ARM 24.159.1640. ADVANCED DELEGATION TO UAPS WORKING IN THE DIALYSIS UNIT

(1) A UAP working in a dialysis unit may receive delegation of advanced nursing tasks identified in this rule if: (a) the delegation is made in an out-patient dialysis unit; (b) the delegation is for an established adult dialysis patient who has been on dialysis for more than 30 days; and (c) the UAP is: (i) under the immediate supervision of the delegating nurse; and (ii) is currently certified as a certified dialysis technician by either the: (A) Nephrology Nursing Certification Commission (NNCC) ; or (B) Board of Nephrology Examiners - Nursing and Technology (BONENT) . (2) The UAP working in the dialysis unit may receive delegation of the following advanced nursing tasks: (a) preparing dialysate according to established procedures and the dialysis prescription; (b) assembling and preparing the dialysis extracorporeal circuit according to protocol and dialysis prescription; (c) preparing and cannulating of mature fistula/graft. Maturity/stability of the graft will be established by a nurse prior to cannulation; (d) initiating, delivering or discontinuing the dialysis treatment; (e) obtaining a blood specimen via a dialysis line or a fistula/graft site; and (f) administering the following medications under the immediate supervision of an RN: (i) heparin, only in concentrations of 1:1000 units or less, in an amount prescribed by an individual authorized by Montana statute to so prescribe: (A) to prime the extracorporeal circuit; (B) to initiate treatment; and/or (C) for routine administration throughout the treatment; (ii) normal saline via the dialysis machine to correct dialysis-induced hypotension; (iii) intradermal anesthetics, in an amount prescribed by an individual authorized by Montana statute to so prescribe, as an integral part of the vascular access cannulation procedure; and (iv) oxygen by nasal cannula.