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CHAPTER 9 DELEGATION OF CLIENT CARE

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CHAPTER 9 DELEGATION OF CLIENT CARE Conclusion Points to Consider Delegation is not new The role is essential for good working relationships Organizational skills are ... – PowerPoint PPT presentation

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Title: CHAPTER 9 DELEGATION OF CLIENT CARE


1
CHAPTER 9 DELEGATION OF CLIENT CARE
2
Delegation of Client Care
3
Definition
  • The reassigning of responsibility for the
    performance of a job from one person to another
  • (ANA, 1996)

4
Concepts of Delegation
  • The responsibility of the task is transferred
  • Accountability remains with the delegator
  • Delegation may be direct or indirect

5
Direct Delegation
  • Usually verbal direction
  • RN decides which staff member is capable of
    performing a specific task

6
Indirect Delegation
  • Contained in an approved listing of tasks
    established by an institution
  • Permitted tasks may vary from institution to
    institution

7
Assigning Tasks
  • The RN may assign a more skilled individual to
    perform a task
  • The RN may not assign an individual to perform an
    activity outside of a job description or the
    scope of practice

8
Delegation vs Supervision
9
Supervision
  • Supervision usually more direct than delegation
  • Requires directly overseeing the work or
    performance of others
  • Includes checking with individuals during the day
  • May entail delegation of tasks and activities
  • Nurse manager performs both

10
The Nursing Process and Delegation
11
Assessment
  • Assess client needs
  • Set client-specific goals
  • Match the personnel with the appropriate skills
    to care for the client

12
Planning
  • Mentally identify who is best suited for the task
    or activity
  • Planning prevents later problems

13
Implementation
  • Assign the appropriate personnel who have the
    level of expertise necessary to deliver the care
    or carry out the activities

14
Evaluation
  • Oversee the care or activities
  • Determine if client care needs have been met
  • Allow for feedback

15
Coordinating Assignments
16
Methods to Help Organize Care
  • Critical pathways
  • Computerized information sheets
  • Personalized worksheets
  • Delegation tree

17
Tips for Organizing Care
  • Plan time around activities that must be
    performed at a certain time
  • Perform high-priority activities first
  • Cluster activities that may be performed together
  • Consider your peak time when performing optional
    activities

18
The Need for Delegation
19
Changes in the Health-Care Environment
  • Nursing shortage
  • Health-care reform
  • Increased need for nursing services
  • Demographic trends
  • Use of unlicensed assistive personnel

20
Unlicensed Assistive Personnel (UAPs)
  • Individuals trained to function in an assistive
    role to the nurse
  • Perform delegated tasks
  • Under direct supervision of the RN
  • May or may not be certified

21
Delegation to UAPs
22
Examples of Tasks
  • Vital signs
  • Skills learned through special training
  • Blood drawing
  • ECGs
  • Measuring intake and output
  • Non-nursing duties

23
Safe Delegation
24
Criteria for Safe Delegation
  • Potential for harm
  • Complexity of the task
  • Problem-solving and innovation necessary to
    complete the task or activity

25
Considerations for Safe Delegation
  • Ability of the individual
  • Fairness of the task

26
Task-Related Concerns
27
Primary Concern
  • Does the individual assigned to the task have
    the ability to perform the task?

28
Other Task-Related Concerns
  • Ability
  • Priorities
  • Efficiency
  • Appropriateness

29
Relationship-Oriented Concerns
  • Fairness
  • Learning opportunities
  • Health
  • Compatibility
  • Preferences

30
Summary of Expectations of Professionals
  • Respect of others
  • A reasonable workload
  • Appropriate wages
  • Determining his/her own priorities
  • Ask for what he/she wants
  • Accountability
  • Give and receive information as a professional

31
Barriers to Delegation
32
Barriers
  • Experience
  • Licensure
  • Quality of care
  • Assigning work to others

33
The Five Rights of Delegation
  • Right task
  • Right circumstances
  • Right person
  • Right direction/communication
  • Right supervision/evaluation

34
Conclusion
35
Points to Consider
  • Delegation is not new
  • The role is essential for good working
    relationships
  • Organizational skills are a prerequisite for
    delegation
  • Understanding client needs is essential for
    appropriate delegation

36
The RN Needs to Understand
  • The state nurse practice act
  • The capabilities of each staff member
  • The tasks that may be delegated
  • The concept of accountability in delegation
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