Delegation: An Art of Professional Practice

Delegation… The transfer of responsibility for the performance of an activity from individual to another while retaining accountability for the outcome. American Nurses Association

Supervision… The provision of guidance, evaluation, and follow-up by a licensed nurse for the accomplishment of a nursing task which has been previously assigned. National Council of State Boards of Nursing

Assignment… The downward or lateral transfer of both responsibility and accountability of an activity from one individual to another. American Nurses Association

Importance of Delegation

To delegate or not to delegate… Nursing Practice Acts and other state laws Patient needs Staff competencies Policy and procedures Clinical situation

Do not delegate… Initial nursing assessment Nursing diagnosis, goals, and care plans Evaluation of patient progress Professional interventions which requires knowledge, judgment, or skills Discharge planning Educational planning

The Delegation Process Define the task Decide on the delegate Determine the task Reach an agreement Monitor performance and provide feedback

The Nursing Process Assessment Plan Intervention Evaluation

The Five Rights of Delegation Right Task Right Circumstance Right Person Right Direction/ Communication Right Supervision

Delegation Obstacles Environmental Delegator Delegate

What do you think?

Delegation Assessment

Mr. Jones, a bedridden but stable patient needs a bed bath. You Assign the task to the nurse assistant Work together with the nursing assistant to give the bath Do the bath yourself because Mr. Jones is a VIP and you know you’ll do the best job

You are the charge nurse, and one of your team members is a float nurse who has never worked on the unit before. You Spend 15 minutes with her assessing her abilities and providing a brief orientation to the unit so that she can take the full assignment Give her three of the “easiest patients” and pick up the rest of the assignment yourself Call the supervisor and tell her that you have no time to orient some and the float will be more trouble than she’s worth

Another new admission is arriving on your unit. You Assign the patient to the LPN, recognizing that one of the registered nurses will be overseeing and completing the admission assessment Ask the nursing assistant to get the vital signs, and you complete the admission before the assigning the patient to another RN Take the admission yourself because everyone else seems to busy

You and a nursing assistant are assigned to 10 patients on a medical surgical floor. You Spend 15 minutes making walking rounds with the nursing assistant, then decide how to distribute patient care tasks Assign tasks according to the assignment board from yesterday Send the nursing assistant to take vital signs without further information or communication

You are uncertain about a new licensed nurses skill in giving a cleansing enema. You Review the hospital procedure with the nursing assistant and observe him performing the task so that next time he can do it alone Give the enema yourself, promising that the next time you’ll teach the new nurse You never assign him to give enemas

Have a relaxing weekend…