Section R4-19-509. Delegation to Medical Assistants

A. Under A.R.S. §§ 32-1456 and 32-1601(19)(d)(vii), an RNP may delegate patient care to a medical assistant in an office or outpatient setting. The RNP shall verify that a medical assis- tant to whom the RNP delegates meets at least one of the fol- lowing qualifications:

1.        Completed an approved medical assistant training pro- gram as defined in A.A.C. R4-16-101(3);

2.        If a graduate of an unapproved medical assistant training program, passed the medical assistant examination administered by either the American Association of Med- ical Assistants or the American Medical Technologists;

3.        Completed an unapproved medical assistant training pro- gram and was employed as a medical assistant on a con- tinuous basis since completion of the program before February 2, 2000;

4.        Was directly  supervised by the same  registered  nurse practitioner for at least 2000 hours before February 2, 2000; or

5.        Completed a medical services training program of the Armed Forces of the United States.

B.       An RNP may delegate the following acts to a medical assistant who is under the direct supervision of the RNP and demon- strates competency in the performance of the act:

1.        Obtain vital signs;

2.        Perform venipuncture and draw blood;

3.        Perform capillary puncture;

4.        Perform pulmonary function testing;

5.        Perform electrocardiography;

6.        Perform patient screening using established protocols;

7.        Perform  dosage  calculations  as  applicable  to  written orders;

8.        Apply pharmacology principles to prepare and administer oral, inhalant, topical, otic, optic, rectal, vaginal and par- enteral medications (excluding intravenous medications);

9.        Maintain medication and immunization records;

10.     Assist provider with patient care;

11.     Perform Clinical Laboratory Improvement Amendments (CLIA) waived hematology, chemistry, urinalysis, micro- biological and immunology testing;

12.     Screen test results;

13.     Obtain specimens for microbiological testing;

14.     Obtain patient history;

15.     Instruct  patients  according   to  their  needs  to   promote health maintenance and disease prevention;

16.     Prepare a patient for procedures or treatments;

17.     Document patient care and education;

18.     Perform first aid procedures;

19.     Perform whirlpool treatments;

20.     Perform diathermy treatments;

21.     Perform electronic galvation stimulation treatments;

22.     Perform ultrasound therapy;

23.     Perform massage therapy (subject to regulation by mas- sage therapy board);

24.     Apply traction treatments;

25.     Apply Transcutaneous Nerve Stimulation unit treatments;

26.     Apply hot and cold pack treatments; and

27.     Administer small volume nebulizer treatments.

Historical Note

Adopted effective November 25, 1996 (Supp. 96-4). Sec- tion repealed by final rulemaking at 5 A.A.R. 4300, effec- tive October 18, 1999 (Supp. 99-4). New Section made by final rulemaking at 11 A.A.R. 3804, effective Novem- ber 12, 2005 (Supp. 05-3). Amended by final rulemaking

at 14 A.A.R. 4621, effective January 31, 2009 (Supp. 08-4). Pursuant to authority of A.R.S. § 41-

1011(C), Laws 2012, Ch. 152, § 1, provides for A.R.S. references to be corrected to reflect the renumbering of definitions. Therefore one of the A.R.S. citations in sub- section (A) was updated. Agency request filed July 12, 2012, Office File No. M12-242 (Supp. 12-3). Amended by final rulemaking at 19 A.A.R. 1438, effective July 6, 2013 (Supp. 13-2).