Which Right?
What are the 5 rights of Delegation?
Right task
Right person
Right Direction
Right Circumstance
Right Supervision
Who can take vital signs for stable patients?
RN, LPN, and PCT
A patient with limited use of their arms asks for help brush their teeth but it is almost 0930 and you are only halfway through your 0900 med pass
Delegate
It is important that you finish the tasks that are in your scope of care and ADLs for a stable patient are delegable to a PCT or LPN
Team member that may or may not be licensed and helps move patients around the hospital
Transport Tech
PCT
A Patient Care Tech is an unlicensed personal that preforms basic patient care under the guidance of a nurse or healthcare professional
A nurse is running behind on a med pass and asks a PCT to give oral medications to a patient. Which right wasn’t followed?
Right Person
An LPN can administer oral medication but a PCT can't
Who can help pass oral medication?
LPN and RN
While you are in the room a patient asks for a cup of water on the other side of their bedside table to be moved closer to them
Don't Delegate
Making sure patient belongings are within reach is a part of your 5 P's when leaving a patient room and finding a team member to complete this task would take longer than for you to do it.
Team member that preforms basic venipuncture and collects blood samples
Phlebotomist
Who is accountable for the outcome of delegated tasks?
The RN
A patient has an order for a heparin drip. The nurse asks an LPN to titrate it. Which right wasn’t followed?
Right Task
Titrating IV medications is a nursing skill outside of scope of an LPN at AdventHealth and Heparin is a high risk medication that should only be administered by an RN
Who could help with bathing a patient?
RN, LPN, and PCT
A patient calls and says they are having chest pain and difficulty breathing
Don't Delegate
The patient may require assessments and clinical judgements. Additionally, patients with a compromised air way or difficulty breathing take priority
Team member that can adjust medication administration times and provide medication information
Pharmacy
Delegation is an important skill because it helps nurses (Name on reason)
Manage time
Nurses can prioritize clinical tasks
Avoid burnout
Foster team work
You ask a PCT to turn a critically ill patient and forgot to tell them that the patient has a wound vac, and several drains that they should not lay on
Right direction
Turning a patient is in a PCT’s scope of practice but the patient’s condition and special considerations weren’t properly explained to them
Who can initiate restraints on a patient requiring non-violent restraints?
RN
Only an RN can initiate non-violent restraints
On a med surge floor a patient that just got back from dialysis and hasn’t ambulated since arriving back on the floor calls and asks to use the bathroom
Delegate
Ambulating patients and assisting with ADLs is in scope of care for UAP.
A team member that can assist with ordering durable medical equipment such as a bedside commode for a patient to use at home
Case management or Care management
What is a possible consequence of over delegation?
Burnt out of the PCT or LPN
At your facility PCTs can remove indwelling foley catheters. You are swamped with other nursing tasks and ask your PCT to remove a foley catheter for you. The PCT says they have never removed a foley before and don’t know how. You explain the procedure to them, hand them a 10ml syringe, and ask them to go do it. Afterwards you focus on your other patients.
Right Supervision or Right Person
While it is appropriate per facility policy and directions were provided, the PCT lacks experience and should have been more closely supervised or a more experienced PCT should have been asked. Additionally, follow up with the completion of the task is a part of proper supervision
Who can take an ABG for a patient?
RT (some ICU RN's with special training)
You are an ICU Nurse. One of your intubated patients' needs to be transported downstairs for a CT scan. The respiratory therapist offers to take a PCT and go so you can stay and chart
Don't delegate
When transporting a patient on mechanical ventilation a respiratory therapist and a critical care nurse must be present at all times
A team member that may or may not be licensed but works in the emergency department assisting nurses
EMT or Paramedic
In Florida the scope of care an LPN can provide is determined by?
The Florida Board of Nursing determines the LPN scope of practice. AdventHealth regularly reviews the policy for the LPN scope of practice to ensure it matches the Board of Nursing.