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Delegation to unlicensed assistive personnel

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Delegation to unlicensed assistive personnel Delegation Guidelines The Nurse Practice Act establishes the standard that each licensed nurse is accountable for the ... – PowerPoint PPT presentation

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Title: Delegation to unlicensed assistive personnel


1
Delegation to unlicensed assistive personnel
2
Delegation Guidelines
  • The Nurse Practice Act establishes the standard
    that each licensed nurse is accountable for the
    safety of nursing care s/he delivers
  • The Boards regulations hold that the nurse is
    also responsible for all the nursing care that a
    patient receives under his/her direction

3
Delegation Guidelines
  • RN retains ultimate responsibility,
    accountability and legal liability for delegation
  • Supervision- directing, guiding or influencing
    the outcome of anothers performance

4
Appropriate activities for Delegation
  • Delegated tasks must be performed according to
    established guidelines/protocols
  • Have little to no modification from one situation
    to another
  • Never involve assessment, interpretation or
    decision-making which cant be separated from the
    task

5
Never Delegate
  • Nursing assessment or formulation of nursing
    care plans
  • Evaluation of patients response to care
  • Health teaching and counseling
  • Administration of medications (micostatin or
    albuterol)
  • O2 therapy

6
Questions to consider before delegating
  • Have I assessed this patient
  • Would a reasonable and prudent nurse delegate
    this activity
  • Documentation of competency of PCT/NA
  • Ability of RN to provide supervision

7
Questions to consider before delegating
  • What information do I need to give the PCT/NA to
    insure they understand what they are being asked
    to do
  • How will I document the hand-off to PCT/ NA
  • Should the PCT/NA use a scut sheet to document
    the task request
  • Does the PCT/NA understand their responsibility
    in documenting when the task is completed

8
Questions to consider before delegating
  • Patient condition
  • Complexity of assignment/Intricacy of task
  • Custodial nature of task
  • Infection control/safety issues
  • Potential for harm
  • Amount of technology used

9
Vignette 1
  • Mrs. D. is recovering from a total abdominal
    hysterectomy. The MD ordered removal of the
    urethral catheter. The PCT has documented
    competencies in removing indwelling catheters.

10
Vignette 1
  • Is this a reasonable activity to delegate?
  • What factors would go into your decision to
    delegate or not delegate?
  • If this were Mr. D. who is due to have the
    urinary catheter removed after successful
    cholecystectomy what factors would go into your
    decision to delegate or not?

11
Vignette 2
  • Mrs. W. has been identified as an aspiration
    risk. She has orders to begin oral feeding.
  • Should this task be delegated?
  • What factors would go into your decision to
    delegate or not?
  • Are there safety precautions you would put at
    the bedside?

12
Vignette 3
  • Mr. P. is in the cardiac unit and has been on
    oxygen therapy for 3 days. He has a new order to
    increase his O2.
  • Is this a task that can be delegated to a PCT/NA?
  • What factors go into your decision to delegate or
    not?
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