Week 6 Flashcards
What are Controlled Acts?
Procedures or activities which may pose a risk to the public if not performed by a qualified practitioner
Controlled acts for nurses (5)
- Performing a prescribed procedure below the dermis or a mucous membrane
- Administering a substance by injection or inhalation
- Putting an instrument, hand, or finger beyond the external ear canal, beyond the point in the nasal passages where they normally narrow, beyond the larynx, beyond the opening of the urethra or labia majora, beyond the anal verge, or into an artificial opening into the body
- Dispensing a drug
- Treating by psychotherapy technique
Order
An authorizing mechanism that is specific to the client - specifies which client it can be given to
Initiation
When nurses can initiate a controlled act
Rules surrounding delegation
- You must have the authority first
- You cannot delegate an act delegated to you (subdelegation)
- You can delegate to an unregulated health care provider or another professional
What is delegation?
Delegation is a formal process through which a regulated health professional (delegator) who has the authority and competence to perform a procedure under one of the controlled acts delegates the performance of that procedure to another individual (delegatee).
When is delegation not required?
if it is an activity required for routine activity of living and there is:
- need for the procedure
-predictable response to the procedure
-predictable outcome for the procedure
Controlled Acts RNs and RPNs can not delegate
Dispensing a drug, treating by psychotherapy
Controlled Acts NPs cannot delegate
-prescribing, dispensing, selling or compounding medication
-ordering the application of a form of energy setting a fracture or joint dislocation
-treating by psychotherapy
The 5 Rights
Right task
Right circumstance
Right person
Right directions and communication
Right supervision and evaluation
The 5 Rights: Right Task
The activity falls within the delegatee’s job description or is included as part of the established written policies and procedures of the nursing practice setting
The 5 Rights: Right Circumstance
The health condition of the patient must be stable. If the patient’s condition changes, the delegatee must communicate this to the licensed nurse, and the licensed nurse must reassess the situation and the appropriateness of the delegation
5 Rights: Right Person
Delegatee possesses the appropriate skills and knowledge to perform the activity.
The nurse along with the employer and the delegatee is responsible for ensuring that the delegatee possesses the appropriate skills and knowledge to perform the activity.
5 Rights: Right Directions and Communication
-Delegation situation should be specific to the patient, the licensed nurse and the delegatee.
-Communicate specific instructions for the delegated activity to the delegatee; the delegatee, should ask any clarifying questions.
-Delegatee must understand the terms of the delegation and must agree to accept the delegated activity.
-Delegatee understands that she or he cannot make any decisions or modifications in carrying out the activity without first consulting the licensed nurse.
5 Rights: Right Supervision and Evaluation
-The licensed nurse is responsible for monitoring the delegated activity, following up with the delegatee at the completion of the activity, and evaluating patient outcomes.
-The delegatee is responsible for communicating patient information to the licensed nurse during the delegation situation. The licensed nurse should be ready and available to intervene, as necessary.
-Documentation
