AN ACT Relating to nursing delegation;
SB 6107 revises Washington’s nursing delegation laws to expand and clarify when registered nurses may delegate certain nursing care tasks to others. The bill authorizes delegation in any setting when the nurse determines it is in the patient’s best interest and within the nurse’s scope of practice, while preserving limits on tasks that require substantial skill, nursing judgment, sterile procedures, central line maintenance, and most medication administration by injection. It also adds specific authority for delegation in home health, hospice, community-based care settings, and in-home care settings, including certain tasks for nursing assistants and home care aides.
The bill creates detailed conditions for delegation, including competency verification, patient stability requirements, training prerequisites, supervision, and documentation. It specifically allows delegation of some diabetes-related tasks, including insulin injections and glucose monitoring, if the aide or assistant completes required core and specialized training. The bill also states that family caregivers trained by a nurse are not considered to be receiving delegated nursing tasks, and it directs the Board of Nursing to adopt rules to implement the new delegation framework and appropriate delegation parameters.
SB 6107 would amend multiple sections of Washington law governing nursing practice, home health, hospice, and in-home care by expanding the statutory authority for registered nurses to delegate nursing tasks and by defining the training, supervision, and liability rules that apply. It affects registered nurses, nursing assistants, certified nursing assistants, home care aides, home health agencies, hospice agencies, community-based care settings, and in-home service providers. The bill also creates or clarifies exemptions from retaliation and liability for nurses and aides acting within the delegation rules, and it requires the Board of Nursing to adopt implementing rules by specified dates.
The overall sentiment reflected in the bill text is supportive of expanded delegation as a way to improve access to care, especially in community-based and home settings. The findings section states that delegation to home care aides may enhance the viability and quality of services and help individuals live as independently as possible with safeguards. No committee transcripts or recorded votes were provided, so there is no additional evidence of opposition or support from hearings or floor action beyond the bill’s pro-delegation framing.
The main points of contention are likely to center on patient safety, professional judgment, and the scope of tasks that non-nurses may perform. The bill repeatedly emphasizes that nurses cannot be coerced into delegating when they believe it is inappropriate, and it bars delegation of tasks requiring substantial skill, nursing judgment, sterile procedures, central line maintenance, and most injections except for narrowly defined insulin-related situations. Another likely issue is the training burden and certification requirements for nursing assistants and home care aides, particularly for diabetes care, as well as the balance between expanding care access and preserving nursing oversight and accountability.