AOS - 15 - Supervision and Delegation of Nursing Tasks to Unlicensed Personnel - Advisory Opinion

Sep 30, 2026

Advisory Opinion Statement of the Kentucky Board of Nursing explains the role of nurses in supervising and delegating nursing tasks to unlicensed personnel. It clarifies that advisory opinions are guidelines, not regulations, and stresses nurse accountability for decisions grounded in education and clinical competence. The document defines “unlicensed person” and outlines key delegation requirements, including appropriate training, supervision, task selection, assessment of patient stability and harm risk, and ongoing communication, monitoring, and evaluation to ensure safe outcomes.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Advisory Opinion Statement

Role of Nurses in Supervision and Delegation

Accountability and Responsibility of Nurses

Rationale for Advisory Opinion

Unlicensed Personnel (UAP)

Delegation Process and Requirements

Page 1 of 11 AOS \#15 Supervision and Delegation Revised 6/2025 KENTUCKY BOARD OF NURSING 312 Whittington Parkway, Suite 300 Louisville, Kentucky 40222-5172 [http://kbn.ky.gov](http://kbn.ky.gov) ADVISORY OPINION STATEMENT Role of Nurses in the Supervision and Delegation of Nursing Tasks to Unlicensed Personnel The Kentucky Board of Nursing is authorized by Kentucky Revised Statutes (KRS) Chapter 314 to regulate nurses, nursing education and practice, promulgate regulations and to issue advisory opinions on nursing practice, in order to assure that safe and effective nursing care is provided by nurses to the citizens of the Commonwealth. The Kentucky Board of Nursing issues advisory opinions as to what constitutes safe nursing practice. As such, an opinion is not a regulation of the Board and does not have the force and effect of law. It is issued as a guideline to licensees who wish to engage in safe nursing practice. Opinion: Roles of Nurses in the Supervision and Delegation of Nursing Tasks to Unlicensed Personnel Approved Date: 6/1987 Revised: 1/1988; 2/1991; 1/1993; 12/1993; 4/2001; 10/2002; 6/2003; 2/2012; 4/2014; 10/2014; 12/2018; 10/2019; 4/2023; 6/2025 Editorial Revisions: 2/2005; 1/2011; 1/2012; 5/2012; 4/2018; 6/2018; 11/2024 Reviewed: 1/2012; 9/2012; 4/2014 Accountability and Responsibility of Nurses In accordance with KRS 314.021(2), nurses are responsible and accountable for making decisions that are based upon the individuals’ educational preparation and current clinical competence in nursing and requires licensees to practice nursing with reasonable skill and safety. Nursing practice should be consistent with the Kentucky Nursing Laws , established standards of practice, and be evidence based. Rationale for Advisory Opinion The Board has received numerous inquiries related to the role of nurses in delegation. The Board has issued the following advisory opinion statement. Page 2 of 11 Advisory Opinion “When certain aspects of nursing care need to be delegated beyond the traditional role and assignment of a care provider, it is imperative that the delegation process and the state nurse practice act (NPA) be clearly understood so that it is safely and effectively carried out.” (National Council State Boards of Nursing, 2019) . “Only a licensed nurse can delegate ” The nurse is responsible, provides direction, determines who is going to carry out the delegated responsibility, and assists with or performs the responsibility if the nurse deems that delegation is appropriate under the given circumstances. (NCSBN and ANA Joint Position Statement, 2019) In accordance with KRS 314.021(2), nurses are held responsible and accountable for their decisions regarding the supervision and delegation of nursing acts to unlicensed personnel who provide nursing assistance, based upon the nurse's educational preparation and current clinical competence in nursing. Unlicensed Personnel Kentucky Administrative Regulation, 201 KAR 20:400 Section 1(14) defines an“unlicensed person” as “an individual, other than a nurse, the client, or the client’s family, legal guardian, or delegatee, who functions in an assistant or subordinate role to the nurse.” Unlicensed personnel (UAP) are trained to perform specific healthcare related job duties and include but are not limited to certified nursing assistants (CNAs), medical assistants (MAs), home health aides, dialysis technicians (DTs), and certified medication aides (CMA I and CMA II) . UAPs function as nursing support through delegation and carry out nursing tasks (NCSBN and ANA Joint Position Statement, 2019) . • CMA I is defined as an individual who receives training preparing for a role in administering topical and oral medications and who works under the supervision of a licensed nurse. • CMA II is defined as an individual who receives training preparing for a role in administering topical and oral medications (CMA I) as well as t

FAQs

Are advisory opinion statements regulations or legally binding rules?

An advisory opinion is a guideline for licensees and does not have the force and effect of law like a regulation.

What responsibilities remain with a licensed nurse when delegation occurs?

The nurse remains responsible, provides direction, determines who carries out the delegated responsibility, and evaluates outcomes to ensure safe practice.

Who qualifies as unlicensed personnel (UAP) under Kentucky guidance?

UAPs are individuals other than a nurse or the client (and related parties) who function in an assistant or subordinate role; examples include CNAs, medical assistants, home health aides, dialysis technicians, and certified medication aides.

Sep 30, 2026

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