Delegation involves delegators (RNs) and Delegatees (HCAs). RNs assign responsibilities and authority accountability to HCAs. Effective delegation demands competence, skills, and knowledge. Improve patient care and coordination among care- stakeholders Delegation needs action plan and appropriate procedure Plan entails communication, resolution, feedback, and evaluation. Delegation is collaborative and requires various stakeholders.

RN –Examines/assesses the patient’s needs Decides on the what to delegate (scope) Look onto HCA’s skills, knowledge, and competence Communicate clear and concise guidelines and expectations. Does supervision and expect feedback Evaluates the feedback Makes resolution and report to patients/families Source: (Hansten, & Jackson, 2009)

Robert (RN) assesses a TB patient He examine Effie’s credentials and patient’s needs Communicates the guidelines, direction and expectations to Effie Delegates the patient care to Miss Effie Effie takes to execute her delegation work Robert continues to supervise and direct Effie Effie reports back to Robert for evaluation

Delegation follows some principles and rules Task must be assigned according to competence It gears towards best quality patient care RN must define the delegation scope/boundary RN has delegation liability; HCA for care HCAs must report cases outside their competence RN should coordinate all operations and stakeholders

Effie cares for the patient as delegated Notes the patients situation, but find complications She is aware of the complication's risks Effie reports to Robert to take over Cardiac issue is not within her competency Robert assesses the case and recommends transfer He involves various health care stakeholders/practitioners.

Robert, CCU RN CCU Nurses Medical Surgery Nurses Medical Laboratory technician Respiratory therapist Hospital ICU coordinator/Supervisor Physician/Doctors  Coordinates transfer and treatment  Receive the Patient at CCU  Prepare patient for Surgery  Test patient’s body samples  Chest TB/Cardiac therapy  Coordinates housekeeping  Work with nurses to treat

Each stakeholder’s must contribute to patient care Their presence must increase patient recovery probability Their number and skills must be manageable All stakeholders should be competent and skilled Each should show work commitment and dedication There should be balance of interest/capabilities All should abide by the care guidelines

Communication-RN to notify all the stakeholders RN direction-RN provides guidelines and responsibilities Delegation- Every practitioner works on tasks assigned Supervision – Managing RN continues to monitor operations Conflict-resolution – stakeholders constitute measure to avert disputes Feedback – RN expects and receive feedbacks Evaluation – RN evaluates the feedbacks about patients

All recommendations should uphold quality patient care. Thus the measures must follow legitimate principles It‘s proper to consider context and resources Consider direction, activity, circumstances, and person rights Ensure the delegation rights support patients care Certify competent entities at minimal resource use Involve all stakeholders in decision-making and care

Right Task- Delegate appropriate task or scope Right Circumstances – Delegation context to match resources Right communication – use clear and concise directives Right supervision- Monitor, intervene, and evaluate need Right person – delegate responsibilities to competent persons  Note: If all is right, Patients benefit more  Always prioritize on caring for the patients

Delegation is imperative and powerful in healthcare It involve two main partners; delegator and delegatee Depends on workers’ competence, skill and knowledge Health care stakeholders produce synergistic patient care Delegation and choosing stakeholder require critical factors Effective delegation improve efficiency and quality care Delegation is complex, but necessary in healthcare

Hansten, R. I., & Jackson, M. (2009). Clinical Delegation skills: A handbook for Professional Practice. Sudbury, MA: Jones and Bartlett. In Cherry, B., & In Jacob, S. R. (2014). Contemporary Nursing: Issues, Trends, & Management. Persily, C. A. (2013). Team Leadership and Partnering in Nursing and Health Care. New York, NY: Springer Pub.Co. Weiss, S., & Tappen, R. (2014). Essentials of Nursing Leadership & Management: Concepts, Connections & Skills. Philadelphia: F. A. Davis Company.