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CHAPTER 9 D ELEGATION OF CLIENT CARE

CHAPTER 9 D ELEGATION OF CLIENT CARE. Delegation of Client Care. Definition. The reassigning of responsibility for the performance of a job from one person to another (ANA, 1996). Concepts of Delegation. The responsibility of the task is transferred

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CHAPTER 9 D ELEGATION OF CLIENT CARE

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  1. CHAPTER 9DELEGATIONOF 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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