Delegation in Nursing

Introduction

• Focus on delegation, management, and leadership in nursing.
• Chapters to review:
  • Delegation: Chapter 20
  • Communication: Chapter 19
  • Management and Leadership Styles: Chapter 17

Understanding Delegation

• Definition: Transfer of responsibility from one RN to another competent staff member while the RN retains accountability for the outcome.
• Two-way process: Between RN and LPN or unlicensed personnel.
• Key questions: What can be delegated? What cannot be delegated? What are the steps?

Provider Roles in Healthcare

• Differences between RN, LPN, and unlicensed personnel (e.g., PCAs).

Importance of Delegation

• RNs often in leadership roles, requiring delegation.
• Why delegate?
  • Shortage of nurses.
  • Meet healthcare facility and patient needs efficiently.
  • Cost-saving strategy allowing RN to focus on complex tasks.

Delegation Guidelines

• Nurse Practice Acts: Legal scope and responsibilities vary by state.
• Organizational Policies and Procedures: Specific tasks and supervision required.
• Job Descriptions: Tasks and responsibilities as conditions of employment.
• Professional Standards of Practice: Established by nursing organizations like the American Nurses Association.

What Can and Cannot Be Delegated

• Cannot delegate:
  • Independent nursing judgment tasks.
  • Initial assessments, teaching, planning, and evaluating.
• Five Rights of Delegation:
  1. Task: Routine standard procedures are okay; independent nursing judgment is not.
  2. Person: Assess if the person is right for the task.
  3. Circumstances: Consider stability of the patient and complexity.
  4. Communication: Clear, concise, and verified.
  5. Supervision: Evaluate outcomes and provide feedback.

Communication in Delegation

• Importance of clear, concise communication.
• Verify understanding through feedback.
• Evaluate patient outcomes and performance.

Difference Between Delegating and Assigning

• Delegating: RN to LPN or unlicensed personnel; RN retains responsibility.
• Assigning: Between RNs; each is responsible for their own patients.

Key Considerations

• Communication: Verbal and non-verbal cues.
• Environment: Trust and cooperation among staff.
• Feedback: Essential for growth and improvement.

Conclusion

• The Five Rights of Delegation as a guiding framework.