DELEGATION 2- STUDY GUIDE

b. Ensuring adequate staffing

10. Which of the following is NOT a responsibility of the employer and/or nurse leader involving delegation? a. Ensuring appropriate policies and procedures regarding delegation are in place b. Ensuring adequate staffing c. Establishing scope of practice guidelines for unlicensed assistive personnel d. Promoting and maintaining a positive culture

b. Perform the activity himself or herself

11. The nurse evaluates a patient's condition and determines that it is inappropriate to delegate a nursing activity to the unlicensed assistive personnel (UAP). What should the nurse do next? a. Ask the UAP to observe and learn how to perform the skill b. Perform the activity himself or herself c. Contact the nursing supervisor d. Consult another nurse

a. By observing the delegatee perform the activity

12. How does the nurse supervise a delegated activity? a. By observing the delegatee perform the activity b. By encouraging autonomy, creativity, and self-discipline c. By providing support, guidance, and instructions d. By assessing the staff member's knowledge, skills, and abilities

a. Right reason

2. Which of the following is NOT one of the Five Rights of Delegation? a. Right reason b. Right person c. Right task d. Right communication

1.The licensed nurse must determine when and what to delegate based on the practice setting, the patients' needs and condition, the state/jurisdiction's provisions for delegation, and the employer policies and procedures regarding delegating a specific responsibility. 2. The licensed nurse must communicate with the delegatee who will be assisting in providing patient care. 3. The licensed nurse must be available to the delegatee for guidance and questions, including assisting with the delegated responsibility, if necessary, or performing it him/herself if the patient's condition or other circumstances warrant doing so 4. The licensed nurse must follow up with the delegatee and the patient after the delegated responsibility has been completed. 5. The licensed nurse must provide feedback information about the delegation process and any issues regarding delegatee competence level to the nurse leader

2.. LICENSED NURSE RESPONSIBILITIES

1. The delegatee must accept only the delegated responsibilities that he or she is appropriately trained and educated to perform and feels comfortable doing given the specific circumstances in the health care setting and patient's condition. 2. The delegatee must maintain competency for the delegated responsibility. 3. The delegatee must communicate with the licensed nurse in charge of the patient 4. Once the delegatee verifies acceptance of the delegated responsibility, the delegatee is accountable for carrying out the delegated responsibility correctly and completing timely and accurate documentation per facility policy

3. DELEGATEE RESPONSIBILITIES

a. Communication and collaboration

3. What two factors help ensure optimal outcomes in delegation? a. Communication and collaboration b. Licensure and experience c. Training and authorization d. Certification and endorsement

a. Any licensed nurse can delegate and supervise unlicensed assistive personnel (UAP).

4. Which statement about regulation and scope of practice is correct? a. Any licensed nurse can delegate and supervise unlicensed assistive personnel (UAP). b. Only registered nurses can delegate and supervise UAP. c. All states prohibit licensed practical/ vocational nurses (LPN/VNs) from delegating and supervising. d. Some states prohibit LPN/VNs from delegating and supervising UAP.

Task Person Circumstance Directions & Communication Supervision & Eval

5 RIGHTS of DELEGATION

b. Variation in roles and responsibilities of UAP

5. Which factor can have a negative impact on delegation? a. Shortage of training programs for unlicensed assistive personnel (UAP) b. Variation in roles and responsibilities of UAP c. Inconsistent use of a decision tree for delegation d. Lack of standardized patient handoffs

d. APRNs can delegate to RNs, LPN/VNs, and UAP.

6. Which statement about members of the nursing team and delegation is correct? a. Unlicensed assistive personnel (UAP) can delegate to other UAP. b. Licensed practical/vocational nurses (LPN/VNs) can delegate to registered nurses (RNs) and UAP. c. RNs can delegate to advanced practice registered nurses (APRNs), LPN/VNs, and UAP. d. APRNs can delegate to RNs, LPN/VNs, and UAP.

b. Delegation

7. Allowing persons to perform a specific nursing activity, skill, or procedure that is outside the traditional role and basic responsibilities of the delegatee's current job is the definition for which of the following terms? a. Supervision b. Delegation c. Responsibility d. Accountability

c. Assignment

8. The nurse asks the unlicensed assistive personnel to measure blood pressure, temperature, pulse, and respirations. This is an example of: a. Delegation b. Supervision c. Assignment d. Authorization

d. The nurse who delegates the activity

9. Who is ultimately accountable for the outcome of the delegation? a. The health care provider b. The health care employer c. The nurse leader d. The nurse who delegates the activity

COMPETENCE_ and KNOWLEDGE

Additionally the literature review found evidence that the UAP's level of _________ impacted effective delegation.

