Delegating

Delegating

"Transferring the responsibility for the performance of an activity from one person to another while retaining accountability for the outcome"

Supervision=

-The more a RN delegates the more supervisory skill is required. -the provision of guidance or direction, evaluation, and follow-up by the licensed nurse for accomplishment of a nursing task delegated to unlicensed assistive personnel."

Supervision

1. Unsupervised 2. Initial Direction: the instructions you provide when delegating a task 3. Periodic Inspection: the decision you make regarding the frequency of checking back with a delegatee based on your judgment of the current situation 4. Continuous Supervision Failure to do either of these 2 points will be interpreted as a failure to adequately supervise the delegatee.

The ability to use delegation skills appropriate will...

With the increased use of UAP in patient care, the need for nurses to have highly-developed delegation skills has never been greater. The ability to use delegation skills appropriately will help reduce the personal liability associated with supervising and delegating to UAP. It will also ensure that clients' needs are met and their safety is not jeopardized.

Professional aspects of a RN cannot be delegated.

Assess the patient's condition. Evaluate the effect of nursing interventions. Plan future nursing interventions. Teaching or discharge planning EX: Performing an initial assessment Making nursing diagnoses Working with patient/family to develop care goals and plan of care Evaluating patient's progress toward achieving expected outcomes Patient/family teaching

Guidelines For Giving Feedback

Be clear Start with the positive Be specific Refer to behaviors that can be changed Offer alternatives Show appreciation Sandwich message Positive, negative, positive.

Delegation: Legal Terms=

Delegation : means an authorization granted by a licensee to a licensed or unlicensed individual to perform selected acts, tasks, or functions which fall within the scope of practice of the delegator** and which are not within the scope of practice of the delegatee** and which, in the absence of the authorization, would constitute illegal practice of a licensed profession"

Accountability:

Is being responsible and answerable for actions or inactions of self or others in the context of delegation (NCSBN, 1995).

Effective Delegation:

Know the task requirements Know yourself Know the team members Remain in contact Communicate clearly and often Evaluate the results

Outcomes after Delegation =

Right Direction and Communication (of the 5 Rights) had the lowest appropriate use. 37% of the time incorrect Factors Affecting Negative outcomes -Not following policy (33%) -Lack of UAP attentiveness to responsibilities (10%

Right direction and communication

Right direction and communication: clearly about each delegated task. Makes sure there is verification of understanding. Ask if she knows how to.....

right person=

Right person - is this specific person competent to perform certain tasks? Is there proof in the facility?, i.e. completed orientation or course. This includes agency nurses.

Right supervision and evaluation

Right supervision and evaluation. Guide, supervise, evaluate how the person carries out the tasks. If expectations not met, step in. Give and ask for feedback. . Plan to evaluate your patient's outcome and the results of the task.

The Five "Rights" of Delegation=

Right task Right circumstances Right person Right direction and communication Right supervision and evaluation

Right task=

Right task - must conform to the est. guidelines, agency policies, job descript of the HCW and adhere to state's nurse practice act. Generally, reoccur in daily care, do not require nursing judgment or application of the nursing process, results are predictable and risk is minimal, use a standard procedure.

Supervisors Require understanding of:

The job descriptions of those they are supervising The competencies of those supervised The perspective of those supervised.

....transferring to a competent individual the ____ to perform a selected nursing task in a selected situation. The nurse retains ______ for the delegation."

authority accountability

Responsibility:

involves reliability, dependability and the obligation to accomplish work when an assignment is accepted.

Assignment:

is defined by both the ANA and NCSBN (2006) as the distribution of work that each staff member is to accomplish during a given shift or work period. Nurses do not delegate to other nurses because they have the same authority and same autonomy and same rules

Authority:

is the right to act or to command the action of others: it comes with the job and is required for a nurse to take action.

Right circumstances =

tasks to UAP that don't require independent judgment. Think about the patient and equipment and the setting to decide if you ask a UAP to carry out the task.