Delegation process
What is the first right of delegation?
The nurse is caring for a diabetic patient in the ambulatory unit who has undergone wound debridement. What task is appropriate to delegate to the UAP?
a. check the vitals
b. assess their pain level
c. palpate their pedal pulses
d. monitor their IV catheter site
A. check the vitals
The State Nurse Practice Acts
Who is accountable for evaluation and overall patient outcomes?
The registered nurse
What are some questions a RN should ask themselves when determining the right person to delegate the task to?
Is the prospective delegatee a willing and able employee?
Are the patient needs a " fit" with the delegatee?
A patient with COPD. Which intervention for airway management should you delegate to the UAP?
a. assist the patient to sit up on the side of the bed
b. instructing the patient to cough effectively
c. teaching the patient to use incentive spirometry
d. auscultation of breath sounds q. 4 hours
a. assisting the patient to sit up on the side of the bed
What kind of nurse can delegate to LPN's and CNA's?
Registered nurses (RN
What must the RN do before delegating patient tasks to the non-RN person?
Assess the patient
Out of the 5 rights, which is arguable the most important in regard to safety and quality outcomes?
Communication and direction
A patient with sleep apnea has a nursing diagnosis of Sleep deprivation r/t disrupted sleep cycle. Which action should you delegate to the UAP?
a. discuss weight-loss strategies such as diet/exercise
b. teach the patient how to set up the BiPAP machine before sleeping
c. remind the patient to sleep on his side instead of his back
d. administer modafinil to promote daytime wakefulness
c. remind the patient to sleep on his side instead of his back
Can an RN delegate a full head to toe assessment to a LPN or CNA?
No
Primary goal of delegation
Patient satisfaction
supervision and evaluation
Which intervention for a patient with a pulmonary embolus could be delegated to the LPN on your patient care team?
a. Evaluating the patient's complaint of chest pain.
b. Monitoring laboratory values for changes in oxygenation.
c. Assessing for symptoms of respiratory failure.
d.Auscultating the lungs for crackles
d. Auscultating the lungs for crackles
- An LPN who has been trained to auscultate lung sounds can gather data by routine assessment and observation, under the supervision of an RN.
What nursing tasks are prohibited from delegation?
-Physical, psychological, and social assessment which requires professional nursing judgment, intervention, referral.
-Creation of nursing care plan/evaluation of patient response.
- Specific tasks involved in implementation of the care plan that requires professional nursing intervention.
- Responsibility and accountability for patient health teaching and health counseling
-Administration of medications (exception of medication aides)
When does a delegate have the right to refuse to accept delegation?
When the UAP is not qualified to complete the task. When the delegator doesn't clearly define the task and expectations.
What are the 5 rights of delegation?
Right task
Right circumstances
Right person
Right communication/direction
Right supervision/evaluation
You are initiating a nursing care plan for a patient with pneumonia. Which intervention for cough enhancement should you delegate to a nursing assistant?
A. Teaching the patient about the importance of adequate fluid intake and hydration.
B. Assisting the patient to a sitting position with neck flexed, shoulders relaxed, and knees flexed.
C. Reminding the patient to use an incentive spirometer every 1 to 2 hours while awake.
D. Encouraging the patient to take a deep breath, hold it for 2 seconds, then cough two or three times in succession.
- Vital signs, height/weight, intake/output, capillary blood/urine test
- patient or family comments related to patient care
- behaviors related to plan of care
- ambulation, positioning, turning
- personal hygiene and eliminations
- feeding, cutting up food, placing of meal trays
-socialization activities
-Activities of daily living
True or false:
A RN delegates to the LPN to administer a scheduled tube feeding to a patient. The RN has now transferred full accountability to the LPN for the task for getting the task done, and the RN is no longer accountable for the task.
False