Delegating
-Transferring authority and responsibility to another member of the healthcare team.
-YOU retain accountability!
Supervising
the
... [Show More] process of directing, monitoring, and evaluating performance of tasks by another member of the healthcare team.
The RN is responsible for supervision of client care tasks delegated to...
-Assistive Personnel (AP)
-Liscnenced Practical Nurses
Certified nursing assistants, certified medicine assistants, dialysis techs, monitor technicians, phlebotomists are all examples of...
Unliscenced personnel, also called ...
-NAP (nursiing assistive personnel)
Who can an RN delegate tasks to?
other RNs, LPNs, and AP
What tasks CAN'T the RN delegate?
-The nursing process
-educating a client
-Tasks that require nursing judgement
Prior to delegating care the nurse should consider...?
(Task factors that would make the task the responsibility of the RN)
-Predictability ( routine treatment w/ predicatable outcome?)
-Potential for Harm (can something negative happen to the client?)
-Complexity (CAN THE DELEGATEE LEGALLY PERFORM THE TASK??? DO THEY HAVE NECESSARY SKILL BASE??)
-Judgement/assessment ( is judging essential? Are nursing assessment skills needed?)
-Level of Interaction (Do we need to perform psychosocial support or education?)
What are the five rights of delegation?
Make sure you have the right...
-Task
-circumstance
-Person
-Direction/communication
-Supervision/evaluation
Right task
Is repetitive, requires little supervision, relatively noninvasive
Right circumstance
How complex is the care the patient needs? Does the team-member have the skill/ time to accomplish the task?
Right person
Is the task within the team-member's scope of practice? Does the teram-member have the right training?
-Continually review/assess the team-member's performance.
What are some tasks that would be incorrect to delegate to an AP?
-Monitoring RN's assessment, reinforcing client teaching/education, tracheostomy care, suctioning, checking nasogastric tube patency, administering enteral feedings, inserting a urinary catheter, administer meds
-THESE ARE ALL LPN DELEGATEE TASKS!!!!
Right direction/communication
Collect right data, have the right method for reporting assessment findings, specific tasks- to perform
Right supervision/evaluation
-The RN MUST provide supervision either directly or indirectly by assigning supervision to another licensed nurse
-Provide clear directions and expectations
-Moniter and intervene if necessary
-Evaluate the client and determine the outcome status
T / F: It would be OK to delegate an AP to assist in ambulating a client PRIOR to performing an admission assessment?
FALSE. You would delegate this task AFTER the admission assessment.
T/ F: It would be OK to delegate an AP to assist the client in room 312 with morning hygiene...
FALSE. It would be OK to delegate an AP to assist the client in room 312 with a shower before 0900 for example.
Right supervision
-Was the task completed on time?
-Was the task performed at a satisfactory level of competence?
-Did the delegatee DOCUMENT and REPORT unexpected findings?
Identify the correct elements of delegation out of these options...
Right client
Right supervision/evaluation
Right direction/communication
Right time
Right circumstances
The correct elements of delegation in this case would be
-Right supervision/evaluation, right direction/communication, right circumstances
The wrong elements would be...
-Right client --> this is on oe of the rights of medication administration, do not confuse it with the right PERSON YOU DELEGATING TO
-Right time --> This is one of the rights of medication administration.
A nurse on a medical-surgical unit has received change-of-shift report and will care for four clients. Which of the following client's needs may the nurse assign to an assistive personnel (AP)?
A. Feeding a client who was admitted 24 hr ago with aspiration pneumonia
B. Reinforcing teaching with a client who is learning to walk using a quad cane
C. Reapplying a condom catheter for a client who has urinary incontinence
D. Applying a sterile dressing to a pressure ulcer
C
A nurse is delegating the ambulation of a client who had knee arthroplasty 5 days ago to an AP. Which of the following information should the nurse share with the AP? (Select all that apply.)
A. The roommate is up independently.
B. The client ambulates with his slippers on over his antiembolic stockings.
C. The client uses a front-wheeled walker when ambulating.
D. The client had pain medication 30 min ago.
E. The client is allergic to codeine.
F. The client ate 50% of his breakfast this morning.
B, C, D
An RN is making assignments for client care to a licensed practical nurse (LPN) at the beginning of the shift. Which of the following assignments should the LPN question?
A. Assisting a client who is 24 hr postoperative to use an incentive spirometer
B. Collecting a clean-catch urine specimen from a client who was admitted on the previous shift
C. Providing nasopharyngeal suctioning for a client who has pneumonia
D. Replacing the cartridge and tubing on a patient-controlled analgesia (PCA) pump
D
A nurse is preparing an in-service program about delegation. Which of the following elements should she identify when presenting the five rights of delegation? (Select all that apply.)
A. Right client
B. Right supervision/evaluation
C. Right direction/communication
D. Right time
E. Right circumstances
B, C, E
A nurse manager of a medical-surgical unit is assigning care responsibilities for the oncoming shift. A client is awaiting transfer back to the unit from the PACU following thoracic surgery. To which staff member should the nurse assign to this client?
A. Charge nurse
B. RN
C. Licensed practical nurse (LPN)
D. Assistive personnel (AP)
B [Show Less]