Chapter 20: Delegation Flashcards
Exam 4 (Final)
1
Q
Delegation: What is it?
A
The process of assigning specific tasks or responsibilities to another qualified individual while retaining overall accountability for the outcome.
2
Q
Delegations negotiations:
What is done?
A
*Getting work done through others.
3
Q
Delegation Negotiations:
What is directed?
A
*Directing the performance of one or more people to accomplish organizational goals.
4
Q
Delegation Negotiations:
What are you giving someone else the authority for?
A
*Giving someone else the authority to complete a task or action on your behalf.
5
Q
Delegation Negotiations:
What is transferred?
A
*Transferring or handing off to a competent individual, the authority to perform a task/activity in a specific setting/situation.
6
Q
Delegation Negotiations:
What is provided to the person who is delegated a task?
A
*Providing that person (the person you are delegating to) the Authority and the responsibility to carry out the assigned task.
7
Q
Delegation:
What should it be used to assign?
A
*Delegation should be used for assigning routine tasks and tasks for which the manager does not have time.
8
Q
Delegation:
What is it appropriate as a tool for?
A
It is also appropriate as a tool for problem solving, changes in the manager’s own job emphasis, and building capability in subordinates.
9
Q
Strategies for successful delegation
Include:
A
Plan ahead
Define Clear Objectives
Choose the Right Person
Provide Context
Set Boundaries
Establish Deadlines
10
Q
Strategies for successful delegation
Include: define clear objectives
Means?
A
*Identify necessary skill and education levels to complete the delegated task.
11
Q
Strategies for successful delegation
Include: Choose the Right Person
Means?
A
*Select capable personnel.
12
Q
Strategies for successful delegation
Include: Provide Context
Means?
A
*Communicate goals clearly.
13
Q
Strategies for successful delegation
Include: Set boundaries/establish deadlines
Means?
A
*If an employee has the skills necessary to complete a task, that employee should be able to carry out the task with autonomy and be provided with the authority and resources necessary.
14
Q
strategies FOR SUCCESSFUL DELEGATION :
What should be identified?
A
Identify necessary skill and education levels to complete the delegated task
15
Q
strategies FOR SUCCESSFUL DELEGATION :
What should be done before you get overwhelmed?
A
Plan; delegate before you become overwhelmed
16
Q
strategies FOR SUCCESSFUL DELEGATION :
What should be selected?
A
Select and empower capable personnel
17
Q
strategies FOR SUCCESSFUL DELEGATION :
What should be communicated?
A
Communicate the goals of the delegation clearly
18
Q
strategies FOR SUCCESSFUL DELEGATION :
What should be set?
A
Set deadlines and monitor progress
19
Q
strategies FOR SUCCESSFUL DELEGATION :
What should be monitored?
A
Monitor the delegated task and provide guidance
20
Q
strategies FOR SUCCESSFUL DELEGATION :
What should be evaluated?
A
Evaluate performance
21
Q
strategies FOR SUCCESSFUL DELEGATION :
What should be rewarded?
A
Reward the completion of successfully delegated tasks
22
Q
Communication & DELEGATION:
What should be defined?
A
Define in significant detail what the task is
23
Q
Communication & DELEGATION:
What should be provided?
A
Provide a timeframe and standard in which the task is expected to be completed by
Provide the individual with the necessary authority and responsibility to do the task
24
Q
Communication & DELEGATION:
What should be delineated?
A
Delineate end results, time frame, and standards.
25
Communication & DELEGATION:
What should be delegated, what should not?
Delegate the objective, not the procedure.
26
Communication & DELEGATION:
In order to assure completion of a task:
in order to assure completion of a task: Managers must delegate the authority and the responsibility necessary to complete the task
27
What goes hand in hand with delegation?
Communication and delegation go hand in hand.
28
State Nurse practice act Essential Elements Regarding Delegation #1
What does it define?
Definition of delegation
29
State Nurse practice act Essential Elements Regarding Delegation #1
What items does it include?
Items that cannot be delegated
Items that cannot be routinely delegated
30
State Nurse practice act Essential Elements Regarding Delegation #1
What guidelines does it include?
Guidelines for RNs about tasks that can be delegated
The guidelines for lowering delegation risks
31
State Nurse practice act Essential Elements Regarding Delegation #1
What does it include a description of?
Description of professional nursing practice
Description of LVN/LPN nursing practice and unlicensed nursing roles
32
State Nurse Practice act Essential Elements Regarding Delegation #2
Degree of what is stated in the Act?
Degree of supervision required to complete a task
33
State Nurse Practice act Essential Elements Regarding Delegation #2
What warning is stated in the act?
