Are you being appropriate or inappropriate?
The PCA informs you the patient's pulse oximeter is reading 86%. You have the PCA apply O2 to the patient while you call the provider. Is this appropriate or inappropriate delegation?
What is inappropriate delegation?
The nurse can't delegate the initiation of O2 to an unlicensed person.
Demonstrating knowledge and skill, through education and experience, to perform the delegated task.
What is competence?
The PCA must have a documented competence to perform an assigned task.
The RN is assigned two patients. One patient needs a straight catheter, while the other patient requires assistance to the bathroom with a gait belt. The RN delegates which task to the CNA.
What is assistance to the bathroom with a gait belt?
RNs, LPNs, PCAs, and Patient Monitors can all be utilized in this patient care role.
What is a Patient Monitor?
Any PCS staff member may be pulled to work as a patient monitor so it is important we all know the role.
Examples: plastic bags, belts, scarves, shoestrings, cords, cables, tube socks, tape, straws, med cups, pill crushers, razors, mirrors, plastic and metal eating utensils, curling irons, lighters, medications, toiletries, saline flushes, etc.
What are some of items to be removed from a SI or agitated patient's room?
You have a patient in non-violent restraints. You ask the PCA to document the 2 hour assessment and the vitals. Is this appropriate or inappropriate delegation?
What is inappropriate delegation?
The nurse can't delegate assessment to the PCA. The assessment is part of the nursing process.
Examples: Bathing, CHG Bathing, 5 and dry foley care, vital signs, accu-check, feeding, toileting
What are examples of tasks for delegation?
These are a few examples of tasks that can be delegated by a licensed nurse to a PCA.
If the RN delegates a PCA to take VS for a patient, the RN must ensure the PCA _______ the vital signs in the chart and reports any __________ vital signs immediately back to him/her.
What is document and abnormal?
Examples: continuous monitoring (even in the bathroom), not covering the head, seeing the hands at all times, wearing paper scrubs, using safety meal trays, completing a room sweep to remove potentially harmful items.
What are SI precautions?
RN report to the sitter
What should be done at the beginning of each shift?
The RN asks the LPN to re-educate a patient about prevention and management of the chronic complications of diabetes. Is this appropriate or inappropriate delegation?
What is appropriate delegation?
Teaching ongoing diabetic education, under the care plan designed by the RN, is within the scope of the LPN's practice.
The process for a nurse to direct an unlicensed person to perform nursing tasks and activities
What is delegation?
Delegation of a task must meet the 5 rights of delegation.
Continuous Direct Patient Supervision (Observation) UCH-PCS-011-02
What is the policy for patient monitors to follow?
This is the most important part of delegation?
What is communication?
paper scrubs
What clothing should the SI patient be wearing?
The RN delegates the PCA to remove a mid-line IV. Is this appropriate or inappropriate delegation?
What is inappropriate delegation?
This is a task for which the PCA has not been trained and has no documented competency.
Right task, right circumstance, right person, right direction, and right supervision.
What are the 5 rights of delegation?
Lack of experience, a need for control, or being overwhelmed
What contributes to lack of delegation?
This is the first thing the licensed nurse must do before delegating patient tasks to unlicensed personnel.
What is assess the patient?
The licensed nurse must assess the patient prior to delegation of a task.
The patient monitor should be located between the patient and the door.
What is the location for the patient monitor?
Always protect yourself, as a patient monitor, by making sure you can escape the room easily. Never sit on the couch in a patient room. Patient monitors in the ED should sit in the hallway, right outside the room with direct visual of the patient
Bob, the PCA, is going to lunch and he asks Sally, the PCA to check room 213's blood sugar. Is this appropriate or inappropriate delegation?
What is inappropriate delegation?
One PCA can not delegate to another PCA
Assessment, diagnosis, planning, implementation, and evaluation--elements of care that can't be delegated
What is the nursing process?
The nursing process can't be delegated.
PCAs should have prior ___________ to the task they are being asked to preform.
What is training/competency?
Examples: sit on the couch, take a nap, play on your phone, read, eat, drink, argue, and untie restraints.
What should a patient monitor never do?
The patient monitor should document every 15 minutes.
What is the frequency of patient monitor documentation for a SI patient?
The documentation frequency for behavioral health patients is every hour.