Answer & Explanation

Solved by verified expert

Rated Helpful

Delegation in Practice

Delegation in practice is a method of making decisions. This necessitates the nurse's

employment of nursing techniques. It possesses knowledge and judgment and maintains

accountability for the delegation and outcome of nursing care by comprehending the nursing

legislation and rules.

Delegation is the authority to conduct a task/activity in a certain setting/situation is transferred or

handed off to a competent individual. Effective delegation promotes safe, competent, and cost-

efficient nursing care while also allowing the nurse to take on more difficult nursing care

responsibilities. The steps of delegation principles provide a framework for nurses to make

effective delegation decisions.

In addition, effective delegation is facilitated by good communication skills, which ensures that

high-quality care is provided. Thus, the nurse retains accountability/responsibility for the

delegating of tasks/activities decision.

Step-by-step explanation

Delegation in Practice
What does your State Board of Nursing of California say about Unlicensed Assistive Personnel

and their role, and the role of the Registered Nurse?

The functions performed by unlicensed assistive personnel (UAP) are the following:

(a) A health facility licensed under Section 1250 of the Health and Safety Code may not assign

unlicensed personnel to undertake nursing functions in place of a registered nurse, and may not

enable unlicensed personnel to execute functions under the supervision of a registered nurse.

Direct clinical supervision of a registered nurse in situations that necessitate a significant degree

of scientific knowledge and technical abilities, such as, but not limited to:

 medication administration;

 intravenous (IV) treatment or venipuncture;

 parenteral or tube feedings;

 invasive operations such as nasogastric tube placement, catheter placement, or tracheal

suctioning;

 evaluation of the patient's condition;

 informing patients and their families about their health-care issues, including post-

discharge care; and

 laboratory tests of moderate complexity.

(b) This section does not prevent anyone from performing any act or function that an individual

desires. As of July 1, 1999, one is entitled to execute under Division 2 (beginning with Section

500) or existing statute or regulation.

The RN's role requires quick information processing and scientific knowledge application in

order to coordinate, delegate, and supervise the delivery of safe, timely treatment. This

encompasses the capacity, knowledge, and skill to:

 verify the information's accuracy and reliability;

 identify trends based on case type, treatment standards, familiar situations and data

relevancy and other factors;

 recognize discrepancies and gaps in one's knowledge;

 seek additional information;

 have hints in groups;

 make a hypothesis on sickness, demands of the patient, and health issues;

 make predictions about what will be found, what will be required, how the treatments

will be utilized, and what will happen;

 set priorities for nursing care implementation, as well as priorities for the urgency of

patient issues; and

 evaluate and update based on the assessment of fresh facts.

In general, the RN is in charge of gathering, analyzing, and coordinating with all information

sources in order to create a thorough written plan of care based on current safe practice

standards.

Describe the responsibilities of the Registered Nurse when delegating patient care tasks.

The nurse assigned to the client is in charge of the delegation process, which includes

communication, supervision/monitoring, and evaluation of task/activity performance. The nurse

is also responsible for the decision to delegate as well as the delivery of safe nursing care.

Delegation is a decision-making process that involves assessing, planning, insuring

accountability, communicating, monitoring performance, evaluating, and revising the nursing

plan of care.

The nurse must be familiar with the Nursing Practice Act (NPA) and Rules, facility/agency

policies and procedures, job description, and clinical competence of unlicensed assistive

personnel (UAP) in order to grant appropriate delegation. The RN's assessment of the client's

nursing care needs, as well as the following factors, are used to make decisions about delegating

nursing tasks/activities to UAP:

  UAP's expertise and abilities;

 confirmation of UAP's clinical efficacy;

 an RN's competency;

 practice setting characteristics such as the complexity and frequency of nursing care

required;

 clients' proximity to employees;

 resources that are easily available;

 the number of employees and their qualifications;

 regulations and procedures of the facility/agency

processes, methods, and routes of communication that support delegated activities; and

 the client's condition's stability.

The following are the four steps of delegation principles:

Step 1: Assessment and

Planning

Assessment and planning necessitate the use of suitability of the tasks/activities that may be

legally delegated to UAP and will be determined by RN. The assignment must be within the

scope of the nurse's practice before the assessment can begin. Following that, the RN assesses

the client's nursing care needs. A nurse who is capable of doing the task must make the
delegation decision.

Step 2: Communication

The second step in the process is communication. Delegation is an important part of this process.

Delegation and delivery effectiveness nursing care must be both safe and competent.

Communication between the nurse and the patient is crucial as well as with the UAP. The nurse

is in charge of giving clear instructions and direction in terms of the tasks/activities that are being

performed.

Step 3: Supervision/Monitoring

Supervision/monitoring necessitates the use of delegation to ascertain the degree or amount of

consultation with the nurse. It is required for the UAP to finish the project tasks/activities that

have been allocated. The doctor's assistant provides oversight by keeping an eye on UAP's

performance. It includes the completion of the tasks/activities, adherence to industry

requirements, practice in accordance with the facility's guidelines and policies, and procedures of

the agency.

Surveillance and monitoring may be necessary. It can be in the form of direct or indirect

communication. Oversight/observation is a form of supervising directly. It will be provided by

this unit. When the nurse is monitoring the patient, it is a must that he or she is physically present

on the grounds. Indirect supervision and monitoring would be beneficial as well.

Step 4: Evaluation and Feedback

Both the RN and the LPN are accountable for evaluating UAP's performance of the allotted

tasks/activities during the fourth step. The effectiveness of the nursing plan of care, achievement

of intended outcomes, adjustment of the nursing plan of care when needed, and success of the

delegation process would all be part of the RN's evaluation.