Warnings about inappropriate delegation
34
State Nurse Practice act Essential Elements Regarding Delegation #2
What is there restricted use for?
If there is a restricted use of the word nurse to licensed staff
35
State Nurse Practice act Essential Elements Regarding Delegation #2
How does each state differ?
EACH STATE IS DIFFERENT IN THE TASK THAT CAN BE DELEGATED AND WHO CAN DELEGATE THOSE TASK
36
Registered Nurses (RNs) and Licensed Practical Nurses (LPNs) both play vital roles in healthcare, but they have different levels of
What?
Education and Training
Licensure
Scope of Practice
Autonomy
37
Registered Nurses (RNs) and Licensed Practical Nurses (LPNs) both play vital roles in healthcare, but they have different levels of
What exactly is a RN responsible for?
RN:
Responsible for comprehensive patient assessments,
developing and implementing nursing care plans,
and administering medications and treatments.
RNs often take on leadership roles and can specialize in various fields.
38
Registered Nurses (RNs) and Licensed Practical Nurses (LPNs) both play vital roles in healthcare, but they have different levels of
What exactly is a LPN responsible for?
LPN:
Provides basic nursing care under the supervision of RNs or physicians.
Responsibilities include monitoring patients, administering medications, and assisting with daily activities.
39
COMMON DELEGATION ERRORS
include:
Underdelegating
Over delegation
Improper delegation
40
COMMON DELEGATION ERRORS
include: Under delegating
What is this and why does this occur?
Not delegating enough tasks or responsibilities to others, often due to a lack of trust or fear of losing control.
41
COMMON DELEGATION ERRORS
include: Over delegating
What is this ?
Assigning too many tasks or responsibilities, often beyond what a person can reasonably manage.
42
COMMON DELEGATION ERRORS
include: Improper delegating
What is this ?
Assigning tasks to the wrong person or failing to provide adequate instructions, resources, or authority.
43
CONSEQUENCES & CAUSES OF UNDER DELEGATION
Consequences of under delegation
What is there an increase of? What does this lead to?
Increased workload for the leader, leading to burnout.
44
CONSEQUENCES & CAUSES OF UNDER DELEGATION
Consequences of under delegation
What is there a missed opportunity for?
Missed opportunities for team members to develop skills.
45
CONSEQUENCES & CAUSES OF UNDER DELEGATION
Consequences of under delegation
What is there an inefficient use of?
Inefficient use of team resources.
46
CONSEQUENCES & CAUSES OF UNDER DELEGATION
Causes of under delegation
Fear of what?
Fear of mistakes or poor performance by others.
47
CONSEQUENCES & CAUSES OF UNDER DELEGATION
Causes of under delegation
A desire for what?
Desire to maintain control over all aspects of work.
A desire to complete the whole job himself or herself
48
CONSEQUENCES & CAUSES OF UNDER DELEGATION
Causes of under delegation
A lack of what?
Lack of confidence in team members’ abilities as a desire to complete the whole job on their own
Lack of experience in the job or with delegation
49
CONSEQUENCES & CAUSES OF UNDER DELEGATION
Causes of under delegation
What is there a fear of?
Fear that subordinates will resent delegated work
50
CONSEQUENCES & CAUSES OF UNDER DELEGATION
Causes of under delegation
What is there a need of?
Need for perfectionism
51
CONSEQUENCES & CAUSES OF UNDER DELEGATION
Causes of under delegation
What is there a fear of how delegation is interpreted?
Fear that delegation may be interpreted as a lack of ability to do the job completely or correctly
52
CONSEQUENCES & CAUSES OF UNDER DELEGATION
Causes of under delegation
What else?
Enjoyment of the work
53
CONSEQUENCES & CAUSES OF UNDER DELEGATION
Causes of under delegation
How is it (at least initially) to allow a team member to complete a task for which you are ultimately responsible?
*It will likely be unnerving (at least initially) to allow a team member to complete a task for which you are ultimately responsible.
54
Causes and consequences of over delegation
Causes of over delegation:
What is there a lack of awareness of?
Lack of awareness of team members’ capacities and workloads.
55
Causes and consequences of over delegation
Causes of over delegation:
What is there an attempt of?
Attempting to shift responsibility without providing support or resources.
56
Causes and consequences of over delegation
Causes of over delegation:
What is there a misjudgment of?
Misjudging the complexity of tasks or the skills of the delegate.
57
Causes and consequences of over delegation
Causes of over delegation:
What is there poor management of?
