precluded by the lack of an available pharmacist to dispense drugs prescribed by an authorized practitioner, a registered nurse designated by the facility and its c…

Public school districts and private schools that offer classes for any of the grades kindergarten through twelve may provide for clean, intermittent catheterization of students or assisted self-catheterization of students who are in the custody of the school district at the time …

A registered nurse may determine and pronounce death, but shall not certify death as defined in RCW 70.58.160 unless the registered nurse is a licensed ARNP as defined in WAC 246-840-300.(1) A registered nurse may assume responsibility for the determination and pronouncement of d…

In settings other than community-based and in-home care that deliver health care services, registered nurses may delegate blood glucose monitoring and testing only to registered or certified nursing assistants under chapter 18.88A RCW in accordance with the delegation process in …

The purpose of the nursing technician credential is to provide additional work related opportunities for students enrolled in an LPN, ADN, or BSN program, within the limits of their education, to gain valuable judgment and knowledge through expanded work opportunities.(1) The nur…

(1) Any person who meets the definition of nursing technician under WAC 246-840-010(30) shall use the title nursing technician.(2) No person may practice or represent oneself as a nursing technician by use of any title or description of services without being registered under cha…

To be eligible for employment as a nursing technician a student must meet the following criteria:(1) Satisfactory completion of at least one academic term (quarter or semester) of a nursing program approved by the commission. The term must have included a clinical component.(2) C…

The nursing technician is authorized only to perform specific nursing functions within the limits of their education, up to their skills and knowledge, as verified by their nursing program. The nursing technician:(1) May function only under the direct supervision of a registered …

The registered nurse who is responsible for supervising the nursing technician:(1) Is accountable at all times for the client's safety and well-being.(2) Is responsible at all times for the nursing process as delineated in WAC 246-840-700 and this responsibility cannot be delegat…

In addition to the responsibilities required by RCW 18.79.360 (4)(e), the employer of the nursing technician shall:(1) Verify the nursing technician's enrollment in a nursing program approved by the commission.(2) Verify that the nursing technician continues to qualify as a nursi…

The nursing program in which the nursing technician is enrolled should:(1) Provide to the employer written documentation of specific nursing functions the nursing technician may perform. This documentation should be based upon, and limited to, the nursing technician's education a…

(1) An individual shall complete an application for registration on an application form prepared and provided by the secretary of the department of health. This application shall be submitted to P.O. Box 47864, Olympia, Washington 98504-7864.(2) Every applicant shall provide:(a) …

This rule defines a consistent standard of nursing care with the delegation of nursing tasks to nursing assistants or home care aides. The registered nurse delegator makes independent professional decisions of the delegation of a nursing task. A licensed registered nurse may dele…

The following definitions apply to WAC 246-840-910 through 246-840-970.(1) "Authorized representative" means a person allowed to provide written consent for health care on behalf of a patient who is not competent to consent. Such person shall be a member of one of the classes of …

(1) In community-based and in-home care settings, before delegating a nursing task, the registered nurse delegator shall decide if a task is appropriate to delegate based on the elements of the nursing process: ASSESS, PLAN, IMPLEMENT, EVALUATE.ASSESS(2) The setting allows delega…

In community-based and in-home care settings, the registered nurse delegator may delegate blood glucose monitoring and testing only to registered or certified nursing assistants under chapter 18.88A RCW or to home care aides certified under chapter 18.88B RCW following the criter…

In community-based and in-home care settings, before delegating a nursing task, the registered nurse delegator shall decide if a task is appropriate to delegate based on the decision tree:(1)Does the patient reside in one of the following settings? A community-based care setting …

(1) Medication. The registered nurse delegator discusses with the nursing assistant or home care aide the process for continuing, rescinding, or adding medications to the delegation list when the changes occur:(a) The registered nurse delegator verifies the change in medication o…

(1) The registered nurse delegator may rescind delegation of the nursing task based on the following circumstances which may include, but are not limited to:(a) The registered nurse delegator believes patient safety is being compromised;(b) The patient's condition is no longer st…

(1) The registered nurse delegator and nursing assistant or home care aide are accountable for their own individual actions in the delegation process. While the delegated task becomes the responsibility of the nursing assistant or home care aide, the registered nurse delegator re…

(1) A licensed practical nurse (LPN) or a registered nurse (RN) must renew their single or multistate license every year on the licensee's birthday.(2) When applying for a license an applicant for an initial or renewal LPN license or RN license must pay, in addition to the applic…

The definitions in RCW 18.88A.020 and in this section apply throughout this chapter unless the context clearly requires otherwise.(1) "Asynchronous" means online learning of classroom or theory content that allows students to view and participate with online instructional materia…

Competencies and standards of practice are statements of knowledge, skills, and behaviors. They are written as descriptions of observable, measurable actions. All nursing assistant competencies are performed under the direction and supervision of a licensed registered nurse or li…