Delegation Basics
What is Delegation?
What is transferring the responsibility for a task while retaining accountability
Define Teamwork in Healthcare
Collaborative effort to achieve patient centered goals. To ensure we are putting patients first while working together to provide top notch care.
What is the first right? What does it mean?
Right task, ensuring that when asking a colleague to complete a task that it is in fact a task your coworker is able to complete. For example, an RN asking a CA to assess a chest tube is NOT the right task.
How does delegation affect patient outcomes?
Proper delegation improves efficiency and safety.
Why do nurse's delegate?
To manage workload and prioritize care. There are some tasks that must be completed by the RN and the CA can assist with the shared tasks and help the workload, while also giving timely and excellent patient care.
Name one task an RN can delegate to a CA
What is take vitals, grab a patient's weight, ADLs, labs, etc....... The caveat to this is the CA must be trained on the skills, if not and the RN can support educating in real time this is the best way to learn and work as a team.
Why is Teamwork Critical?
What is to improve patient safety and outcomes. It is also critical to work as a team in such a high stress environment, to prevent burn out, frustrations, and unnecessary added stress.
What is the second right of delegation? and what does it mean?
Right Circumstance. The task should only be delegated when the clinical conditions and setting make it safe and reasonable to do so.
Example: The patient is stable, not too high risk for the CA to be completing said task. The patient's situation and overall environment is appropriate for delegation
What happens if delegation fails?
Errors and poor patient outcomes. Increase risk of errors, missed labs, vitals not taken, missed FS, increase in pressure injuries due to poor communication and teamwork, increased falls, important patient changes not reported back to the nurse, reduced trust in the healthcare team and each other.
How does delegation help patients?
Ensures timely and efficient care, increases teamwork and communication.
Name one task that cannot be delegated from an RN to a CA.
Assessments, Nursing Judgement, Care planning, med administration of any kind, emptying drains (not including foley)
Give an example of teamwork.
Both the RN and CA go into a total care room, the patient needs meds, repositioning and is soiled. The RN and CA together get the patient cleaned up, repositioned, vitals, the RN medicates as appropriate. They speak to each other and communicate on who will be putting what documentation in after patient care is complete.
What is the third right? What does it mean?
Right person. The task is being delegated to a person who has the appropriate skills, knowledge, training, competency, and scope of practice to safely perform it.
Why should delegated tasks be monitored/ followed up with?
Ensure patient safety, confirms task was complete, allows for evaluation of patient response, provides support and guidance to delegate, maintains accountability, improves communication and teamwork!
How does delegation help nurses?
Helps to assist in patient care load, reduces burnout, improves focus, build a strong team atmosphere
Why is communication important in delegation?
What is to ensure clarity, safety, and provide excellent patient care.
What is a barrier to teamwork?
What is poor communication, unclear roles, high stress, burnout.....
What is the fourth right? What does it mean?
Right direction/communication.
This means the nurse must give:
Clear, concise, and specific instructions about the task
Expected outcomes
Timeline for completion
Any limitations or special considerations
What to report and when
The communication should be two-way, ensuring the delegate understands the instructions and can ask questions.
Give an example of a positive outcome of delegation.
Timely and efficient care, improved patient safety, enhance patient comfort, increased team productivity, higher staff satisfaction, improved patient satisfaction, which all leads to an improved working experience and builds a strong well-oiled team.
How does delegation help the CA?
Clarifies responsibilities, builds skills and confidence, ensures support, encourages teamwork, protects the CA legally and professionally (reduces the risk that the CA performs something outside their legal scope of practice.)
Who is the RN, (but this does not mean the CA is absolved from all accountabilities in regard to patient care.)
How can teamwork be improved?
What is clear delegation, respectful and clear communication, check ins throughout shift, report at beginning of shift, holding eachother accountable.
What is the final and fifth right? What does it mean?
Right Supervision/Evaluation
This means the nurse must:
Provide appropriate monitoring, guidance, and support during the task.
Be available to answer questions or assist if needed.
Evaluate the outcome of the task once it is completed.
Give feedback to the delegate and address any issues.
In short, the nurse remains accountable for ensuring the task is completed safely and correctly.
Give an example of a negative outcome.
Missed vitals, missed FS (incorrect dose of insulin given), missed labs, which can lead to missed or late interventions, trust between the patient and care team is damaged as well as trust between team remembers.
What is something delegation is NOT?
It is NOT dumping tasks, abandoning responsibilities, assigning tasks outside of scope, doing everything for others, ignoring communication and accountability.