Delegation and Communication

Betty was willing to administer Samantha's 8:00 a.m. medications. If Betty were unwilling to accept this delegated task, what would be Samantha's best action?

Assess the reasons why Betty is unable or unwilling to give the medications. The best initial response to a subordinate's reluctance to accept delegation is to assess the reasons why he or she is reluctant. The reasons may be varied, and the nurse should dialogue in order to avoid making assumptions. Initially, there is no need to involve the manager or leader. Reminding Betty of her scope of practice is an action that is based on an assumption of the reasons why she might refuse the task.

The nurse on a busy hospital unit is anticipating the arrival of an acutely ill patient. What task should the nurse delegate to unlicensed assistive personnel (UAP)?

Feeding a patient who is recovering from a stroke Feeding a patient is an example of the task implementation that can be delegated to UAP. While some patients who have experienced a stroke have an increased risk for aspiration, the nurse could safely delegate this task if the UAP had the knowledge and experience to feed the patient safely. Lung auscultation is a form of assessment and cannot be delegated to UAP. Similarly, patient education and documentation should be performed by a licensed nurse and not delegated to UAP.

What would accurately describe appropriate delegation? (Select all that apply.)

Helps manage the health care team, Increases the scope of the nurse's liability, Is based on clear communication Delegation is a necessity of managing teams. The nurse assumes a role of greater responsibility in delegating care, as the nurse is now responsible for his/her own actions as well as those of the person who completes the delegated task. Delegating increases the scope of liability to the nurse. The communication from the delegator must be clear and concise for effective teamwork. Bargaining is not part of appropriate delegation.

A registered nurse on a busy hospital unit is responsible for several tasks that require clear and accurate communication. For which task should the nurse use the SBAR technique for communication?

Informing a health care provider about a change in a patient's health status The SBAR technique can be effectively used in a wide range of circumstances. However, it is most commonly applied in cases where succinct interprofessional communication is needed, such as when a nurse informs a care provider about a change in a patient's status. The SBAR technique is not used as a framework for completing nursing documentation. The SBAR technique is intended for use within the health care team, not between nurses and patients.

Betty, a licensed practical nurse/licensed vocational nurse (LPN/LVN), took phone report from the emergency department (ED) and accepted a patient onto the floor. Which of the five rights of delegation does this action violate?

Right person The five rights of delegation include right task, circumstance, person, communication, and level of supervision. In this instance, Betty's action violated the right of right person, because as an LPN/LVN it is beyond Betty's scope of practice to accept and assess a new patient. Betty should have asked the charge nurse to take the call from the ED.

Samantha delegated the administration of her 8:00 a.m. medications to Betty so that she could assess Mary promptly. What criteria must be met for this example of delegation to be safe and appropriate? (Select all that apply.)

Samantha must be able to confirm that Betty has given the medications., Samantha must be familiar with Betty's scope of practice with regard to medications., Betty must have sufficient time to give each patient his or her medications. Safe and appropriate delegation requires that the nurse be familiar with the knowledge, skills, attitudes, and experience of the person to whom a task is being delegated. Additionally, the nurse must be certain that the task is within the person's scope of practice and that the timeline available for completing the task is sufficient. All of these considerations are examples of ensuring the right task, circumstances, person, communication, and supervision. Betty's ability to give the medications safely is not necessarily dependent on her personal familiarity with each of the patients. Supervision does not entail working alongside a person to whom a task is delegated.

Samantha communicated with Dr. Gonzalez about Mary's health status using the SBAR technique. When applying this technique, a nurse should begin the communication by presenting what information?

The specific reason why the nurse has contacted the provider The "S" in SBAR stands for situation. In this component of the model, the nurse identifies the reason for calling, followed by any necessary background information for context. The client's relevant health history and assessment data are then presented and the nurse's communication ends with a suggestion for action.

A nurse has begun working in a new state and is unsure whether tasks involving a patient's intravenous line can be delegated to a licensed professional nurse/licensed vocational nurse (LPN/LVN). What is the best source for identifying whether this task can be delegated?

The state's Nurse Practice Act (NPA) The scope of practice for different nursing roles is ultimately defined by each state's NPA. Experienced practitioners are likely to be familiar with their scope of practice, but they are not the ultimate authority and may not know about tasks that are less common. Legal departments are unlikely to provide guidance on the specifics of care, and they cannot provide authoritative guidance. Peer-reviewed literature informs best nursing practice, but it does not address the variations in scope of practice that exist in different jurisdictions.

The nurse at a long-term care facility is considering whether to delegate some tasks to nursing assistive personnel (NAP). Before doing so, the nurse must:

be familiar with the NAP's knowledge, skills and experience. In order to delegate safely and effectively, the nurse must be familiar with the other individual's skills, education and experience. The nurse provides oversight and supervision but does not work alongside the NAP. A nurse who delegates does not necessarily have to justify why he or she is not personally doing the task. NAPs do not have legally defined scopes of practice, unlike RNs and LPN/LVNs.