Final Prep - Delegation & Supervision Flashcards

Delegation Description

the process for a nurse to direct another person to perform
nursing tasks & activities transfer of
responsibility to another person to complete task,
but RN retains accountability for the outcome

Sources of Authority for Delegation

Federal, State, NPA employer policies &
standards professional nursing standards ANA
Code of Ethics specialty nursing organizations
The Joint Commission National Committee for Quality
Assurance (NCQA)

Effective Delegation When RN...

knows parameters regulating practice as well as institutional
policy has assess pt & ID'ed their need for task that can
be delegated knows the unlicensed staff capabilities to
perform task task is performed & RN is able to evaluate
expected outcome has been achieved

Direct Delegation

usually verbal direction by RN regarding an activity or task in
a specific nursing situation

Indirect Delegation

is usually an approved listing of activities or tasks that have
been established in the health care facility

Five Rights of Delegation

Right Task - potential for harm, complications
Right Circumstance - acuity & condition of pt,
staff mix, job description, policy
Right Person - defined by NPA (RN, LPN, UAP)
Right Direction/Communication - task to be done,
why, what, when, right pt, when to be reported back
Right Supervision - progress of task, outcomes
performed, feedback, effectiveness by delegatee

Delegation Criteria

potential for harm to pt complexity of nursing
activity extent of problem solving required
predictability of outcome

Delegation Obstacles

lack of training, experience, or confidence with
delegation poor communication or interpersonal skills
lack of resources, inadequate staffing lack of
organizational support delegator insecure or unwilling
nurse unwilling to trust others or to let go, lack of mutual
trust between staff members staff mix

Activities That Can be Delegated

ADL's: bathing, ambulating, oral care, VS complex
basic activities: catheterization, dressing changes, oral med admin,
Accuchecks nursing activities/tasks which do not require
nursing assessment or judgment during implementing
collecting, reporting, & documentation of simple data (inc.
anything w/ elimination) activities which meet or assist
the pt in meeting basic human needs

Activities That Can't be Delegated

initial nursing assessment & additional assessments that
require nursing judgment evaluation of nursing care
tasks that require nursing judgment formulation &
evaluation of plan of care NDx related decisions
IV med admin, except where allowed (LPN IV certified)
consultation with other medical professionals

Steps of Delegation Process

define task select delegatee communicate
reach an agreement delegator to delegatee monitor &

Tasks Delegated to LPN/LVNs - Examples

non-IV meds: PO, SQ, IM, topical, vaginal, rectal
second assessments reinforce education previously
given dressing changes treatments trach
care feeding tube NG foley
delegate to PCT

Tasks Delegated to PCTs - Examples

VS I&O's ambulation, transfer to
chair bathroom use Accuchecks feeding
oral care bed baths, other hygiene daily
weights turning, repositioning set up, remove tele
(if trained) SCDs & Ted hose splints

Typical RN Tasks The CAN'T be delegated

initial assessments care plan evaluation
teaching unstable pt care CP, SOB IV
meds blood products trach suction