At times in the long-term care (LTC) setting, RN and LPN licensure levels are not delineated

Discuss the effect of "ROLE CONFUSION" on delegation.

1. communication between an RN and an NA contributes to effective delegation. 2. collaborative relationship between the licensed nurse and the UAP influences the effectiveness of delegation and promotes positive patient outcomes

In the literature review, what were the two things that contributed to EFFECTIVENESS of delegation?

Employer/Nurse Leader Responsibilities ⦁ Identify a nurse leader ⦁ Determine nursing responsibilities that can be delegated, to whom, and in what circumstances ⦁ Develop delegation policies and procedures ⦁ Periodically evaluate delegation process ⦁ Promote positive culture/work environment Licensed Nurse Responsibilities ⦁ Determine patient needs and when to delegate ⦁ Ensure availability to delegatee ⦁ Evaluate outcomes of and maintain accountability for delegated responsibility Delegatee Responsibilities ⦁ Accept activities based on own competence level ⦁ Maintain competence for delegated responsibility ⦁ Maintain accountability for delegated activit

List out the Guidelines for Delegation for each of the following: 1. EMPLOYER/NURSE LEADER RESPONSIBILITIES 2.. LICENSED NURSE RESPONSIBILITIES 3. DELEGATEE RESPONSIBILITIES

1. EMPLOYER/NURSE LEADER RESPONSIBILITIES 1.The employer must identify a nurse leader responsible for oversight of delegated responsibilities for the facility. 2. The designated nurse leader responsible for delegation, ideally with a committee (consisting of other nurse leaders) formed for the purposes of addressing delegation, must determine which nursing responsibilities may be delegated, to whom, and under what circumstances. 3.Policies and procedures for delegation must be developed. 4.The employer/nurse leader must communicate information about delegation to the licensed nurses and UAP and educate them about what responsibilities can be delegated. . 5. All delegatees must demonstrate knowledge and competency on how to perform a delegated responsibility. 6. The nurse leader responsible for delegation, along with other nurse leaders and administrators within the facility, must periodically evaluate the delegation process. 7. The employer/nurse leader must promote a positive culture and work environment for delegation.

List out the Guidelines for Delegation for each of the following: 1. EMPLOYER/NURSE LEADER RESPONSIBILITIES 2.. LICENSED NURSE RESPONSIBILITIES 3. DELEGATEE RESPONSIBILITIES

nurse who delegates the activity

No matter what is delegated, who maintains OVERALL accountability for the patient?__

employer/nurse leader, individual licensed nurse, and delegatee

The _____________all have specific responsibilities within the delegation process. ( Note the Delegation Model- figure 1 image for those responsibilities)

licensed nurse cannot delegate nursing judgment or any activity that will involve nursing judgment or critical decision making

What are the main concepts of what CANNOT be delegated?

Assignment :The routine care, activities, and procedures that are within the authorized scope of practice of the RN or LPN/VN or part of the routine functions of the UAP Delegation : allowing a delegatee to perform a specific nursing activity, skill, or procedure that is beyond the delegatee's traditional role and not routinely performed

What does this position paper say about assignment vs delegation?

confusion about what activities, skills, or procedures can be delegated to CNAs. The regulations define the minimum curriculum to be included in a CNA program but do not necessarily define all the activities, skills, or procedures that can be performed by a CNA. It is likely that nursing practice has understood these regulations to mean that CNAs can only perform those activities, skills, or procedures that were learned in the basic state-approved CNA training program

What problems do you see with the interpretation of certified nursing assistant regulations/guidelines?

d. Nurses cannot delegate any element of the nursing process.

Which statement about delegation is correct? a. Nurses are accountable for predicting adverse outcomes. b. Unlicensed assistive personnel (UAP) must accept any delegated nursing activity. c. UAP work under the license of the delegating nurse. d. Nurses cannot delegate any element of the nursing process.