Delegation in Nursing

Overview

• Discussion on delegation in nursing, focusing on what nursing assistants are allowed to do.
• Importance of understanding state-specific rules and the Nurse Practice Act.
• Example provided based on Florida's regulations.

Nurse Practice Act

• Every state has a Nurse Practice Act defining the role of nurses and CNAs.
• Specific tasks for CNAs outlined in state statutes.
• Reference to Florida Statute 464.201 for CNA responsibilities.

CNA Responsibilities

• Daily Living Activities: Bathing, dressing, grooming, oral hygiene, etc.
• Mobility Assistance: Ambulating, transferring, positioning, etc.
• Nutrition and Hydration: Feeding, assisting with fluids, etc.
• Elimination: Toileting, catheter care, specimen collection, etc.
• Environment Maintenance: Cleanliness, safety, infection control, etc.
• Assistive Devices: Care for dentures, glasses, hearing aids, prosthetics, etc.
• Basic Nursing Skills: Vital signs, intake/output measurement, etc.
• Life and Death Support: CPR, first aid, emergency and end-of-life care.
• Socialization and Rights: Facilitate activities, orientation, validation, etc.

Delegation

• Definition: RN assigns tasks to unlicensed personnel (e.g., CNAs) beyond their initial training.
• Legal framework allows for additional task training under RN supervision.
• Training and skill validation required for new tasks.

Rules for Delegation

• RN must ensure the CNA is trained and competent in the task.
• RN assesses the patient's needs and ensures task suitability.
• RN communicates task details, expectations, and reporting requirements.
• RN monitors and evaluates the delegated task, retaining liability.

CNA's Role in Delegation

• Task Instructions: Must receive clear instructions on task details.
• Training: Have proper training and knowledge of the task.
• Communication: Know how to contact the RN if needed.
• Reporting: Understand what needs to be reported back.

Liability

• Liability remains with the RN even if the CNA performs the task.
• Importance of adhering to delegation rules for safety and effectiveness.

Conclusion

• Emphasis on learning new skills and following delegation rules.
• Encouragement to work within the framework to ensure safe patient care and professional growth.