Lecture Notes: Delegation in the Clinical Setting

Introduction

• Professor Forsythe discusses delegation in clinical settings.
• Located in Chapter 14, page 325 of "Nursing Today."

Defining Delegation

• Clinical Delegation: Process for nurses to direct another person to perform nursing tasks and activities.
  • State Board of Nursing & Professional Associations define terms related to clinical leadership.
  • ANA: Transfer responsibility.
  • NCSBN: Transferring authority.
• Involves accountability; the nurse retains accountability after delegating tasks.

Importance of Supervision

• Supervision: Guidance by a qualified nurse for nursing tasks.
  • Not limited to managers; anyone delegating has supervisory responsibility.
  • Requires initial direction and periodic inspection.

The Delegation Process

1. Assessment and Planning
   • Ensures rules and laws support delegation.
   • Assesses the needs and competencies of the patient and nursing assistant.
   • Determines appropriate supervision availability.
2. Communication
   • Two-way process involving clear initial direction and ongoing discussion.
3. Surveillance and Supervision
   • Ongoing monitoring of task performance.
   • Varies based on patient needs and team member competence.
4. Evaluation and Feedback
   • Essential for determining the success of the delegation.
   • Part of the nursing process; evaluates outcomes and ensures positive results.

Accountability

• Accountability: Being answerable for one's actions.
  • Nurse is accountable for total nursing care.
• Ensures personal accountability is based on professional knowledge and judgment.

Five Rights of Clinical Delegation

1. Right Task
   • Tasks delegated based on state regulations and job descriptions.
   • Certain tasks cannot be delegated (e.g., assessment, evaluation).
2. Right Circumstances
   • Consideration of patient setting, resources, and team strengths.
   • Assign tasks based on strengths but challenge to grow abilities.
3. Right Person
   • Select competent individuals for delegation.
   • RNs accountable for determining delegation situations.
4. Right Direction and Communication
   • Use four Cs: Clear, Concise, Correct, Complete.
5. Right Supervision and Evaluation
   • Monitor and ensure task quality and patient results.
   • Provide constructive feedback using a feedback formula.

Conclusion

• Delegation involves ensuring tasks are assigned to the right person under the right circumstances.
• Emphasize communication, supervision, and feedback.
• Practice and understanding of delegation are crucial for effective patient care.

Additional Tasks

• Review the provided questions and answers to assess understanding of delegation in the clinical setting.