*Poor management of time; spending too much time trying to get organized
58
Causes and consequences of over delegation
Causes of over delegation:
What is there an insecurity of?
*Insecurity in the ability to perform a task
59
Causes and consequences of over delegation
Consequences of over delegation:
How may team members feel?
Team members may feel overwhelmed and stressed.
60
Causes and consequences of over delegation
Consequences of over delegation:
How may this effect quality of work?
Quality of work may decline due to high workload.
61
Causes and consequences of over delegation
Consequences of over delegation:
What is there a potential for?
Potential for missed deadlines and decreased morale.
62
Causes and consequences of IMPROPER delegation
Causes of improper delegation
What is inadequate?
Inadequate assessment of tasks and delegate qualifications.
63
Causes and consequences of IMPROPER delegation
Causes of improper delegation
What is poor?
Poor communication of expectations and requirements.
64
Causes and consequences of IMPROPER delegation
Causes of improper delegation
What is ignored?
Ignoring organizational policies or scope of practice limitations.
65
Causes and consequences of IMPROPER delegation
Causes of improper delegation
What is wrong?
*Wrong time, to the wrong person, or for the wrong reason
66
Causes and consequences of IMPROPER delegation
Causes of improper delegation
What is it beyond?
*Beyond the capability of the person, or something the manager should do
67
Causes and consequences of IMPROPER delegation
Causes of improper delegation
What is done without providing adequate information?
*Decision making without providing adequate information
68
Causes and consequences of IMPROPER delegation
Consequences of improper delegation
What is there an increase of?
Increased risk of errors and poor outcomes.
69
Causes and consequences of IMPROPER delegation
Consequences of improper delegation
What is there an frustration of?
Frustration among team members due to unclear expectations.
70
Causes and consequences of IMPROPER delegation
Consequences of improper delegation
What is there a potential for?
Potential harm to patient safety or project success.
71
FIVE RIGHT OF DELEGATION
What do they provide a framework to ensure?
The "Five Rights of Delegation" provide a framework to ensure safe and effective delegation in nursing and healthcare.
72
FIVE RIGHT OF DELEGATION
What are they?
Right Task:
Right Circumstance
Right Person
Right Direction/communication
Right Supervision
73
FIVE RIGHT OF DELEGATION
Right Task: What does this mean?
One that is delegable for a specific patient
74
FIVE RIGHT OF DELEGATION
Right circumstances: What does this mean?
Appropriate patient setting, available resources, and other relevant factors considered
75
FIVE RIGHT OF DELEGATION
Right person: What does this mean?
Right person is delegating the right task to the right person to be performed on the right person.
76
FIVE RIGHT OF DELEGATION
Right direction/communication: What does this mean?
Clear, concise description of the task, including its objective, limits, and expectations
77
FIVE RIGHT OF DELEGATION
Right supervision: What does this mean?
Appropriate monitoring, evaluation, intervention, as needed, and feedback
78
RULES OF DELEGATION:
What should you always do?
Always delegate the task to the right person, at the right time and for the right reason
79
RULES OF DELEGATION:
What should you be aware of?
Being aware of the individuals' qualifications
80
RULES OF DELEGATION:
What should you know?
Knowing that appropriate experience does not matter
81
RULES OF DELEGATION:
What should you be clear about?
Be clear and direct about delegating task
82
RULES OF DELEGATION:
When should you reward subordinates?
Reward subordinates on a job well done
83
RULES OF DELEGATION
What should managers ask the individuals to whom they are delegating?
Managers should ask the individuals to whom they are delegating if they are capable of completing the delegated task.
84
RULES OF DELEGATION
If the person lacks the appropriate qualifications, what is relevant?
If the person lacks the appropriate qualifications, the fact that he or she has experience is irrelevant.
85
RULES OF DELEGATION
What should the manager not base delegation decisions on?
The manager should not base delegation decisions primarily on whose turn it is or on cost.
86
Delegation as a function of professional Nursing
What should organizations have?
Organizations must have a clearly defined structure where the Registered Nurse is recognized as a leader
87
Delegation as a function of professional Nursing
How should job descriptions be?
Job descriptions need to be clear, and role need to be defined appropriately
88
Delegation as a function of professional Nursing
What should be developed to help personnel establish roles and responsibilities?
Training and educational programs must be developed to help personnel establish roles and responsibilities
89
Delegation as a function of professional Nursing
What should be developed to foster leadership and delegation?
Programs must be developed to foster leadership and delegation
90
Delegation as a function of professional Nursing
Monitoring Delegated Tasks :
*Managers should ask the individuals to whom they are delegating if they are capable of completing the delegated task but what else should they do?
should also validate this perception by direct observation.
