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 CNA
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 CNA or LPN
UAP that usually has a CNA license and helps move patients around the hospital
Transport Tech
What is a UAP?
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 CNA to give oral medications to a patient. Which right wasn’t followed?
Right Person
An LPN with proper training can administer oral medication but a CNA 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 60 second safety check when leaving a patient room and finding a UAP to complete this task would take longer than for you to do it.
A UAP 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 start it. Which right wasn’t followed?
Right Task
Administering IV medications is a nursing skill outside of scope for most UAP 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 CNA
A patient calls and says they are having chest pain and difficulty breathing
Don't Delegate
The patient may require assessments and clinical judgements that is out of scope of care for UAP. Additionally, patients with a compromised air way or difficulty breathing take priority
A UAP that assists a physical therapist but the nurse may also ask for help with ambulating patients.
Mobility tech/physical therapy assistant
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 CNA 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 CNA’s scope of practice but the patient’s condition and special considerations weren’t properly explained to them
Who can preform wound care for a stage 4 pressure ulcer?
RN
wound care is too advanced for an LPN
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 UAP that has received additional training to pass medications usually found in skilled nursing facilities and assisted living homes
QMAP
What is a possible consequence of over delegation?
Burnt out UAP
At your facility CNAs can remove indwelling foley catheters. You are swamped with other nursing tasks and ask your CNA to remove a catheter for you. The CNA 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 UAP lacks experience and should have been more closely supervised or a more experienced CNA 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?
RN with special training
You are an ICU Nurse. One of your intubated patients needs to be transported downstairs for a CT scan. The respiratory therapists offers to take a CNA 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 UAP that usually has an EMT license but works in the emergency department assisting nurses
ER Tech
In Colorado the scope of care a LPN can provide is determined by?
The level of training provided in their education program