A Certified Nursing Assistant (CNA) serves as a foundational component of the healthcare team, providing direct patient support across various settings. These professionals are tasked with assisting patients in their daily lives, which requires a clear understanding of the limits and boundaries of their role. Because their practice involves direct patient care, the question of whether a CNA can perform specialized medical tasks, such as changing a colostomy bag, is governed by strict regulations designed to protect patient safety. Understanding the defined scope of practice for CNAs is a fundamental requirement for maintaining professional standing and providing appropriate care within the Florida healthcare system.
The Governing Bodies for Florida CNAs
The regulation and oversight of Certified Nursing Assistants in Florida are managed by a framework of state agencies and statutes. The Florida Board of Nursing (BON) holds the primary authority for defining the scope of practice and enforcing the standards for all nursing personnel, including CNAs, under Chapter 464 of the Florida Statutes (the Nurse Practice Act). This body is responsible for initial certification, setting competency requirements, and administering disciplinary action against CNAs who violate the rules of practice.
The Florida Department of Health (DOH) maintains the official CNA registry and oversees the certification requirements. The DOH ensures that candidates complete an approved training program and pass a competency evaluation. The rules that specifically detail the authorized duties of a CNA are codified in the Florida Administrative Code (F.A.C.), particularly Rule 64B9-15.002, which ensures a consistent boundary for the tasks CNAs are allowed to perform.
General Duties Within the CNA Scope of Practice
The authorized duties of a CNA in Florida revolve around providing basic patient care and assisting with Activities of Daily Living (ADLs). Routine tasks include bathing, dressing, grooming, and providing oral hygiene and denture care to patients. CNAs also assist with mobility, which involves safely transferring patients, repositioning those who are bedridden, and helping them with ambulation.
Patient monitoring is another standard function, where CNAs are responsible for measuring and recording vital signs, such as temperature, pulse, respiration, and blood pressure. They are also tasked with observing and documenting any changes in a patient’s condition, which must be promptly reported to a licensed nurse for assessment. These duties are non-invasive and do not require the independent clinical judgment of a licensed nurse.
Specific Rules Regarding Ostomy Care Procedures
The Florida Administrative Code specifically addresses whether a CNA can change a colostomy bag. Rule 64B9-15.002 explicitly addresses tasks related to elimination, which includes ostomy care procedures. The rule states that a certified nursing assistant is permitted to perform tasks such as “Emptying ostomy bags” or “changing bags that do not adhere to the skin.” This distinction separates routine, non-adhesive appliance changes from more complex procedures.
A CNA is generally not permitted to change a full, adhesive colostomy bag system that requires skin assessment, stoma measurement, or application of a new barrier. These procedures involve specialized nursing knowledge and judgment. The law prohibits CNAs from performing any task that requires specialized nursing knowledge, including the assessment of the stoma or surrounding skin for complications. However, emptying an established ostomy pouch or changing a non-adhesive bag on a stable patient falls within personal care and can be performed under the general supervision of a licensed nurse. Complex ostomy care, such as colostomy irrigation or changing an appliance on a newly created or unstable stoma, remains the responsibility of a licensed practical nurse (LPN) or registered nurse (RN).
The Process of Delegation and Competency Requirements
When a CNA is authorized to perform routine ostomy care, it occurs through a formal process of delegation by a licensed nurse. The delegating nurse, usually a Registered Nurse (RN), must first assess the patient’s condition to ensure stability and confirm the task is appropriate for delegation. The task must be a routine and repetitive procedure that does not require the specialized nursing knowledge, judgment, or skill of a licensed professional.
For delegation to be proper, the CNA must receive specific training and demonstrate competence in the task. The facility or the delegating nurse must validate the CNA’s skill and ensure they are proficient in the procedure for that specific patient. This process requires a plan, teaching, and ongoing supervision to confirm the CNA can perform the task safely and effectively.
Consequences of Exceeding the Scope of Practice
A CNA who performs tasks outside of the defined scope of practice faces serious professional and legal repercussions. Florida Statute 464.204(1)(b) makes it unlawful for a Certified Nursing Assistant to practice beyond their authorized scope. Violating this statute can lead to formal disciplinary action initiated by the Florida Department of Health (DOH) and the Board of Nursing.
Penalties for exceeding the scope include the suspension or revocation of the CNA license, the imposition of substantial fines, and mandatory probation. The supervising nurse who improperly delegates a prohibited task or fails to provide adequate supervision may also face disciplinary action against their own license. Unauthorized practice compromises patient safety and constitutes professional misconduct, resulting in a public disciplinary record.