Current through August 30, 2024
(a) A physician,
podiatrist, osteopath, or physician assistant licensed under AS 08.64 may
delegate the performance of routine medical duties to an agent of the
physician, podiatrist, osteopath, or physician assistant, if the following
conditions are met:
(1) the duty to be
delegated must be within the scope of practice of the delegating physician,
podiatrist, osteopath, or physician assistant;
(2) a licensed physician, podiatrist,
osteopath, or physician assistant must assess the patient's medical condition
and needs to determine if a duty for that patient may be safely delegated;
(3) the patient's medical
condition must be stable and predictable;
(4) the person to whom the duty is to be
delegated has received the training needed to safely perform the delegated
duty, and this training has been documented;
(5) the delegating physician, podiatrist,
osteopath, or physician assistant determines that the person to whom a duty is
to be delegated is competent to perforin the delegated duty correctly and
safely and accepts the delegation of the duty and the accountability for
carrying out the duty correctly;
(6) performance of the delegated duty would
not require the person to whom it is delegated to exercise professional medical
judgment oivknowledge of complex medical skills;
(7) the delegating physician, podiatrist,
osteopath, or physician assistant provides to the person, with a copy
maintained on record, written instructions that include
(A) a clear description of the procedure to
follow to perform each task in the delegated duty;
(B) the predicted outcomes of the delegated
task;
(C) Procedures For
observing, reporting and responding to side effects, complications, or
unexpected outcomes in the patient, and
(D) the procedure to document the performance
of the duty in the patient's record.
(b) A physician, podiatrist, osteopath, or
physician assistant who has delegated a routine duty to another person shall
provide appropriate direction and supervision of the person, including the
evaluation of patient outcomes. Another physician, podiatrist, osteopath, or
physician assistant may assume delegating responsibilities from the delegating
physician, podiatrist, osteopath, or physician assistant if the substitute
physician, podiatrist, osteopath, or physician assistant has assessed the
patient, the skills of the person to whom the delegation was made, and the plan
of care. Either the original or substitute delegating physician, podiatrist,
osteopath, or physician assistant shall remain readily available for
consultation by the person to whom the duty is delegated, either in person or
by telecommunication.
(c) The
delegation of a routine duty to another person under this section is specific
to that person and for that patient, and does not authorize any other person to
perform the delegated duty.
(d) The
physician, podiatrist, osteopath, or physician assistant who delegated the
routine duty to another person remains responsible for the quality of the
medical care provided to the patient.
(e) Routine medical duties that maybe
delegated to another person under the standards set out in this section means
duties that
(1) occur frequently in the daily
care of a patient or group of patients;
(2) do not require the person to whom the
duty is delegated to exercise professional medical knowledge or judgment;
(3) do not require the exercise of
complex medical skills;
(4) have a
standard procedure and predictable results; and
(5) present minimal potential risk to the
patient.
(f) Duties
that require the exercise of professional medical knowledge or judgment or
complex medical skills may not be delegated. Duties that may not be delegated
include
(1) the assessment of the patient's
medical condition, and referral and follow-up;
(2) formulation of the plan of medical care
and evaluation of the patient's response to the care provided;
(3) counseling of the patient and the
patient's family or significant others regarding the patient's
health;
(4) transmitting verbal
prescription orders, without written documentation, from the patient's health
care provider;
(5) duties related
to pain management and opioid use and addiction;
(6) the initiation, administration, and
monitoring of intravenous therapy, including blood or blood products;
(7) the initiation administration, and
monitoring of procedural sedation;
(8) assessing sterile wound or decubitus
ulcer care;
(9) managing and
monitoring home dialysis therapy;
(10) oral tracheal suction;
(11) medication management for unstable
medical conditions requiring ongoing assessment and adjustment of dosage or
timing of administration;
(12)
placement and administration of nasogastric tubes and fluids;
(13) initial assessment and management of
newly-placed gastrostomy tubes and the patient's nutrition; and
(14) the administration of injectable
medications, unless
(A) it is a single
intramuscular, intradermal, or subcutaneous injection, not otherwise prohibited
under 12 AAC
40.967(33); and
(B) all other provisions of this section are
met; and
(C) the delegating
physician, podiatrist, osteopath, or physician assistant is immediately
available on site.
(g) The provisions of this section apply only
to the delegation of routine medical duties by a physician, podiatrist,
osteopath, or physician assistant licensed under AS 08.64; they do not apply
when duties have not been delegated, including when a person is acting
(1) within the scope of the person's own
license;
(2) under other legal
authority; or
(3) under the
supervision of another health care provider licensed under AS 08, who has
authority to delegate routine duties
Authority:
AS 08.64.100
AS 08.64.106
AS 08.64.107
AS 08.64.170
AS 08.64.326
AS 08.64.336
AS 08.64.380
