Delegation is a critical skill in nursing that involves transferring the responsibility for performing a specific task or activity to another competent individual while retaining accountability for the outcome. It is a process that enables nurses to manage their workload efficiently, ensure patient care continuity, and foster a collaborative healthcare environment.
Key Aspects to Consider in Delegation
Understanding Scope of Practice:
- Candidates must be familiar with the scope of practice for registered nurses (RNs), licensed practical nurses (LPNs), and unlicensed assistive personnel (UAPs).
- Knowing what tasks can be delegated to whom is essential for safe and effective care.
The Five Rights of Delegation:
- Right Task: Ensure the task is appropriate to delegate based on the patient’s needs and the delegatee’s competence.
- Right Circumstances: Assess the patient’s condition and the environment to determine if delegation is suitable.
- Right Person: Select the right person to delegate the task, considering their skills, experience, and legal authority.
- Right Direction and Communication: Provide clear, concise, and specific instructions about the task.
- Right Supervision and Evaluation: Monitor the task’s completion, provide feedback, and evaluate the outcomes.
Communication and Collaboration: Effective communication is vital for successful delegation. Clear instructions, open dialogue, and timely feedback are crucial. Collaborating with the healthcare team ensures that tasks are performed efficiently and patient care goals are met.
Legal and Ethical Considerations: Candidates must be aware of the legal and ethical implications of delegation. They should understand their accountability and the importance of adhering to nursing regulations and standards.
Patient Safety: The primary goal of delegation is to enhance patient care and safety. Ensuring that delegated tasks are performed competently is essential to preventing errors and adverse outcomes.
Supervision and Feedback: Continuous supervision and providing constructive feedback are critical components of delegation. It helps in identifying areas for improvement and enhancing the delegatee’s skills.
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Question of
Which task is most appropriate for an RN to delegate to a licensed practical nurse (LPN)?
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Conducting a comprehensive assessment of a newly admitted patient.
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Developing a plan of care for a patient with chronic heart failure.
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Administering oral medications to a stable patient.
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Providing discharge teaching to a patient who has had a myocardial infarction.
Correct Wrong
Explanation: Administering oral medications to a stable patient is within the scope of practice for an LPN. Conducting a comprehensive assessment, developing a plan of care, and providing discharge teaching are tasks that require the advanced clinical judgment and skills of an RN.
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Question of
When delegating tasks to unlicensed assistive personnel (UAP), the RN should ensure that the UAP:
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Is legally authorized to perform the task.
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Has the required education and training.
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Understands the task and has demonstrated competency.
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All of the above.
Correct Wrong
Explanation: It is essential that the UAP is legally authorized, has the necessary education and training, and fully understands the task to ensure patient safety and quality care.
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Question of
Which task should an RN avoid delegating to a UAP?
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Performing sterile wound dressings.
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Assisting a patient with ambulation.
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Taking and recording vital signs.
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Assisting with patient hygiene.
Correct Wrong
Explanation: Performing sterile wound dressings requires clinical judgment and skill, which are beyond the scope of practice for a UAP. Assisting with ambulation, taking vital signs, and assisting with hygiene are appropriate tasks for a UAP.
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Question of
Which principle of delegation emphasizes that the RN remains accountable for the overall patient care?
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Right task.
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Right circumstances.
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Right person.
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Right direction and communication.
Correct Wrong
Explanation: The principle of "right direction and communication" ensures that the RN provides clear instructions and remains accountable for the overall patient care, even when tasks are delegated.
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Question of
A nursing assistant reports to the RN that a patient’s blood pressure is elevated. What is the RN’s best initial response?
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Delegate the task of rechecking the blood pressure to the nursing assistant.
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Personally recheck the patient’s blood pressure.
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Ignore the report and continue with other tasks.
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Notify the physician immediately.
Correct Wrong
Explanation: The RN should personally recheck the patient's blood pressure to confirm the accuracy of the report and determine the appropriate course of action.
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Question of
Which of the following tasks can be delegated to an LPN?
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Monitoring patient response to IV therapy.
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Initiating IV therapy.
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Administering IV push medications.
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Conducting patient education for newly diagnosed diabetes.
Correct Wrong
Explanation: Monitoring patient response to IV therapy is within the scope of practice for an LPN. Initiating IV therapy, administering IV push medications, and conducting patient education are tasks that require the advanced skills of an RN.
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Question of
In delegating tasks to UAP, the RN must consider the ‘right task’. Which of the following is an example of an appropriate task to delegate to a UAP?
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Performing a complex dressing change.
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Feeding a patient who requires aspiration precautions.
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Measuring and recording a patient’s intake and output.
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Assessing a patient’s pain level.
Correct Wrong
Explanation: Measuring and recording a patient's intake and output is an appropriate task for a UAP. Complex dressing changes, feeding patients with aspiration precautions, and assessing pain levels require the clinical judgment of an RN.
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Question of
The RN delegates the task of ambulating a patient to a UAP. What should the RN ensure before the UAP performs the task?
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The UAP has performed the task previously.
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The UAP understands the patient’s care plan and condition.
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The patient has consented to being ambulated by the UAP.
