Week 9 - UCPs and Delegation

Question 1

IF..

Answer 1

RN works in an RPN job category and uses the RPN title, she/he is responsible for using RPN knowledge, skills and judgment. If the client’s condition becomes complex, and there are no other RNs available, an RN working as an RPN is expected to function as an RN until another RN becomes available.
The following describes the accountability of an RN or RPN working in a UCP role.

Question 2

Stable conditions: When the client’s health status appears predictable, a nurse working as a UCP is accountable for:

Answer 2

■ knowing and performing within the limits of the
UCP role; and
■ recognizing when the client’s condition deviates
from the norm.

Question 3

DELEGATION AND COSTS

Answer 3

Delegation of certain tasks helps reduce health care costs by making more efficient use of nursing time and the facility’s resources

Efficient delegation of care protects the client and provides desirable outcomes

An essential skill for new and experienced nurses

Question 4

Delegation

Answer 4

is defined as the transfer of responsibility for a task when it is not part of the scope of practice of the care provider

Question 5

Accountability means that the nurse is accountable for:

Answer 5

1. monitoring changes in the patient’s status
2. noting and implementing treatment for illness
3. Preventing complications
4. Analyzing the data provided by the UCP

Question 6

The nurse has the responsibility to follow up with:

Answer 6

1. On-going supervision
2. Evaluation of activities performed by the UCP

Nurses are accountable and responsible for the delegation PROCESS

Question 7

Assignment Making

Answer 7

Assignment making is the process of delegating the duties & aspects of care for a patient to individual personnel

The education, skill, knowledge, & judgment levels of the personnel being assigned to a task must be relative to the assignment

Question 8

UCPs can:

Answer 8

deliver supportive care (intake/output, beds, baths, feeds, elimination)
document
report information related to their activities

Question 9

UCPs cannot:

Answer 9

practice nursing
provide total patient care
assess or evaluate responses to treatment.

Question 10

Direct delegation

Answer 10

is usually verbal direction by the RN delegator

Question 11

Indirect delegation

Answer 11

is done using an approved listing of activities or tasks that have been established in the policies and procedures of the health care institution or facility.

Question 12

Underdelegation

Answer 12

Usually occurs when a person is in a new job role

Potential causes:
Perception that old staff will resent new staff telling them what to do
Knowledge/ trust of staff
Scope of staff duties
Seeking approval by demonstrating competency in all duties
Change from student (delegated to) to delegator

Question 13

Five Rights of Delegation

Answer 13

The right task
The right circumstance
The right person
The right direction and communication
The right supervision

Question 14

Transcultural Delegation

Answer 14

Transcultural delegation is the process of having personnel perform duties with the diversities of culture taken into consideration.

Cultural phenomena include: *WHICH IS PART OF THE OBJECTIVES

Communication (body language, voice volume)
Space (physical proximity)
Social organization (expectations r/t support)
Time (past, present, future oriented)
Environmental control (internal locus vs fate/luck)
Biological variations (size, pregnancy)

Question 15

The nurse must know the UCP is competent, knows when to ask for help and how to report outcomes before:

Answer 15

1. Teach – RNs, RPNs (has knowledge, skills and judgement), q’s
2. Delegate – transfer authority to perform
3. Assign – allocating various aspects of care, is not responsible for testing competence of UCP-teacher/delegator does that
4. Supervise – monitoring for a defined period of time

Question 16

A nurse may teach a procedure to a UCP when all

of the following six conditions have been met.

Answer 16

1. The nurse has the knowledge, skill and
   judgment to perform the procedure
   competently.
2. The nurse has the additional knowledge, skill
   and judgment to teach the procedure.
3. The nurse accepts accountability for the
   decision to teach the procedure after
4. The nurse has determined that the UCP has acquired, through teaching and supervision of practice, the knowledge, skill and judgment to perform the procedure safely, effectively and ethically
5. The nurse teaches the procedure to a UCP who
   will perform the procedure for one specific client.
   The nurse may teach the performance of the
   procedure for more than one client if she/he has
   determined that the factors in Conditions 3 and
   4 are conducive to performing the procedure.
6. Considering the factors in Conditions 3 and 4,
   the nurse evaluates the continuing competence
   of the UCP to perform the procedure or
   reasonably believes that a mechanism is in place
   to determine continuing competence.

Question 17

Initial signs of a problem:

Answer 17

In the event that symptoms present that are beyond the expectations of a UCP role, a nurse working as a UCP is accountable for:
■ stepping out of the UCP role to identify and assess
the problem as a nurse;
■ ensuring the client receives appropriate care —
whether by communicating the information to a
nurse or by practising as an RN or RPN if another
nurse is unavailable within an appropriate period of
time;
■ practising as an RN or RPN until a member
practising at the RN or RPN level is available; and
■ assessing why she/he has stepped out of the
UCP role.

Question 18

Emergency situations:

Answer 18

In the event of an emergency situation, the nurse working as a UCP will immediately function at the RN, NP or RPN level.
The member is accountable for:
■ stepping out of the UCP role to identify, assess and
respond to the emergency at the level of
her/his RN, NP or RPN preparation;
■ practising at the RN, NP or RPN level until a
member practising at the RN, NP or RPN level is
available; and
■ assessing why she/he has stepped out of the
UCP role.