Nursing - Delegation of Work
The National Council of State Boards in Nursing defines delegation as “transferring to a competent individual the authority to perform a selected nursing task in a selected situation” (National Council of State Boards of Nursing, Resources section, 4). When delegating, the registered nurse (RN) assigns nursing tasks to unlicensed assistive personnel (UAP) while still remaining accountable for the patient and the task that was assigned. Delegating is a management strategy that is used to provide more efficient care to patients. Authorizing other individuals to take on nursing responsibilities allows the nurse to complete other tasks that need tended to. However, delegation is done at the nurses’
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268). Accountability and responsibility differ, because responsibility belongs to the person doing the task and accountability belongs to the person who assigned the task. The nurse is both accountable for the task being completed and is also responsible for evaluating the task or the results of the task. Therefore, within every delegated procedure, both the nurse and the UAP hold responsibility, yet only the nurse is accountable. If a procedure is done wrong or the patient is harmed by the task, the nurse is at fault because she delegated that procedure and she is ultimately accountable for patient outcomes.
For example, Jill is a RN and Marie is a UAP at General Hospital. Jill and Marie are assigned to work together. Jill delegates to Marie the vital signs, patient hygiene, and blood glucose monitoring of all of her patients except for Mrs. Smith, who is sicker than any of the other patients. Jill decides not to delegate any of Mrs. Smith’s care because all of her care will require professional nursing judgment due to the severity of her condition; therefore Jill will be accountable and responsible for Mrs. Smith’s care. Marie is responsible for performing the duties that were delegated to her by Jill; however Jill remains accountable for all of the delegated tasks. If Jill overlooks a patient’s blood glucose level of 45 and the
The first consideration a registered nurse should determine is if “The Right Task (Cherry 355-356)” is being delegated to the right staff member. Delegation to the right staff member must be in their scope of practice and have proven to competent to complete. An individuals’ scope of practice will be set forth by the facility in which they work. In addition to individual facility polices the nurse must adhere to the scope of delegation set forth in the Nurse Practice Act of Maryland. Per the Nurse Practice Act of Maryland the task to be delegated must be “within the area of responsibility of the nurse delegating the act (Code of Maryland Regulations 10.27.11.03).” An example of incorrect delegating would be having an unlicensed individual, CNA or LPN to
Accountability means:” being accountable for one’s own action”. The American Nursing Association (ANA) states in its code that the nurse will assume accountability for individual nursing judgments and actions. Professional nurses are accountable in several areas including accountability to the public, client, profession, employer, and self (Hood, 2010, p. 307). All professional nurses have the responsibility to work within their scope of practice to provide the best possible care to patients. Nurses’ should have a thorough knowledge about their accountability in specific areas of practice. The level of responsibility and accountability depends on professional levels. A nursing supervisor has more responsibility than a charge- nurse. A
The American Nurse Association defines delegation as “the transfer of responsibility for the performance of an activity from one individual to another while retaining accountability for the outcome” (Cherry, 2011). Delegation is an essential tool used by the registered nurse to routinely distribute responsibility and allow them to effectively complete more tasks during their daily routine. With this shared responsibility comes accountability for the registered nurse to know how, when and to whom he or she must appropriately distribute these tasks. To safely delegate patient care, the registered nurse must follow his or her own state
ABSTRACT: Delegation refers to the practice of a registered nurse assigning certain tasks and activities to other people while still maintaining responsibility for the actions of the others to whom responsibility has been delegated. The act of delegating assumes that the delegator has a certain amount of trust in the person to whom they delegate. Additionally, quality communication is paramount in maintaining superior patient care when delegating tasks to others. One signifigant obstacle to delegation is ensuring that the proper tasks are delegated to the appropriate individuals. The organizational structure and leadership
Nurses demonstrate the value of autonomy by acting on their own intuition daily to improve the quality of all aspects of human life. This is evident when a patient arrives into an urgent care center with an asthma attack. A prudent nurse will act autonomously by giving the patient a nebulizer treatment, place him on oxygen, or take the time to find out if there are standing orders and carry them out without a doctor’s order.
Nurses play many roles in the healthcare field, can have many duties to fulfill under their licensure. It is important for a nurse of any degree, or licenses to know all of the duties that can be performed under their scope of practice. Olin (2012) states, “Scopes of practice are the same for every nurse at a basic level and very different by specialty.” Therefore, it is important to understand the scope of practice, that the nurse is licensed for. A nurse has many roles under the scope of practice that the nurse is licensed under. There are times when a nurse is asked to perform a task that isn’t under the nurse’s scope of practice and guidelines, and it is very important not to fulfill the task at hand if it
This article discusses about the process of nursing delegation. For the process of nursing delegation, it must have strong communication, empowered staff, and organizational support. The guidelines identify 5 rights of delegation, which include right task, right circumstances, right person, right direction & communication, and right supervision & evaluation. When a delegator, such as a nurse, delegates, they will remain responsible for the tasks that were delegated. Delegation of an action/task is done based on the patient’s safety and their quality of care. Following the process enables a nurse to appropriately delegate to benefit the care of the patient.