91
What does monitoring delegated tasks do?
*Monitoring delegated tasks keeps the delegated task before the subordinate and the manager so that both share accountability for its completion.
92
Delegation as a function of professional Nursing
What is effective delegation?
*Effective delegation=Periodically during the day, the RN checks with the team members to determine whether they are having difficulty completing their assigned tasks
93
UNLICENSED ASSISTIVE PERSONNEL (uap)
What significantly impacted the landscape of nursing home care and the role of CNAs?
The Omnibus Budget Reconciliation Act of 1987 significantly impacted the landscape of nursing home care and the role of CNAs.
94
UNLICENSED ASSISTIVE PERSONNEL (uap)
What are the implications for CNAs?
Enhanced Training:
Focus on Resident Care:
Increased Accountability:
95
UNLICENSED ASSISTIVE PERSONNEL (uap)
Implications for CNAs
Enhanced Training:
CNAs are required to undergo more rigorous training, which enhances their skills and knowledge in patient care.
96
UNLICENSED ASSISTIVE PERSONNEL (uap)
Implications for CNAs
Focus on Resident Care:
The emphasis on resident rights and quality of care means that CNAs play a critical role in advocating for and providing high-quality care.
97
UNLICENSED ASSISTIVE PERSONNEL (uap)
Implications for CNAs
Increased Accountability:
With the establishment of standards and evaluation processes, CNAs must adhere to strict guidelines and protocols in their daily practice.
98
UNLICENSED ASSISTIVE PERSONNEL (uap)
Omnibus Budget Reconciliation Act of 1987: What did it establish?
the Omnibus Budget Reconciliation Act of 1987 established regulations for the education and certification of “certified nurse’s aides”- CNA)
99
UNLICENSED ASSISTIVE PERSONNEL (uap)
Omnibus Budget Reconciliation Act of 1987: the Omnibus Budget Reconciliation Act of 1987 established regulations for the education and certification of “certified nurse’s aides”- CNA)
What is required?
(minimum of 75 hours of theory and practice and successful completion of an examination in both areas),
100
UNLICENSED ASSISTIVE PERSONNEL (uap)
Omnibus Budget Reconciliation Act of 1987: the Omnibus Budget Reconciliation Act of 1987 established regulations for the education and certification of “certified nurse’s aides”- CNA)
What has not been established?
no federal or community standards have been established for training the more broadly defined NAP. (Nursing Assistive Personnel) (also known as unlicensed assistive personnel)
101
UNLICENSED ASSISTIVE PERSONNEL (uap)
Omnibus Budget Reconciliation Act of 1987: the Omnibus Budget Reconciliation Act of 1987 established regulations for the education and certification of “certified nurse’s aides”- CNA)
no federal or community standards have been established for training the more broadly defined NAP. (Nursing Assistive Personnel) (also known as unlicensed assistive personnel) or any of the definitions below:
Technicians
Nurse aids
Nurse extenders
Attendants
Assistants
Health Care Assistants
Orderlies
Nursing techs
102
What do NAPs not have?
NAPs do not have a license that they can lose.
103
You are the charge nurse on a medical-surgical unit. You have a team consisting of one registered nurse (RN), one licensed practical nurse (LPN), and two nursing assistants (NAs). A new patient is admitted with a stroke. Which task is appropriate to delegate to the nursing assistant?
A. Assessing the patient's neurological status.
B. Assisting the patient with personal hygiene.
C. Administering prescribed medications.
D. Monitoring the patient's vital signs.
Correct Answer: B. Assisting the patient with personal hygiene.
Rationale: Assisting with personal hygiene is within the scope of practice for nursing assistants. The assessment and medication administration require the clinical judgment and training of an RN or LPN.
104
DELEGATION TO A UAP
What are potential costs?
Liability for negligence
Issues for task delegations (knowledge base, job description and demonstrating skills)
Responsibility for patient outcome
105
DELEGATION TO A UAP:
The _________ always bears the ultimate responsibility for ensuring that the nursing care provided by the team members meet or exceeds minimum safety standards
The Registered Nurse always bears the ultimate responsibility for ensuring that the nursing care provided by the team members meet or exceeds minimum safety standards
106
What protects the nurse from liability?
*Proper delegation practices that include assessment and evaluation help protect the RN from liability.
In general, accountability is shared and does not lie solely with the subordinate.
107
You are caring for a patient who just had a hip replacement. The patient is stable but requires assistance with ambulation. You have an LPN and two NAs on your team. Which task should you delegate to the LPN?
