Delegation-UAP & LPN Flashcards
Right Task:
The task must be within the capabilities of the auxiliary nursing staff. This is defined by federal and state statues (Nurse Practice Act), organizational policies and procedures; job descriptions and accreditation.
Assess each client before delegating. Ensure there is a match between the client’s needs and the skills, abilities and experience of the auxiliary nursing staff. Consider the client’s condition, the personnel’s capabilities, the complexity of the task, and how much supervision will be required.
Assistive personnel should not be assigned duties requiring ongoing assessment, evaluation or decision making.
Right circumstances:
- The care setting should be taken into consideration.
- Client stability as well as the desired client outcomes should be taken into consideration.
•UAP’s can perform tasks on stable clients in uncomplicated situations.
•Tasks like routine, simple, repetitive, common activities that do not require nursing judgement such as bathing and dressing, hygiene, feeding, ambulation, toileting, oral care.
everyday things!
Right Person:
- know your facility’s competency standards!
- Know the job descriptions of co-workers!
- Has the personnel been trained on the task?
- Identify personal strengths and weaknesses of Auxiliary Nursing Staff.
- You must always monitor activities of the UAP to see that the nursing tasks that you assigned are done properly.
- You must communicate a time frame and the priority of the task.
- Tell people what you want done first! And what you want done by a particular time.
- provide clear directions and expectations of how you want the task to be performed and define the findings you wish reported.
Right direction and communication
- The registered nurse is responsible for providing clear, concise, correct, and complete communication to Auxiliary Nursing Personnel at the time of delegation as well as providing continued direction on an ongoing basis.
- Communicate clearly about the delegated task.
- Be specific about how and when he/she should report back to you.
•Make sure the personnel understands what is expected, and do not hesitate to ask them if they know how to perform the task.
Right supervision:
- you cannot merely assign the task. You must guide, supervise, and evaluate the carrying out of the delegates task.
- you must ensure the work meets your expectations. If it does not, you must step in.
- Give credit and praise for accomplishments. Do not hesitate to offer observations and share concerns.
- you should give the personnel feedback and ask for theirs.
- Encourage input on how to resolve care issues and reach agreement on future course of action.
- You must evaluate the client’a outcome and the results of the task to ensure the desired outcome is achieved.
Prioritization, Delegation, and Assignment Principles:
- Consider outcomes expectations of the client and family.
- Maintain compliance with your state’s Nurse Practice Act as well as the healthcare facilities guidelines and job descriptions.
- Tailor the level of supervision to the experience and knowledge level of staff assigned delegates duties.
- Be cognizant that accountability for nursing judgement decisions remain with the RN.
- The RN is also accountable for maintaining the appropriate level of supervision for delegated duties.
- The nursing process and clinical judgement cannot be delegated by the RN to nursing assistive personnel.
- It is imperative for the RN to be familiar with the client and their clinical presentation in order to prioritization, delegate and assign care.
- Be aware that client conditions and clinical situations can change; the RN must be able to re-evaluate and re-assign care as the client’s needs or the nursing team’s ability change.
LPNs CAN:
- Data collect, monitor, observe
- Reinforce teaching from plan of care
- Administer IVPB medication
- Monitor transfusion of blood products
- Administer topical, PO, or IM pain medications.
- Adminster Med’s & nutrition via NG tube, G-tube or button, J-tube
- Insert, maintain & remove NG tunes and urinary catheters
- Maintain & remove peripheral IV catheters
- Calculate and monitor IV flow rate
LPNs CANNOT do:
- Asses, Evaluate
- Initiate teaching plan of care
- Administer IV push medication
- Initiate transfusion of blood products
- Administer IVP pain Medications
- Administer Med’s & nutrition via central line (no TPN)
Stable patients:
- Post-op client being discharged with no family
- Client with COPD, stable vital signs, and issues O2.
- Diabetic with a wound, stable blood sugar, taking medications as ordered.
- Client with neurological problems, stable vital signs, no change in LOC/Nuevo check
- Client w/ dehydration, stable electrolytes, appropriate urine output l, and improving hydration status.
- Client with chronic hypertension, history of angina controlled with meds & lives alone.
- Client with HIV+, medication compliance and works full time.
- Client with history of cancer in remission and young children in home.
- Client with history of stroke, paresthesias, and rehab equipment.
Unstable Patients:
- New admission
- Neuro checks suddenly change
- Diabetic with low blood sugar
- Client returning from an invasive procedure
- Client with acid-base imbalance and respiratory distress with unstable vital signs
- Client with syncope and chest pain
- Client with recent 2nd & 3rd degree burns
- Client with infectious diseases- New onset
- Client with multiple IV fluids & Meds, plus lab & vital sign changes.