Guidelines For The Administration Of Medications
In Michigan Assisted Living Facilities

APPENDIX B
LEGAL DEFINITION OF NURSING

Public Health Code / Act 368 of 1978 Section 333.17201 (1)(1) defines the "practice of nursing" as a systematic application of substantial specialized knowledge and skill derived from the biological, physical and behavioral sciences, to the care, treatment, counsel, and health teaching of individuals who are experiencing changes in the normal health processes or who require assistance in the maintenance of the normal health processes or who require assistance in the maintenance of health and the prevention or management of illness, injury, or disability.

An L.P.N. cannot assume the role of an R.N. Section 333.17201 (1)(b) of the Public Health Code/Act 368 of 1978 defines a licensed practical nurse (L.P.N.) "As the practice of nursing based on less comprehensive knowledge and skill than that required of a registered professional nurse and performed under the supervision of a registered professional nurse, physician, or dentist.

Section 333.17201(1)(c) further states that the "Registered Professional Nurse" or "R.N." means an individual licensed under Article 15 of the Public Health Code to engage in the practice of nursing when scope of practice includes the teaching, direction, and supervision of less skilled personnel in the performance of delegated nursing activities.

Section 333.16104 states delegation (1) means an authorization granted by a licensee to a licensed or unlicensed individual to perform selected acts, tasks, or functions which fall within the scope of practice of the delegator and which are not within the scope of practice of the delegatee and which, in the absence of the authorization, would constitute illegal practice of a licensed profession.

Section 333.16109(2) defines supervision as the overseeing of or participation in the work of another individual by a licensed health professional where at least all of the following conditions exist:

(a) The continuous availability of direct communication in person or by radio, telephone, or telecommunication between the supervised individual and a licensed health professional.
(b) The availability of a licensed health professional on a regularly scheduled basis to review the practice of the supervised individual, to provide consultation to the supervised individual, to review records, and to further educate the supervised individual in the performance of the individual's function.
(c) The provision by the licensed health professional of predetermined procedures and drug protocol.

R338.10104 Rule 104 addresses delegation requirements
(1) Only a registered nurse may delegate nursing acts, functions, or tasks. A registered nurse who delegates nursing acts, functions, or tasks shall do all of the following:

(a) Determine whether the act, function or task delegated is within the registered nurse's scope of practice.
(b) Determine the qualification of the delegatee before such delegation.
(c) Determine whether the delegatee has the necessary knowledge and skills for the acts, functions or tasks to be carried out safely and competently.
(d) Supervise and evaluate the performance of the delegatee.
(e) Provide or recommend remediation of the performance when indicated.

(2) The registered nurse will bear ultimate responsibility for the performance of nursing acts, functions, or tasks performed by the delegatee within the scope of delegation.

These legal regulations of nursing practice apply to all licensed nurses regardless of the practice setting or employment status. Should licensed staff violate these licensure laws, the respective licensure board is to be notified and may deny, limit, suspend or revoke an individual's license.

Return to the Medication Administration Guidelines Index

All content © 2007 Michigan Nurses Association