Delegation and Prioritization Flashcards
how is delegation governed
by each state’s Nurse Practice Act
what is delegation
“allowing a delegatee to perform a specific nursing activity,
skill or procedure, that is beyond the delegatee’s traditional
role and not routinely performed”
what is a delegated responsibility
a nursing activity, skill, or procedure that is transferred from a licensed nurse to a delegatee
what is a delegator
the individual who delegates a nursing responsibility
what is a delegatee
an individual who is delegated a nursing responsibility by a
licensed nurse who must be competent to perform the
delegated responsibility and verbally accept the responsibility
what is the difference between assignment and delegation
Assignment: Accepting the care within the scope of
practice of the nurse: when you walk through the door
Delegation: specific tasks are requested and be completed and overseen by the licensed person
why is delegation so essential in patient care
Complexities of patient care
delivery increased, the work
demand and expectation of RNs
became more challenging,
creating the need to employ more
UNP/AP to support patient care
too much for one person
employer/nurse leader responsibilities
- Identify a nursing leader
- Determine nursing responsibilities that can be
delegated, to whom, and in what circumstances - Develop delegation policies and procedures
- Periodically evaluate delegation process
- Promote positive culture/work environment
licensed nurse responsibilities
- Determine patient needs
and when to delegate - Ensure availability to delegatee
- Evaluate outcomes of and maintain accountability for delegated responsibility
Delegatee responsibilities
*Accept activities based on own
competence level
* Maintain competence for
delegated responsibility
* Maintain accountability for
delegated activity
employer/nurse leader and licensed nurse responsibilities
Communicate information about
delegation process and delegatee
employer/nurse leader and delegatee responsibilities
training and education
licensed nurse and delegatee responsibilities
two-way communication
employer/Nurse Leader
and licensed nurse and delegatee responsibilities
public protection
components of two-way communications
trust
advocacy
components of Communication for safe/efficient person-centered care
Clear
Concise
Timely
Reliable
Strategies for Communication when Delegating
Give information
Give direction
Seek clarity
Seek advice
organizational accountability
Ensures the team has what it needs to perform at peak.
Promotes positive culture
Shared governance
individual accountability
Be answerable for choices.
Accountable for:
–nursing judgment
–decision making
–actions
Nurses have the ability to delegate a nursing responsibility…
BUT…
We retain the accountability for ensuring that the delegated by the right person with proper supervision
delegation must comply with the law
right #1 of delegation
Task
Is the delegated responsibility appropriate to delegate based on the individuals’ job description and facility policies and procedures?
Is the delegated responsibility legally appropriate to delegate?
right #2 of delegation
circumstance
Is the delegation process appropriate to the situation?
Are the equipment and resources available to complete the delegated responsibility?
Do staffing ratios demand the use of high-level delegation strategies?
Does the delegatee have appropriate supervision to complete the delegated responsibility?
right #3 of delegation
person
Is the prospective delegatee a willing and able employee?
Does the delegatee have the knowledge and experience to perform the specific delegated responsibility safely?
Does the delegatee have the expertise to complete the delegated responsibility safely and effectively in relation to the acuity of the patient?
right #4 of delegation
direction/communication
Do the delegator and delegatee understand a common
work-related language? (Do terms such as time frame,
patient needs, and critical mean the same to each of
them?)
Does the delegator provide clear and concise directions
for the delegated responsibility?
Does the delegatee understand the assignment,
directions, limitations, and expected results as they
relate to the delegated responsibility?
Do the delegator and delegatee know how to maintain
open lines of communication for the purpose of questions
and feedback?
Does the delegatee understand how, what, and when to
report to the delegator?
right #5 of delegation
supervision
Is it clear that the delegatee will provide feedback related to the delegated responsibility when appropriate?
Is the delegator able to monitor and evaluate the patient appropriately?
delegatee condition: Has limited knowledge and ability to
perform the task
DELEGATEE RELEVANCE
Requires more guidance
TERMINOLOGY
Tell (if the relationship is not going to be
ongoing)
CLINICAL EXEMPLAR
“It is important that you take his blood pressure every 15 minutes.”
DELEGATEE CONDITION
Has ongoing relationship, but a new task is delegated
DELEGATEE RELEVANCE
Requires explanation
TERMINOLOGY
Sell
CLINICAL EXEMPLAR
“This is what you need to accomplish; in fact, let me show you what is necessary.
DELEGATEE CONDITION
Has willingness and ability, but the relationship is new
DELEGATEE RELEVANCE
Requires that both individuals create mutual expectations and conditions for performance
TERMINOLOGY
Participate
CLINICAL EXEMPLAR
“Please tell me how you go about performing this procedure, and I will share with you my expectations about how frequently and under what conditions we need to communicate/report to each other.”
DELEGATEE CONDITION
Has established relationship and
expertise
DELEGATEE RELEVANCE
Little guidance is needed
TERMINOLOGY
Delegate
CLINICAL EXEMPLAR
“I know you know what you are doing and when to report. Just remember that I am available to you at any time if an issue or
concern arises. Thank you for being part of the team.”
Challenges to delegation
Often unlicensed nursing personnel are the delegatee
Job descriptions vary
Multiple designations and levels
Requires awareness of individual ability
complicating factors of delegation
age
gender
ethnicity
culture
barriers in delegation lead to:
underdelegation
overdelegation
improper delegation
job of nurse in delegation
The nurse must understand the
delegation process, develop critical
judgment skills, and effectively use
delegation skills to maximize
productivity while providing safe,
high-quality, cost-effective person-
centered care.
