D. A. S. E.
The idea of delegation is
It allows for staff to maximize their productivity and provide patients with high-quality care by utilizing caregivers from a variety of education levels.
True or False
Delegatees practice under the RNs license
False
True or False:
Hospitals are looking for more cost-efficient care by replacing RNs with less costly and less educated personnel to complete tasks
True
Which action is most appropriate for the nurse to delegate to an unlicensed assistive personnel (UAP)?
1. assisting a pt with a prosthetic leg to ambulate to the bathroom
2. teaching a pt with diabetes about the importance of eating an entire meal
3. helping a pt to drink contrast media that was poured into a cup by a nurse
4. asking a pt who recently had surgery about the intensity of pain being experienced
1.
rationale: assisting a pt with ADLs is within the capabilities of UAP
_____ introduced the idea of delegation.
Florence Nightingale
To decrease the risk for liability, the RN should avoid (name at least 1)
-assigning tasks that are highly invasive or have the potential to cause significant physical harm to the pt
-assigning tasks that are designated under the scope of practice or standards of care as belonging exclusively to the RN (admission assessments, care plan development)
-assigning tasks that the person is not trained for or lacks the knowledge to complete safely
-assigning tasks when there is inadequate time to safely monitor or evaluate the practice of the person performing the tasks
True or False
all levels of nursing staff should accept any task that is outside their scope of practice or for which they do not have the expected skill/knowledge level
False
A charge nurse is making assignments to staff working on a surgical unit. Which pt should be assigned to a new grad RN rather than an experienced RN?
1. a woman with an increased temp after surgery for an ectopic pregnancy
2. a middle aged pt who had elective surgery for abdominal hernia repair
3. a young adult who had a fractured femur with multiple soft tissue injuries from an MVA
4. an older male who had a TURP procedure and has cherry red drainage from the CBI
2.
Rationale: This pt is less likely to experience life threatening complications than any of the others and is an appropriate assignment for a new nurse.
Who can RNs delegate to?
PCT/CNA
LPN/LVN
4 Cs of Communication
-clear
-concise
-correct
-complete
2 potential outcomes of an RN delegating an out of scope task to an LPN which is accepted by the LPN
-malpractice charge
-negligent homicide if the pt dies as a result of the care
-potential physical harm to the pt
The RN is assigning tasks for the care of a pt after surgery for colon cancer. Which of the following assignments should the RN reconsider?
1. the UAP is to check the pts new stoma for redness when assisting the pt with a bed bath
2. the LVN is to report blood glucose readings that are outside a given range
3. the UAP is to assist the pt in ambulating twice per shift
4. The LVN is to administer medications as ordered by the provider
1.
Rationale: a licensed nurse should assess the pt's stoma for signs of irritation or infection.
When considering delegating a task, you should take _____ and ____ into account.
knowledge and skills
4 Guidelines For Delegation
1. assess the pt
2. know staff availability
3. know the job description
4. educate the staff member
Direct vs. Indirect Delegation
Direct: a specific decision made by the RN about who can perform what tasks
Indirect: a list of tasks that certain health care personnel, who are not nurses, can perform that is produced by the health care facility
_________ is the transfer of responsibility for the performance of an activity from one individual to another while retaining accountability for the outcome.
Delegation
Rationale: In delegation, the delegatee is acting in the place of the RN and will be carrying out tasks that generally fall under the RN's scope of practice. However, the person taking on the RN level task must be qualified, under the state's nurse practice act, to perform the task.
The difference between delegation and assignment
delegation is for tasks outside of the traditional role of the delegatee
assignment is for tasks within the scope of practice of the staff
The difference between responsibility and accountability
responsibility: the duty of the person as a reasonable/prudent member by training/licensure to complete tasks and assignments within their power and control
accountability: the obligation to be answerable for one's own actions and/or the actions of another, particularly where there is assignment/delegation of tasks
3 things LPNs can't do
admission assessments
give IV push medications
write nursing diagnoses
cannot do most teaching
cannot do complex skills
take care of clients who are unstable or have acute conditions.
Assigning the right task to the right person is a principle of nursing delegation and assignment. Which of the following meets this principle?
1. a 4mo with down syndrome is assigned to a nurse whose own child died of heart disease due to down syndrome 6 months ago
2. a child with a central IV that occluded on a previous shift is assigned to a new LPN
3. a child newly diagnosed with acute leukemia is assigned to an experienced peds oncology nurse who floated to the general peds unit
4. a child with new onset T1D is assigned to an RN who has 4 other complex care pts
3.
Rationale: This nurse's skills and knowledge are well suited to caring for this pt.