Delegation of Nursing Tasks – Key Vocabulary

Vocabulary flashcards summarizing essential terms and definitions related to delegation of nursing tasks, roles, responsibilities, and the Five Rights framework.

Delegation

The transfer of responsibility for performing a task to another person while the nurse/delegator retains accountability for the outcome.

Authority

The legal power or right to give orders, make decisions, and enforce obedience.

Responsibility

The obligation to perform duties or tasks and make decisions without additional authorization within one’s scope of practice.

Accountability

Being answerable to oneself and others for choices and actions; willingness to accept responsibility for outcomes of tasks performed or delegated.

Assignment

Full transfer of responsibility, authority, and accountability for patient care to another health-care team member.

Supervision

Directing, monitoring, and evaluating another’s performance of delegated tasks.

Registered Nurse (RN)

Licensed caregiver educated at diploma, associate, baccalaureate, or higher level; provides and directs complex patient care and retains accountability for delegated activities.

Licensed Practical Nurse (LPN)

Nurse educated 12–18 months, licensed by NCLEX-PN, functions under RN or provider direction to care mainly for stable clients and reinforce education.

Assistive Personnel (AP)

Unlicensed or certified staff (e.g., CNA) who perform basic, non-invasive patient-care and support tasks under RN or LPN supervision.

Unlicensed Assistive Personnel (UAP)

Assistive workers often trained on the job who perform duties as outlined in their job description under licensed supervision.

Decision-Making in Delegation

The RN’s judgment process used to determine whether, what, and to whom tasks should be delegated.

Delegation Considerations

NPA, facility policy, job descriptions, staff competency, patient needs, and legal responsibilities.

Activities That Cannot Be Delegated by RN

Initial and specialized assessments, the nursing process steps (ADPIE), and patient education that is not merely reinforcement of prior teaching (EAT).

Five Rights of Delegation

Right task, right circumstance, right person, right direction/communication, right supervision/evaluation

Right Task

Within the delegatee’s scope/job description, frequent with predictable outcome, and requires minimal supervision or clinical judgment.

Right Circumstance

Patient’s condition is stable, there’s adequate resources, and delegatee’s current workload permits safe completion.

Right Person

Choosing a delegatee whose job description, competence, education, and strengths align with the task to be performed.

Right Direction / Communication

Providing clear, complete, and concise instructions about the task with expected outcomes, time frames, and necessary follow-up to the delegatee; delegatee confirms understanding and first asks questions for clarification.

Right Supervision

RN monitors performance, resources, outcomes; provides feedback and determines if patient goals met (licensed nurse remains accountable).

Pairing

Temporary working relationship in which an RN and LPN/NA collaborate for a shift, often increasing delegation opportunities.

Partnering

Purposeful scheduling of an RN with an LPN/NA for consistent collaboration and efficient delegation over time.

SMART Goals

Specific, Measurable, Attainable, Relevant, and Timed

Obstacles to Delegation

Lack of skills, reluctance to relinquish control, fear of dislike, poor communication, or role confusion.

Scope of Practice

The range of permitted duties and responsibilities defined by state nurse practice acts and facility policies for each caregiver level.

Competency Validation

Formal confirmation that a delegatee has acquired the knowledge and skill to perform a specific task safely and effectively.

_______ optimizes time-management, workload distribution, staff development, and patient outcomes.

Delegation

General Rule of Delegation

Delegate to lowest appropriate person in hierarchy with demonstrated competence (knowledge of skills)

Who can manage stable and unstable, high-acuity patients utilizing independent clinical judgement?

Registered Nurses (RNs)

What can an LPN do?

Care for stable pts, reinforce education, calculate and monitor IV fluids, administer oral meds and IVPB solutions.

An LPN cannot…

Administer high risk meds (heparin, chemo), titrate infusions, discharge patients, formulate nursing care plans.

An AP/CNA can…

Perform direct skills like hygiene, grooming, ADL support (nutrition, elimination), non-sterile VS, I&O.

What are some indirect skills an AP/CNA can do?

Transport, stocking, clerical duties

What are limitations of an AP/CNA?

No independent clinical decision-making or delegation, may reinforce education but no original education, no tasks prohibited by agency even if trained elsewhere

If a nurse is unsure about an assignment, what should they do?

Speak with the charge nurse and explore modifications or redistribute assignment

SMART goals help a nurse decide…

What to delegate and when

Which delegation approach is suggested?

Algorithmic approach

RN’s accountability is ____________

Non-transferable

What can delegation failure lead to?

Burnout, errors, and ethical breaches

Before delegating a task, what should be known?

Scope of practice

Who can reinforce education after the nurse gives initial education?

CNA and LPN

What kind of meds can an LPN administer?

Oral and IVPB solutions