Question

* 2 paragraphs During clinical experience, observe & COMMENT on the delegation of client care (Ctrl) -

Answer 1

Ans) Delegation generally involves assignment of the performance of activities or tasks related to patient care to unlicensed assistive personnel while retaining accountability for the outcome.

- The registered nurse cannot delegate
responsibilities related to making nursing judgments.

- Examples of nursing activities that cannot be delegated to unlicensed assistive personnel include:

• assessment and evaluation of the impact of interventions on care provided to
the patient.
Delegation involves “the transfer of responsibility for the performance of a task
from one individual to another while retaining accountability for the outcome.
Example: the RN, in delegating a task to an assistive individual, transfers
the responsibility for the performance of the task but retains professional
accountability for the overall care.

• The following principles provide guidance and inform the registered nurse’s
decision-making about delegation:
- The nursing profession determines the scope and standards of nursing
practice.
- The RN takes responsibility and accountability for the provision of nursing
practice.
- The RN directs care and determines the appropriate utilization of resources
when providing care.
- The RN may delegate tasks or elements of care but does not delegate the
nursing process itself.
- The RN considers facility/agency policies and procedures and the knowledge
and skills, training, diversity awareness, and experience of any individual to
whom the RN may delegate elements of care.
- The decision to delegate is based upon the RN’s judgment concerning the care complexity of the patient, the availability and competence of the individual accepting the delegation, and the type and intensity of supervision
required.
- The RN acknowledges that delegation involves the relational concept of
mutual respect.
- Nurse leaders are accountable for establishing systems to assess, monitor,
verify, and communicate ongoing competence requirements in areas related to delegation.
- The organization/agency is accountable to provide sufficient resources to
enable appropriate delegation.
- The organization/agency is accountable for ensuring that the RN has access
to documented competency information for staff to whom the RN is delegating tasks.
- Organizational/agency policies on delegation are developed with the active participation of registered nurses.

To determine if delegation is appropriate, the registered nurse will:
1. Perform an assessment of the healthcare consumer’s:
a. Care needs and determine if any cultural modifications are required
b. Condition to determine if it is stable and predictable
c. Environment where care will be provided
2. Develop a plan of care with the healthcare consumer and his/her family,
identifying the delegable task and intended outcome as part of the overall
plan of care. Involving and educating healthcare consumers and their
families about appropriate expectations of the roles of care providers
promotes a safer environment and improved patient outcomes. The plan
of care should include:
a. Baseline status of the healthcare consumer
b. Specific unchanging task performance steps
c. When and to whom the UAP need to report if the baseline status is
changed
d. Documentation of expectations as appropriate
3. Analyze the following:
a. Is the task within the delegating RN’s scope of practice?
b. Are there federal or state laws, rules, or regulations that support the
delegation?
c. Does the employing organization/agency of the delegating RN and
the UAP permit the delegation?
d. Is the delegating RN competent to make the delegation decision?
e. Is the UAP competent to perform the delegated task?
f. Is RN supervision of the UAP available?
4. Monitor implementation of the delegated task as appropriate to the overall.