Delegation is a formal process through which a regulated health professional (delegator) who has the authority and competence to perform a procedure under one of the controlled acts delegates the performance of that procedure to another individual (delegatee) (College of Nurses of Ontario, 2014).
The nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurse’s obligations to provide optimum patient care. (Bosek & Savage, 2007, p. 59) The nursing student realized that she wasn’t an expert in pharmacokinetics and requested the help of a pharmacist to provide quality care for her patient. (Bosek & Savage, 2007, p. 59) Delegation is a huge responsibility and should never be taken lightly. The duty of the nurse is to ensure the patient receives quality care. This means delegating responsibilities to others to ensure that care is met. If a nurse feels she is unsure of a certain area of care, that nurse is obligated to find the precise person who can provide that care. The author’s daughter (Bella) was in the hospital for a reoccurring MRSA infection. When the nurse walked in the door they were asked a question regarding infectious disease protocols and how best to handle the situation. Instead of giving an answer they thought might be correct, the nurse requested that an infectious disease doctor be called in to answer all questions concerning the patient.
Responsibility is defined as the "reliability, dependability, and the obligation to accomplish work”, responsibility also includes each person's obligation to perform at an acceptable level, the level that the person has been educated (Kelly-Heidenthal, 2003, p. 268). Accountability is defined as, "being responsible and liable for actions or failure of actions of oneself or others in the context of delegation" (NCSBN, 2009). This is in reference to the nurse's legal liability for the actions taken and patient outcomes. Accountability and responsibility are different, as responsibility belongs to the person doing the task and accountability belongs to the person who assigned the task. The nurse is both accountable for the
It is up to the nurse/delegator to determine the delegatee’s knowledge, skills, abilities, and any training that will ensure that the task will be handled appropriately and safely. If it is necessary the nurse/delegator must provide instruction and direction to the delegatee. The nurse/delegator or another qualified nurse must be available to supervise the delegate and delegated task. The level of supervision needed will be determined by the training, capability, and willingness of the delegate to perform the task. A delegate may not delegate to another person or expand the delegated task without the permission of the nurse/delegator. Once the delegated task is completed the nurse must evaluate the delegated task, patient’s health status, determination if the goals are being met and if the delegation of the task may be continued (UT Admin Code R156-31b. Nurse Practice Act Rule, 2013). In section R156-31b-704 the rules for the recognized scope of practice of an RN are outlined. It states that the RN, RN managers, and RN administrators should practice
Being the primary nurse, I assigned each of my group members to a specific task. I assigned one colleague to assess the vital signs of the patient. In the scenario there were two medications that should be administered to the
The standards of practice describe a competent level of nursing care as exhibited by the critical thinking model known as the nursing process. This practice includes the areas of assessment, diagnosis, outcome identification, planning, implementation, and evaluation. The nursing process includes significant actions taken by registered nurses (RN) and forms the foundation of the nurse’s decision-making (“American Nurses Association,” 2010).
1a Explain the differences between modern day nursing education and the old hospital based training model
Nursing assignment is one of the most essential decisions a charge nurse or nurse mangers has to make on a daily basis. It allows nursing managers to assign patient to a nurse based on education and level of experience. Assignments are most often mistaken as delegation. However they are not the same. Nursing assignment are basically made with regard to patient medical need, and acuity level. Delegation on the other hand, is when simple nursing tasks such as feeding, bathing, etc. are assigned to other nursing personnel to complete. According Catalano, “Delegation is recognized as designating ancillary personnel for the responsibility of carrying out a specific group of nursing tasks in the care of certain clients. Whereas “assignment is designating tasks for ancillary personnel that fall under their own level of practice according to facility policies, position descriptions, and, if applicable, state practice act (Catalano 2014). Nursing assignments involves critical thinking skills because accuracy is important to optimize care. It is important for charge nurses to ensure proper and appropriate assignment because lapse can lead to poor quality of care, disappointing outcomes of care, the jeopardized of client safety, and could even legal consequences. Thus as a charge nurse, it is important to incorporate critical thinking, clinical reasoning and judgement when assigning patient care.