These LPNs and unlicensed nursing assistants are a critical part of the team and a great assistance. Working together, it is important to work on your delegation skills. As a nurse, you are a steward of healthcare resources: So what should you know about delegating responsibility to nursing assistants?
It requires sophisticated clinical judgment and final accountability for patient care. Work Complexity Assessment, a program that defines and quantifies various levels of care complexity based on the knowledge and skill required to perform the work, has demonstrated that methods of patient assignment and staff scheduling that support consistency increase what could be delegated to ancillary personnel by using the more effective assignment patterns.
The author begins this article by discussing delegation and the related concepts of responsibility, accountability, and authority.
Next factors to consider in the delegation process, namely nursing judgmentinterpersonal relationshipsand assignment patterns are presented. The author concludes by sharing how to develop delegation skills.
RNs decide what patient care interventions are necessary and how, when, and by whom these interventions Nursing and delegation to be provided. These decisions are made in a clinical environment in which shrinking resources and increased demands for services heighten the need for nurses to delegate care based on professional guidelines and their state nurse practice acts.
Next factors to consider in the delegation process, namely nursing judgment, interpersonal relationships, and assignment patterns are presented. The author concludes by sharing how delegation skills can be taught and strengthened. Delegation and Related Concepts Delegation is an important skill that influences clinical and financial outcomes Perhaps one of the most difficult responsibilities an RN has is that of effective delegation.
The following scenario is a typical situation that RNs frequently describe when sharing their need for more staff: Near the end of her shift, the RN finds that the LPN and nursing assistant have all their work completed and are sitting in the nursing station waiting for the next shift to arrive.
The RN is struck by how overwhelmed she feels and questions the LPN and nursing assistant about why they did not help her. Rather the situation developed because the RN performed work that others could have completed.
Almost all RNs can benefit from strengthening their delegation skills so as to maximize the available resources. In the delegation process, RNs need to match the skills of the staff with the needs of the patient and family. Matching staff skill to patient and family needs highlights the difference between delegation and assignment.
This task, however, needs to be one that the person accepting the assignment is qualified to perform. Clarifying the difference between delegation and assignment helps staff members understand why one cannot develop a simple laundry list of what can be delegated to others.
Delegation belongs to the practice of registered nurses, but often it is not well understood or practiced. Work redesign has relied heavily on assistive personnel, sometimes called nurse extenders; however, many tasks cannot be delegated to these assistants because they exceed the scope of practice of these personnel Ebright, et al.
In the scenario provided above, the RN was the person directing the work of others. However, the RN did not communicated with the LPN and nursing assistant about what needed to be done. In addition, the RN accepted the responsibility to perform additional activities requested by other departments rather than redirecting some of them.
This behavior is not uncommon. Nurses are stewards of healthcare resources. Delegation is a skill that maximizes the available resources in the interest of patient care. RNs are responsible for the care they provide and for determining what care can be appropriately delegated to others.
Responsibility Frequently when discussing delegation, RNs will comment: This statement infers that one is liable or has to answer for the actions of another. Responsibility is a two-way process that is both allocated and accepted Creative Health Care Management, Assistive personnel accept responsibility when they agree to perform an activity delegated to them.
Accountability Accountability involves a retrospective review which includes critical thinking to determine if the action was appropriate and giving an answer for what has occurred.
RNs demonstrate accountability when they answer both for themselves and for others regarding their actions ANA Code of Ethics, Authority RNs, by virtue of their professional licensure, have the authority to transfer a selected nursing activity in a specific situation to a competent individual NCSBN, Authority is the right to act in areas where one is given and accepts responsibility Creative Health Care Management, RNs have authority, or legitimate power, to analyze assessments, plan nursing care, evaluate nursing care, and exercise nursing judgment NCSBN which includes delegation.
Summary LPNs are accountable for the quality of their performance In the delegation process accountability rests within the decision to delegate, while responsibility rests within the performance of the task.
LPNs are accountable for the quality of their performance and responsible for caring out the activities assigned to them. When a RN delegates an activity, such as medication administration, to an LPN, the LPN is accountable for safely performing this medication administration according to established regulations and standards, and responsible for completing this activity.
This intentional reflection on the delegated activity directs future efforts and promotes learning Creative Health Care Management, Understanding the difference between responsibility and accountability helps to clarify how RNs can delegate work to another without being held responsible for their actions.
These Rights of Delegation include:The following are the mandatory forms to be used for all DSHS contracted nurse delegators. Nurse Delegation Program Home» NDP Purpose: The Nurse Delegation Program (NDP) provides training and technical support to community-based providers that serve individuals who require assistance with medication administration and health monitoring in certified residential and day rehabilitation settings.
Click below for a listing of nurses or nursing agencies with DSHS contracts to provide nurse delegation services to Medicaid clients. Some of these RND’s may also . Chapter 3 Delegation of Nursing Tasks Chapter Objectives 1.
Define delegation. 2. Identify the five rights of delegation. 3. Review the circumstances where delegation is appropriate. 4.
Identify tasks appropriate for delegation. 5.
Discuss the role of unlicensed personnel in the delivery of health care. 6. Identify the role of the nurse in the delegation of health care. When discussing delegation within nursing practice, it is important to understand competency and how it is determined for the nursing specialty area.
Competency is an ongoing process; it is the ability to integrate knowledge, skills, and judgment to practice safely and ethically in a designated role. 1. Delegation and Nursing Judgment. The ANA Code of Ethics notes that delegation is based on the RN’s judgment concerning a patient’s condition, the competence of all members of the nursing team, and the degree of supervision required.