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Learn the art of delegation in nursing with concepts, tips, and examples to ensure safe and efficient client care. Understand the role of UAPs, safe delegation criteria, and barriers to effective delegation.
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Definition The reassigning of responsibility for the performance of a job from one person to another (ANA, 1996)
Concepts of Delegation • The responsibility of the task is transferred • Accountability remains with the delegator • Delegation may be direct or indirect
Direct Delegation • Usually verbal direction • RN decides which staff member is capable of performing a specific task
Indirect Delegation • Contained in an approved listing of tasks established by an institution • Permitted tasks may vary from institution to institution
Assigning Tasks • The RN may assign a more skilled individual to perform a task • The RN may not assign an individual to perform an activity outside of a job description or the scope of practice
Supervision • Supervision usually more direct than delegation • Requires directly overseeing the work or performance of others • Includes checking with individuals during the day • May entail delegation of tasks and activities • Nurse manager performs both
Assessment • Assess client needs • Set client-specific goals • Match the personnel with the appropriate skills to care for the client
Planning • Mentally identify who is best suited for the task or activity • Planning prevents later problems
Implementation • Assign the appropriate personnel who have the level of expertise necessary to deliver the care or carry out the activities
Evaluation • Oversee the care or activities • Determine if client care needs have been met • Allow for feedback
Methods to Help Organize Care • Critical pathways • Computerized information sheets • Personalized worksheets • Delegation tree
Tips for Organizing Care • Plan time around activities that must be performed at a certain time • Perform high-priority activities first • Cluster activities that may be performed together • Consider your peak time when performing optional activities
Changes in the Health-Care Environment • Nursing shortage • Health-care reform • Increased need for nursing services • Demographic trends • Use of unlicensed assistive personnel
Unlicensed Assistive Personnel (UAPs) • Individuals trained to function in an assistive role to the nurse • Perform delegated tasks • Under direct supervision of the RN • May or may not be certified
Examples of Tasks • Vital signs • Skills learned through special training: • Blood drawing • ECGs • Measuring intake and output • Non-nursing duties
Criteria for Safe Delegation • Potential for harm • Complexity of the task • Problem-solving and innovation necessary to complete the task or activity
Considerations for Safe Delegation • Ability of the individual • Fairness of the task
Primary Concern Does the individual assigned to the task have the ability to perform the task?
Other Task-Related Concerns • Ability • Priorities • Efficiency • Appropriateness
Relationship-Oriented Concerns • Fairness • Learning opportunities • Health • Compatibility • Preferences
Summary of Expectations of Professionals • Respect of others • A reasonable workload • Appropriate wages • Determining his/her own priorities • Ask for what he/she wants • Accountability • Give and receive information as a professional
Barriers • Experience • Licensure • Quality of care • Assigning work to others
The Five Rights of Delegation • Right task • Right circumstances • Right person • Right direction/communication • Right supervision/evaluation
Points to Consider • Delegation is not new • The role is essential for good working relationships • Organizational skills are a prerequisite for delegation • Understanding client needs is essential for appropriate delegation
The RN Needs to Understand: • The state nurse practice act • The capabilities of each staff member • The tasks that may be delegated • The concept of accountability in delegation
