The broadly written laws and rules allow nurses to practice to their full scope of practice in any setting. It is impossible for the Nursing Care Quality Assurance Commission (NCQAC) to provide a comprehensive listing of the duties that licensed nurses are permitted to perform since nursing practice is reflective of the dynamic changes occurring in healthcare and society. The Revised Code of Washington (RCW) 18.79 and Washington Administrative Code (WAC) 246-840 provide the statutory and legal basis of nursing practice. The nursing commission provides advisory opinions, interpretive statements, and guidance documents related to specific areas of nursing practice.
These documents are approved by the nursing commission and offer information and general guidance regarding the practice of professional nursing in the State of Washington. However, they do not constitute legal advice. You should contact your legal advisor to obtain advice with respect to any particular issue or problem.
If you have a question related to nursing practice in the state of Washington, please use the tools provided by the scope of practice decision tree and the approved documents below.
Additional Advisory Resources
For further guidance, please contact nursingpractice@doh.wa.gov or arnppractice@doh.wa.gov for advanced nursing practice questions.
| Document ID | Name | Approved Date | Nurse Type | Nursing Group Type |
|---|---|---|---|---|
| NCAO 1.01 | Perioperative Registered Nurse First Assistant (RNFA) | May 14, 2021 | RN, LPN, ARNP | Surgical Settings, Perioperative Nursing, Surgical Nursing |
| NCAO 2.01 | Camp Nursing | May 13, 2022 | RN, LPN, NA, UAP | Camp Nursing, Non-Traditional Health Care Setting, School Nursing, Nursing Delegation |
| NCAO 3.00 | Neonatal Intubation and Related Procedures | March 14, 2014 | RN, LPN, ARNP | All Settings |
| NCAO 5.02 | Portable Orders for Life Sustaining Treatment (POLST) – Scope of Practice for the Registered Nurse (RN), Licensed Practical Nurse (LPN), and Nursing Assistant-Registered/Nursing Assistant-Certified (NA-R/NAC) | September 09, 2021 | RN, LPN, ARNP, NA, UAP | All Settings, POLST |
| NCAO 7.10 | Administration of Sedating, Analgesic, and Anesthetic Agents | March 13, 2015 | RN, LPN | All Settings, Medication Management, Medication Administration |
| NCAO 8.10 | Prevention and Treatment of Opioid-Related Overdoses | March 12, 2021 | RN, LPN, ARNP, NA, UAP, NT | All Settings |
| NCAO 9.00 | Public Health Nurses: Dispensing Medications/Devices for Prophylactic and Therapeutic Treatment of Communicable Diseases and Reproductive Health | November 18, 2016 | RN, LPN | All Settings, Public Health Nursing, Medication Management, Standing Orders |
| NCAO 10.00 | Completion of Death Certificates by Advanced Registered Nurse Practitioners | November 18, 2016 | RN, LPN | All Settings |
| NCAO 11.01 | Compounding and Reconstituting Medications | November 12, 2021 | RN, LPN | All Settings, General, Medication Management |
| NCAO 12.00 | Medical Acupuncture | November 17, 2017 | ARNP | All Settings, Holistic Nursing, Complementary Nursing, Alternative Nursing |
| NCAO 13.02 | Registered Nurse and Licensed Practical Nurse Scope of Practice | September 13, 2019 | RN, LPN | All Settings, General SOP |
| NCAO 14.10 | Delegation of Blood Glucose Monitoring | November 08, 2019 | RN, LPN, NA, UAP | Nursing Delegation, Community-Based Nursing, Home Care Nursing |
| NCAO 15.01 | Registered Nurse Delegation in School Settings | January 14, 2022 | RN, LPN, NA, UAP | School Nursing, Nursing Delegation, Non-Traditional Health Care Setting |
| NCAO 16.01 | Opioid Use Disorder Medication Assisted Treatment – Nurse Care Managers and Scope of Practice | May 10, 2019 | RN, ARNP | Nurse Case Managers, Nurse Care Coordinators, Behavioral Health Nursing, Medication Management, Substance Use Disorder, Controlled Substances, Mental Health, Medication Assisted Treatment Facilities, Behavioral Health Facilities, Psychiatric Hospitals, Mental Health Facilities, Substance Use Disorder Facilities |
| NCAO 17.01 | Administration of Cannabis/Marijuana Products in School Settings | September 11, 2020 | RN, LPN | School Nursing, Nursing Delegation, Non-Traditional Health Care Setting |
| NCAO 18.00 | Advanced Registered Nurse Practitioner Scope of Practice: Repetitive Transcranial Magnetic Stimulation (rTMS) | July 12, 2019 | ARNP | All Settings, Mental Health, Behavioral Health |
| NCAO 19.00 | Role of the Nurse in Supervised Injection Services (SIS) Facilities | May 08, 2020 | RN, LPN, ARNP | Nurse Case Managers, Nurse Care Coordinators, Behavioral Health Nursing, Medication Management, Substance Use Disorder, Controlled Substances, Mental Health, Medication Assisted Treatment |
| NCAO 20.03 | Death with Dignity (Aid-in-Dying): Role of the Nurse | September 09, 2021 | RN, LPN, ARNP | All Settings, POLST |
| NCAO 21.00 | Mobile Anesthesia: Scope of Practice for Advanced Registered Nurse Practitioners | March 18, 2019 | ARNP | |
| NCAO 22.00 | Naloxone Prescribing Clarification | July 10, 2020 | RN, LPN, ARNP, NA, UAP | All Settings |
| NCAO 23.01 | Determining, Pronouncing, and Certifying Death | November 12, 2021 | RN, LPN, ARNP, NA, UAP | All Settings, POLST |
| NCAO 24.00 | Infusion Therapy Management | September 11, 2020 | RN, LPN, ARNP | All Settings, Medication Management, Medication Administration |
| NCAO 25.00 | Nursing Telehealth Practice: Registered Nurse, Licensed Practical Nurse, Nursing Technician, and Nursing Assistant | March 12, 2021 | RN, LPN, NA, UAP, NT | All Settings |
| NCAO 26.00 | Telehealth Advanced Practice Nursing Care Services | March 12, 2021 | ARNP | All Settings |
| NCAO 27.00 | Cosmetic/Aesthetic Dermatologic Procedures | May 14, 2021 | RN, LPN, ARNP | All Settings |
| NCAO 28.01 | Standing Orders | November 12, 2021 | RN, LPN, ARNP | All Settings |
| NCAO 29.01 | Verbal Orders | November 12, 2021 | RN, LPN, ARNP | All Settings |
| NCAO 30.00 | Seizure Disorder Management: Nursing Care Coordination | January 14, 2022 | RN, LPN, NA, UAP | All Settings |
| NCAO 31.00 | Endoscopy – Role of the Licensed Practical Nurse | March 10, 2023 | LPN | All Settings |