TX HHS Form 1572. Nursing Tasks Screening Tool

The Texas Health and Human Services (HHS) Form 1572, Nursing Tasks Screening Tool, is designed to assess the level of assistance required by individuals in need of nursing care. This comprehensive tool helps healthcare professionals identify the specific tasks that require delegation from a physician to unlicensed staff.

The form consists of several sections, including Physician Delegation, Medication Administration, Special Procedures, Eating, Bathing, Toileting, and Mobility. Each section presents a series of yes/no questions that help determine whether an individual requires assistance with various tasks, such as medication administration, sterile procedures, or mobility-related activities.

This screening tool is essential for healthcare providers to ensure the safe and effective delivery of nursing care to individuals who require delegated tasks. By completing Form 1572, healthcare professionals can identify areas where unlicensed staff may need guidance or support, ultimately promoting better patient outcomes and compliance with regulatory requirements.