Delegation in Nursing Practice (Ch. 20) Flashcards
what is delegation?
Getting work done through others.
Directing the performance of one or more people to accomplish organizational goals.
It’s a learned skill
Provides learning or ‘stretching’ opportunities for subordinates.
Cannot delegate total responsibility.
Do not delegate responsibility without authority.
Delegate to the right person, at the right time, and for the right reason (don’t delegate to someone who is overwhelmed)
Reward subordinates for jobs well done.
what is ANA’s definition of delegation?
Transfer responsibility of a task to another.
what is NCSBN’s definition of delegation?
Transferring responsibility to a competent person to perform a task in a situation.
what is Joint Statement’s definition of delegation?
A skill that is taught & practiced for proficiency.
what are some considerations for delegation?
Freedom to manage complex or situations requiring ^ level of expertise.
If someone is better, have ^ knowledge or higher expertise for solving a problem.
Provide learning & stretching opportunities for subordinates.
what is the leadership role in delegation?
Role model, supporter, resource person
- Delegate proactively
- Establish a culture of trust, teamwork & communication
- Stretch, & empower via delegation
- Convey confidence & encouragement
- Teach delegation as a time mgt. tool & team building strategy
- Be active politically to legislate for UAP
what are the management functions in delegation?
- Provide training, education & rewards
- Manage and monitor delegation activities
- Share accountability for delegation
- Knowledgeable legal liabilities
- Know scope of practice for UAP/NAP
- Evaluate capabilities & motivation of subord.
- Delegate authority with tasks
- Monitor subordinates involved in delegation
how is delegating done effectively?
Plan ahead
Identify necessary skills and education levels
Select capable personnel
Communicate goals clearly
Empower the delegate
Set deadlines & monitor progress
Model the role & provide guidance
Evaluate performance
Reward accomplishment
why would managers have to sometimes delegate routine tasks?
so they are free to handle problems that are more complex or require a higher level of expertise.
Managers may delegate work if someone else is better prepared or has greater expertise or knowledge about how to solve a problem.
For nurses and managers, delegation is not an option, but a necessity.
Delegation is a managerial tool for subordinate accomplishment and enrichment.
what are common delegation errors?
Under-delegating
Over-delegating
Improper Delegating
what are the causes of under-delegating?
- Fear that delegation may be interpreted as a lack of ability.
- A desire to complete the whole job.
- Fear that subordinates will resent delegated work.
- Lack of experience in the job or with delegation.
- Need to control or be perfect.
- Enjoyment of the work.
what are the causes of over-delegating?
Poor managers of time who spend too much time trying to get organized.
Insecurity in the ability to perform a task.
Be careful not to over-delegate to people who are very competent.
what are the causes of improper delegating?
Wrong time, to the wrong person, or for the wrong reason.
Beyond the capability of the person or something the manager should do.
Decision making without providing adequate information.
When the task is boring and the manager does not want to do it.
what are the 5 rights of delegation?
Right task
Right circumstances
Right person
Right direction/communication
Right level of supervision
what are the actions to ensure safe delegation?
- Clear defined structure where RN’s are leaders of HCT.
- Job descriptions defines roles & responsib.
- Educational programs re: R & R
- Programs to foster leadership & delegation
- Personnel supervision, & delegation principles instruction.
- Nsg. Programs & HCO ^ training.
- HCO need to instruct new nurses
what is the responsibility of SON and HCO in preparing RN’s for delegator role?
Educate RN’s about the NPA re: delegation.
~ Principles, 5 rights & actions to take with unsafe or inappropriate.
Create climate where teamwork, mutual respect, are valued.
Provide environment where nurses feel free to delegate without fear.
how is delegation a function of professional nursing?
- RN’s are expected to delegate
- Assure safe delegation organizations must:
~ I.D RN’s leaders of HCT
~ Job descriptions of R & R of all
~ Educational programs for R&R
~ Programs for delegating & Leadership - SON & HCO prepare RN’s to delegate
~ NPA, principles, & actions for safety
~ Support nurses, teamwork, respect & comm - RNs are expected to make assignments and supervise the work of different levels of employees (LPNs, UAPs)
- Are RN’s prepared??
how does clear communication equal effective delegation?
Define the task clearly.
Delineate end results, time frame, standards.
Delegate the objective, not the procedure.
what are delegation considerations?
Is the individual competent in the task being delegated?
Validate the individuals ability to complete the task.
If individual challenged with delegated task. Be a role model, resource in alternative solutions
Monitor delegated tasks.
Keeps the delegated task before the subordinate and the manager.
This provides shared accountability for the delegated task completion.
what should you know about delegating UAP (Unlicensed Assistive Personnel)?
~ NAP (Nursing Assistive Personnel)
` ANA replaced UAP
` Licensed & formally recognized
~ Includes nurse extenders, care partners, nurse’s aide, orderlies, assistants, attendants and technicians
~ Why do RN’s need them?
~ Increases scope of liability for RN’s
~ In assigning tasks
` The RN must be aware of the job description, knowledge base, and demonstrated skills of each person
` Must supervise
~ No federal or community standards have been established for training UAP’s. Education levels vary.
~ Many UAP’s have a task list or skills set (SBN) they must do before giving patient care.
~ Omnibus Budget Reconciliation Act 1987
what should be known about delegating to an NAP/UAP?
As the RN, NEVER lose sight of your ultimate responsibility for ensuring that patient’s receive appropriate, quality and safe care.
Decision Tree for delegation
Step by step analysis nurses use
Decision on whether a task can be delegated.
No national standards of practice for UAP
what is the criteria for delegation to UAP/NAP?
Frequently occur in daily care Performed according to standards Little or no modification with clients Performed with a predictable outcome Does not involve use of nsg. Process or DM Does not endanger client well being Allowed by HCDS P & P
what nursing tasks may be delegated?
Answering phones
Cleaning up after procedures
Patient transportation (patient must be stable)
Ordering supplies and other clerical tasks
Stocking procedure and exam rooms
Assisting with procedures
Data collection without analysis (vitals, EKG’s)
what nursing tasks CANNOT be delegated?
Any task involving nursing judgment or sophisticated application of the nursing process
Physical assessments
Assessing pain
Teaching injections
Evaluation of success of a treatment
Interpreting test results
Establishing plans of care
Identifying needs
Triage
Counseling and Teaching
Supervise students
