Delegation in Nursing
Delegation refers to assigning the performance of certain activities regarding patient care to unlicensed assistive personnel. The process of delegation ensures that the nurse retains accountability for the outcome of the delegated task. Delegation of activities is a vital tool in nursing care because it helps in ensuring that the nurses spend their time in productive ways (Marquis & Huston, 2009). Besides, delegation helps in building essential skills in the individuals who the tasks are delegated to. It is of the essence for the nurse leaders and the registered nurses to understand the principles and the rights associated with the concept of delegation.
The American Nurse Association provides detailed information regarding the various principles of delegation. Thus, the registered nurses have to make delegation decisions based on the principles. The registered nurses are expected to consider the facility or agency policies before delegating a particular task to unlicensed assistive personnel (UAP) (National Council of State Boards of Nursing, 2016). The registered nurses are expected to consider such factors as knowledge and skills, training, availability, competence and diversity of awareness of the individual to whom the task is to be delegated. Besides, the registered nurses are supposed to consider the complexity of the task before making judgments on whether or not it should be delegated to UAP (National Council of State Boards of Nursing, 2016). It is also critical for the registered nurses to understand that they cannon delegate tasks that require the UAP to make nursing judgements.
The principles of delegation equally touch on nurse leadership. The nurse leaders are responsible for the establishment of systems that monitor, assess, verify and communicate competencies vital in the various areas of delegation (National Council of State Boards of Nursing, 2016). Additionally, organizations, through leadership are expected to provide enough resources that are critical in creating positive delegation outcomes. Nurse leaders and other registered nurses should adhere to these principles for effective delegation outcomes.
Rights of Delegation
Apart from the principles of delegation in nursing care, it is of the essence for the registered nurses to understand the rights of delegation. The five rights of delegation are critical and are often used as a checklist to help the nurses in making decisions regarding the delegation of tasks to unlicensed personnel. The five rights of delegation make it clear that the nursing service administrators and the staff nurses have to collaborate to ensure that the public is protected when delegating activities. The rights of delegation include right task, right circumstances, right person, right direction/communication as well as right evaluation/supervision.
Right Task
Registered nurses have to ensure that the tasks delegated to unlicensed personnel fit their level of competence. The nursing service administrator thus helps in identifying the appropriate activities that can be delegated to the unlicensed personnel through a UAP job description (Barrow & Sharma, 2019). Therefore, it is the responsibility of the staff nurse to ensure that appropriate activities are identified as spelt out by the nurse service administrator (Barrow & Sharma, 2019). In most cases, the activities delegation consideration include those that do not involve complex nursing processes, those that reoccur frequently in clients’ daily care as well as those that do not require any nursing judgement from the UAP.
Right Circumstance
Regarding the right circumstances, the nursing service administrator ensures a proper assessment of the client community health status and analyse the information to identify the care needs and priorities. The staff nurse, on the other hand, participates in the assessment of individual client status to identify the nursing needs. The nursing service administrator should equally aid in the provision of elementary staffing and skill mix with clear lines of reporting (Barrow & Sharma, 2019). The staff nurses, on the other hand, are expected to match the complexity of the activity that is to be delegated with the UAP competency. Matching the complexity with the competency helps in identifying the level of supervision needed (Barrow & Sharma, 2019). As the nursing service administrators provide preparations in management technique to delegate care, the staff nurses monitor and guide the UAP to address the needs of the patients.
Right Person
The right person in delegation requires the nursing service administrators to set standards that are in line with the law and spell out the educational and training needs as well as competency measurement for the UAP. The nursing service administrators equally have to participate in the incorporation of the standard in the policies of the institution (Barrow & Sharma, 2019). They equally have to perform evaluations on the standards. The staff nurse, on the other hand, is tasked with the mandate of assessing, verifying and identifying the relevant UAP competencies regarding client needs.
Right Direction/Communication
Direction/communication is elementary in the process of delegation because it ensures that the instructions are as clear as possible. Nursing service administrators ensure the communication of UAP competencies, accepted activities for delegation as well as the supervision plan (Barrow & Sharma, 2019). The staff nurse, on the other hand, communicates the decisions for delegation on both UAP-specific and client specific bases (Barrow & Sharma, 2019). Besides, the staff nurse takes part in situation-specific communication such as the collection of specific data using an appropriate method.
Right Supervision/Evaluation
In most cases, the supervision is often given by the delegating registered nurse. The delegating nurses have to apply appropriate supervision skills that are in line with the UAP competencies and the nature of the delegated activity (Barrow & Sharma, 2019). The nurse service administrator should thus provide enough human resources to facilitate the supervision process (Barrow & Sharma, 2019). The administrator is equally expected to participate in the identification of the nurse who is to play the supervisory role. The staff nurse, on the other hand, ensures proper oversight of the delegated activity. The staff nurses also make sure that the directions of the delegation are as clear as possible. They thus have to oversee the performance, obtain feedback and make interventions (if needed)
In conclusion, it is the responsibility of the registered nurses to adhere to the principles and rights of delegation. Adherence to the principles and standards guarantee the safety of the patients who are the recipients of the delegated activities. Nurse service administrator and staff nurse have to collaborate to register positive delegation outcomes.
References
Barrow, J. M., & Sharma, S. (2019). Nursing Five Rights of Delegation.
Marquis, B. L., & Huston, C. J. (2009). Leadership roles and management functions in nursing: Theory and application. Lippincott Williams & Wilkins.
National Council of State Boards of Nursing. (2016). National guidelines for nursing delegation. Journal of Nursing Regulation, 7(1), 5-14.