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The UAP has no other tasks to complete.
Correct Wrong
Explanation: The RN must ensure that the UAP understands the patient's care plan and condition to safely ambulate the patient.
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Question of
When an RN delegates a task to another nurse, which of the following must the RN communicate clearly?
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The scope of the task, including any specific instructions and expected outcomes.
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The nurse’s previous experience with the task.
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The time of day the task should be completed.
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The reason the RN is delegating the task.
Correct Wrong
Explanation: Clear communication of the scope of the task, specific instructions, and expected outcomes is essential for successful delegation.
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Question of
Which of the following is a key consideration when determining the ‘right person’ to delegate a task to?
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The person’s willingness to perform the task.
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The person’s knowledge and skill level related to the task.
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The person’s availability during the shift.
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The person’s relationship with the patient.
Correct Wrong
Explanation: The RN must ensure that the person has the necessary knowledge and skill level to perform the task safely and effectively.
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Question of
Which of the following is an example of appropriate delegation to a UAP in a long-term care setting?
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Performing tracheostomy care.
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Assisting residents with activities of daily living (ADLs).
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Conducting a dietary assessment.
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Administering medications.
Correct Wrong
Explanation: Assisting residents with ADLs is an appropriate task for a UAP in a long-term care setting. Tracheostomy care, dietary assessments, and medication administration require the skills of a licensed nurse.
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Question of
Which of the following tasks is inappropriate for an RN to delegate to an LPN?
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Administering oral medications.
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Performing routine dressing changes.
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Monitoring glucose levels.
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Conducting a head-to-toe assessment.
Correct Wrong
Explanation: Conducting a head-to-toe assessment requires the comprehensive clinical judgment of an RN and should not be delegated to an LPN.
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Question of
When delegating a task, what does ‘right direction and communication’ involve?
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Providing a detailed written instruction for the task.
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Verifying that the delegate has completed similar tasks in the past.
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Delegating only routine and simple tasks.
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Giving clear, concise, and specific instructions about the task.
Correct Wrong
Explanation: Clear, concise, and specific instructions are crucial for successful delegation to ensure the delegate understands the task and expectations.
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Question of
An RN delegates the task of taking a patient’s vital signs to a UAP. What should the RN do after the task is completed?
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Trust that the UAP performed the task correctly.
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Evaluate the results and provide feedback if necessary.
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Recheck the vital signs personally.
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Document the vital signs without verification.
Correct Wrong
Explanation: The RN should evaluate the results and provide feedback to ensure accurate and reliable patient data.
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Question of
Which task should not be delegated to an LPN?
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Administering oral medications.
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Monitoring patient condition.
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Initiating a blood transfusion.
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Collecting specimens for laboratory tests.
Correct Wrong
Explanation: Initiating a blood transfusion requires advanced clinical skills and should be performed by an RN. Other tasks listed can be appropriately delegated to an LPN.
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Question of
Which task can be appropriately delegated to a UAP in a hospital setting?
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Assisting with feeding a patient.
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Performing a patient assessment.
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Developing a patient care plan.
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Administering intravenous medications.
Correct Wrong
Explanation: Assisting with feeding a patient is an appropriate task for a UAP. Performing assessments, developing care plans, and administering IV medications require the skills of an RN.
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Question of
Which task is suitable for delegation to a UAP in a community health setting?
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Conducting a home visit assessment.
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Teaching a patient about medication side effects.
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Assisting with patient transportation to appointments.
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Administering vaccinations.
Correct Wrong
Explanation: Assisting with patient transportation to appointments is an appropriate task for a UAP in a community health setting. Home visit assessments, patient education, and vaccination administration require licensed nursing skills.
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Question of
An RN should consider the ‘right circumstances’ before delegating a task. What does this involve?
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Assessing the complexity of the task and the patient’s condition.
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Ensuring the task is within the delegate’s job description.
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Confirming the delegate’s willingness to perform the task.
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All of the above.
Correct Wrong
Explanation: The 'right circumstances' involve assessing both the complexity of the task and the patient's condition to ensure that the task can be safely delegated. This principle ensures that the task is appropriate for delegation given the current patient situation and environment.
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Question of
Which task is appropriate for an RN to delegate to an LPN in a post-operative care unit?
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Administering IV push medications.
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Assessing the patient’s surgical incision.
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Providing patient education on post-op care.
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Monitoring the patient’s vital signs.
Correct Wrong
Explanation: Monitoring the patient's vital signs is an appropriate task for an LPN. Administering IV push medications, assessing surgical incisions, and providing patient education require the advanced skills and clinical judgment of an RN.
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Question of
Which of the following demonstrates the principle of ‘right supervision and evaluation’ in delegation?
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Observing the delegate perform the task and providing immediate feedback.
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Delegating the task and assuming it was done correctly.
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Giving detailed written instructions and leaving the delegate to complete the task independently.
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Allowing the delegate to perform the task without any follow-up.
Correct Wrong
Explanation: The principle of 'right supervision and evaluation' involves observing the delegate while they perform the task and providing immediate feedback. This ensures that the task is completed correctly and allows for any necessary adjustments or improvements.
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Question of
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