Both the RN and the LPN would be able to help. UAP should receive appropriate feedback on

the completion of the allotted tasks/activities. Both the nurse and the UAP can use feedback to

improve the delegation process and the delivery of safe nursing care.

The RN roles and responsibilities

include the following:

 analyze the client's nursing care needs and develop a care plan before deciding which

tasks/activities to delegate;

 assess the client's needs for care and the UAP to determine activities qualifying proper

delegating in the professional setting and with the client population;

  evaluate and validate the clinical data Initial and ongoing competence of licensed and

unlicensed personnel;

 assign tasks/activities related to nursing care to qualified people;

 ensure adequate supervision/care performance that is being monitored and delivered;

 assess UAP's performance on the tasks/activities as well as the care outcome;

 re-evaluate the nursing care plan and make any necessary changes;

 receive input on

completing tasks/activities and delegating authority;

 be responsible for the nursing care given by staff to whom activities/tasks have been

delegated; and

 explain tasks/activities that may be appropriate to delegate to UAP in the nursing plan of

care.

How does the ICU environment differ from a general medical-surgical unit as far as assigned

responsibilities for Unlicensed Assistive Personnel?

The level of care provided is the fundamental difference between an ICU and general medical-

surgical unit. Nurses and other medical/surgical care providers are well-versed in a wide range

of diseases and illnesses—after all, they deal with a wide range of disorders that necessitate
hospitalization, including post-surgery recovery, infectious diseases, and other delicate

situations.

While all nursing specializations require the same basic skill set, medical/surgical nurses must

be conversant with a wide range of ailments and illnesses, as well as every body system, in order

to treat and care for patients appropriately. They also meet more patients on a daily basis, so they

are involved in the care of patients with a wide range of diseases and disorders, and they must

develop treatment regimens in collaboration with physicians based on the individual needs of

each patient. In the United States, medical/surgical nursing is the most common nursing

specialization.

Intensive Care Unit (ICU) nurses, also known as critical care nurses, work with patients who

have life-threatening medical conditions or are recovering from significant surgeries such as

open-heart surgery. The intensive care unit (ICU) provides critical care to patients who have

serious illnesses or injuries that require regular monitoring. Patients in the ICU may be

recovering from major surgery, undergoing therapy for significant injuries, or undergoing

treatment for serious medical illnesses.

While medical/surgical units feature monitoring equipment for patient care, intensive care

units (ICUs) have a lot more to monitor. An ICU floor is littered with machines such as IV

tubes, feeding tubes, catheters, and breathing machines, to name a few. ICU nurses may perform

procedures that medical/surgical nurses are not prepared to perform, such as inserting a central
line, inserting a chest tube, and operating a ventilator. ICU nurses are required in difficult patient

cases requiring a high level of assessment.

(Assigned responsibilities for Unlicensed Assistive Personnel)

The use of unlicensed assistive personnel (UAP) has grown in the health-care system due to a

financial imperative, although their usage in ICU is still relatively new. Several themes

significant to ICU nursing practice were identified from an assessment of the transcripts, field

notes, and diagrams, as well as a comparison of the emerging categories to the literature.

In the analysis, three themes emerged: constant vigilant assessment, quick response, and

understanding the big picture. These findings show that requiring UAP to accomplish tasks

assigned to them in other areas will deprive ICU nurses of crucial, albeit subtle,

components of their nursing practice. ICU nurses must be mindful of divulging tacit aspects of

their position that allow them to synthesize contextual variables with proclaimed theory and

experience to achieve the best possible patient care and results.

As the demand on licensed health care professionals' time and resources grows, and

organizations face cost-cutting measures, Cahill, et al. (2021) specified that the employment of

unlicensed assistive employees for patient care activities grows. When registered nurses (RNs)

outsource specific activities and parts of patient care, the emphasis on safe and effective care

delivery remains critical.

The American Nurses Association and the National Council of State Boards of Nursing

have established delegation principles that include the RN's responsibility and accountability

for patient care outcomes. Overall, the authority for delegation of clinical activities differs

greatly by state. Despite the personnel skill mix, the RN is responsible for overseeing difficult

duties.

References

 Cahill, M. L., Painter, D. R., & Branch, J. L. (2021). The Authority for Certain Clinical

Tasks Performed by Unlicensed Patient Care Technicians and LPNs/LVNs in the

Hemodialysis Setting: An Update and Invitation to Take Action. Nephrology nursing

journal : journal of the American Nephrology Nurses' Association, 48(2), 119-129..

 Differences Between ICU and Inpatient Hospital Floors. (2018). OakBend Medical

Center. Accessed on 10 December 2021. Retrieved from

https://www.oakbendmedcenter.org/2018/08/31/differences-between-icu-and-inpatient-

hospital-floors/.

 Understanding the Role of the Registered Nurse and Interim Permittee. (n.d.).

CALIFORNIA BOARD OF REGISTERED NURSING. Accessed on 10 December

2021. Retrieved from https://www.rn.ca.gov/pdfs/regulations/npr-b-53.pdf.

 Unlicensed Assistive Personnel - California Board of Registered Nursing. (n.d.). BOARD

OF REGISTERED NURSING. Accessed on 10 December 2021. Retrieved from

https://www.rn.ca.gov/pdfs/regulations/npr-b-53.pdf.

 Winstead, J. (n.d.). Delegation: What are the Nurse's Responsibilities?. North Carolina

Board of Nursing. Accessed on 10 December 2021. Retrieved from

https://www.ncbon.com/vdownloads/course-bulletin-offerings-articles/bulletin-article-

winter-2013-delegation.pdf.