Delegation is an essential part of nursing as it aids in effective patient care. Without proper nursing skills in delegation, the hospital would be in chaos. Here are some notes I have that may help you as well as some sample questions.
◉DELEGATION-transferring authority & responsibility to another staff member but not accountability.
Delegating tasks to another staff who isn’t an RN, you as the RN is still accountable.
◉SUPERVISING-directing, monitoring and evaluating that the task is accomplished.
You must follow up to ensure that the task was done correctly. Always be specific as far as time and priority of the task being delegated.
Ask yourself: Was the task done correctly? Were the clients needs met?
◉ASSIGNING– the distribution of work among the healthcare team.
RN has the responsibility and accountability for all the work that has to be done.
Must ensure that the staff member has the adequate skill level, any prior experience with similar clients, etc
◉5 RIGHTS OF DELEGATION
Right Task– identify what tasks are appropriate to delegate for each client
Right Communication– RN must give clear, complete communication or directions.
Be specific, tell staff when to report changes
Right Circumstance– Match the staff members skill level to the client’s care need
Right Person– Task must be within the staff member’s scope of practice.
Staff member must have the proper training
Right Supervision– RN supervises or monitors the staff, provides clear directions
RN must state expectations of tasks
Evaluate the outcomes
◉RN:
Do not delegate Teaching, Evaluation, Assessment, IV’s
Does initial assessments
◉LPN/LVN:
Can care for long term clients, Stable clients. (Never “fresh” clients) Can do follow up teaching and assessments. Medication administrations excluding IV’s
Can do trach care, suctioning, check nasogastric tube patency
◉CNA/NAP:
Vital signs on stable clients ,ADLs, Specimen collections, I&Os and established enteral feeding via Gtube (They can do tasks that are routinely done).
Book: Prioritization, Delegation and Assignment 3e http://amzn.to/2igef47
Sample Questions
- A Registered Nurse is delegating activities to the nursing staff. Which activity is least appropriate for the nursing assistant? (p. 346)
- Assigning a post cardiac catheterization client who needs to lie flat to eat lunch
- Obtaining frequent oral temperatures on client
- Accompanying a man being discharged to his transportation to home
- Collecting a urine specimen from a client
2) A medication nurse is supervising a newly licensed LPN during the administration of a client with myasthenia gravis. Which observation by the medication nurse would indicate safe practice by the LPN? (p. 341)
- Asking the client to lay down on his or her right side
- Instructing the client to void before taking medication
- Asking the client to take sips of water
- Asking the client to look u at the ceiling for 30 seconds
Rationales:
- (1) Work that is delegated to others must be done consistent with the individual’s level of expertise and licensure or lack of licensure. The least appropriate task for the CNA would be assisting the post cardiac catheterization client who needs to lie flat to eat lunch. Since the client needs to lay flat, this client is at risk for aspiration.
- (3) Myasthenia gravis can affect the client’s ability to swallow. The primary assessment is to determine the client’s ability to handle oral medications or any oral substance. Options 1, 4 are not appropriate. Option 1 would result in aspiration and the client does not need to void before taking this medication.
***Taking from Saunders Q & A Review for the NCLEX-RN Examination edition 3***
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