Principles And Guidelines Of Delegating
Delegation is a process of transferring performance of selected nursing task in a situation to an individual who is competent to perform that specific task. It involves achieving outcomes and sharing activities with other individuals who have authority to accomplish the task.
Even though a task may be delegated to someone, the nurse who delegates maintains accountability for the overall nursing care of the patient.
Only the task, not the ultimate accountability, may be delegated to another.
Guidelines for patient care assignment:
1. Always ensure patient safety.
2. Be aware of individual variations in work abilities.
3. Determine which tasks can be delegated and to whom.
4. Match the task to the delegatee based on the nurse practice act and appropriate position description.
5. Provide directions that are clear, concise, accurate, and complete.
6. Validate the person's understanding of the directions.
7. Communicate a feeling of confidence to the delegate, and provide feedback promptly after the task is performed. 8. Maintain continuity of care as much as possible when assigning patient. care.
Here are a few differences of RN, LPN, and PAB task:
PAB: Generally noninvasive interventions such as skin care, range-of-motion exercises, ambulation, grooming, and hygiene measures.
LPN: Can perform not only the task that the PAB can perform but also can perform certain invasive tasks, such as dressings changes, suctioning, urinary catheterization, and medication administration (oral, subcutaneous, and intramuscular) according to the education and job description of the LPN.
RN: Can perform the tasks that a LPN can perform and is responsible for assessment and planning care, initiating teaching, and administering medications intravenously.
Note: Some tasks are different on practice, based on the institution or by the province.
LPNs are accountable to self-assess competency and learning needs and may function within their level of education and competence once:
the patient has been assessed by the Registered Nurse and
the level of complexity and predictability has been established with a plan of care
Note: If a patient becomes more complex or less predictable:
-the LPN is to consult with the RN
-the RN is to re-assess the patient, re-evaluate a plan of care
SEE COMPLEXITY AND PREDICTABILITY TABLE:
"Now, since you know the basic differences of their tasks, I want you to focus on the skills the LPN can do or cannot do" AVAILABLE FOR VIP MEMBERS ONLY
"It is not necessary to memorize all the LPN skills on the list, just familiarize yourself, I already marked the important topics that you should know"
REFERENCES:
Saunders NCLEX RN EXAMINATION (Comprehensive review)
Association of Registered Nurses of Prince Edward Island (ARNPEI), Licensed Practical Nurses Association of Prince Edward Island (LPNAPEI) and Prince Edward Island Health Sector (PEIHSC), Exemplary Care: Registered Nurses and Licensed Practical Nurses Working Together, 2008.
The Ottawa Hospital Model of Nursing Clinical Practice - RPN Skills List, Revised October 21, 2003.
College of Licensed Practical Nurses of Nova Scotia, Entry Level Competencies for Licensed Practical Nurses – Psychomotor Competencies, Approved February 14, 2002.
College of Registered Nurses of Nova Scotia. Entry Level Competencies for New Graduates. Draft – March 2004.