A. Assisting the patient with ambulation.
B. Educating the patient on postoperative exercises.
C. Monitoring the patient's pain level.
D. Obtaining the patient's height and weight.
Correct Answer: C. Monitoring the patient's pain level.
Rationale: Monitoring pain levels is a task that requires nursing judgment, making it appropriate for an LPN to handle. The other options may be more suitable for nursing assistants or would require RN oversight.
108
*In assigning tasks to NAP, the RN must be aware of:
*In assigning tasks to NAP, the RN must be aware of the job description, knowledge base, and demonstrated skills of each person.
109
*Assuming the role of delegator and supervisor to the NAP increases what?
*Assuming the role of delegator and supervisor to the NAP increases the scope of liability for the RN.
Although the NAP does bear some personal accountability for their actions, this does not negate accountability for the RN who delegated the task(s).
110
When is liability reduced for the RN?
*Liability is reduced when the RN delegates appropriately and supervises the completion of the tasks.
111
Steps that a nurse must take when delegating task:
How many are there?
9
112
Steps that a nurse must take when delegating task:
What must be assessed?
1. Assess the Patient’s Needs
6. Assess the Environment
113
Steps that a nurse must take when delegating task:
What should be identified?
2. Identify the Right Task
114
Steps that a nurse must take when delegating task:
What should be evaluated?
3. Evaluate the Competence of the Nurse Tech
115
Steps that a nurse must take when delegating task:
What should be provided? What should be set?
4. Provide Clear Instructions
5. Set Clear Expectations
116
Steps that a nurse must take when delegating task:
What should be established?
7. Establish Supervision and Support
117
Steps that a nurse must take when delegating task:
What should be documented?
8. Document the Delegation
118
Steps that a nurse must take when delegating task:
What should be done at the end of delegation?
9. Follow Up
119
Effective delegation
The individual who gave request or delegated the task must do what?
The individual who gave request or delegated the task to be done needs to check in periodically.
120
Effective delegation
What must the delegator ensure?
To ensure the the member has the tools and resources that they need to complete the task.
121
Effective delegation:
If there is any difficulty with the task delegated to someone, what should the delegator do?
If there is any difficulty the individual who delegated the task needs to step up and help while providing guidance.
122
Which of the following statements by a nursing student indicates a misunderstanding of delegation?
A) "I need to assess my patient's condition before delegating tasks.”
B) "I can delegate any task that I don’t like doing.”
C) "I should only delegate tasks that are within the scope of practice of the person I'm delegating to.”
D) "I must provide clear instructions when I delegate tasks."
B) "I can delegate any task that I don’t like doing.”
Rationale: Delegation should be based on the task’s appropriateness for the delegate’s scope of practice, not personal preference.
123
Causes for resistance to delegation
Lack of Trust
Fear of Losing Control
Perceived Complexity
Poor Communication
Workload Imbalance
Lack of Training
Previous Negative Experiences
124
What is a common response by subordinates to delegation?
*Resistance is a common response by subordinates to delegation.
125
One of the most common causes of subordinate resistance to, or refusal of, delegated tasks is
is the failure of the delegator to see the subordinate’s perspective.
126
Methods to overcome resistance
Build
Offer
Follow Up and Provide
Provide
Empower
Foster
Set
127
Methods to overcome resistance
Build:
Build Trust
128
Methods to overcome resistance
Offer:
Offer Training and Resources
129
Methods to overcome resistance
Follow Up and Provide:
Follow Up and Provide Feedback
130
Methods to overcome resistance
Provide:
Provide Clear Communication
131
Methods to overcome resistance
Empower:
Empower Team Members
132
Methods to overcome resistance
Foster:
Foster a Supportive Environment
133
Methods to overcome resistance
Set:
Set Realistic Expectations
134
Elements affecting delegation to a transcultural work team:
Communication
Space
Social organization
Time
Environmental control
Biologic variations
135
Elements affecting delegation to a transcultural work team
Communication:
especially dialect, volume, use of touch, and eye contact
136
Elements affecting delegation to a transcultural work team
Space:
interpersonal space differs between cultures
137
Elements affecting delegation to a transcultural work team
Social organization:
family unit of primary importance in some cultures
138
Elements affecting delegation to a transcultural work team
Time:
cultures tend to be past, present, or future oriented
139
Elements affecting delegation to a transcultural work team
Environmental control:
cultures often have either internal or external locus of control
140
Elements affecting delegation to a transcultural work team
Biologic variations:
Susceptibility to diseases and physiologic differences
141
A Leadership role associated with delegation—
Demonstrating sensitivity to how cultural phenomena affect transcultural delegation.
