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Chapter 3

Delegation of Nursing Tasks

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Delegation

Allows the transfer of responsibility to another person to complete a task or activity while the initial person retains the accountability for the outcome

The person that is entrusted the delegated task must be qualified, competent and able to perform the task

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Unlicensed Assistive Personnel (UAP)

Also known as: Non-credentialed assistive personnel Nursing assistant (NA) Certified nursing assistant (CNA) Patient care associate (PCA) Nursing technician Unit technician

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RN is responsible for all patient care

The UAP cannot practice nursing UAP must be directed, supervised and

evaluated by the RN Licensed practical nurse (LPN / LVN) works

under direction and supervision of the RN. Their limitations of practice are governed by their state board regulations

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Direct Patient Care Activities

Grooming Feeding Hygiene care Vital signs Ambulation Electrocardiogram Measuring Blood sugar levels

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Indirect Patient Care Activities

Restocking supplies Transporting patients Clerical activities

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The Five Rights of Delegation

The National Council of State Boards of Nursing(1997) has defined the Five Rights ofDelegation, as follows:1. Right task2. Right circumstance3. Right person4. Right direction / communication5. Right supervision

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Should You Accept a Delegated Assignment?

Is it consistent with your defined scope of practice? Is there a valid order? Is it in accordance with the

agency policies and procedures? Is the act supported by research data or a position

statement? Are you competent to perform it safely? Is the act to be performed with the acceptable

“standards of care”? Would another nurse with similar education and clinical skills perform similarly?

Are you prepared to assume accountability for the provision of safe care?

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Factors to Consider

Your state’s nurse practice act Hospital policies and procedures Job descriptions Staff competencies Clinical situation Professional standards Patient needs

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What can be delegated?

Non-invasive non-sterile treatments such as emptying Foley catheters and providing hot/cold soaks

Vital signs, height, weight, capillary blood sugar results

Bathing, toileting, feeding, assistance with ambulation

Socialization activities

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What cannot be delegated?

Patient assessments Planning and evaluation of nursing care Development of a plan of care Health teaching and health counseling

(unless it is reinforcement of previously taught material)

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Obstacles to Delegation

Lack of training for nurses on how to delegate Personal qualities, such as poor

communication or interpersonal skills Lack of resources Insecure delegator Unwilling to delegate Nurse unwillingness to trust others

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Levels of Clinical Experience

Novice Advanced beginner Competent nurse Proficient nurse Expert

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Priority Setting

Identify your priorities Interact differently with others in order to

maintain control over your time, energy and priorities Identify a time when you will be able to manage a

task, set a realistic timeline Understand the scope, intended outcome and

deadline of assignments before accepting the assignment

Ask for help when needed Delegate where you can – you cannot do it all!!!

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Set Realistic Goals

Be SMARTSpecificMeasurableAttainableRelevantTime bound