Nursing Delegation and Prioritization Principles Flashcards

Vocabulary flashcards generated from lecture notes covering key definitions, guidelines, and principles of nursing delegation, communication, clinical judgment, and patient prioritization.

Accountability

To be answerable to oneself and others for one's own choices, decisions and actions as measured against a standard.

Delegated responsibility

A nursing activity, skill or procedure that is transferred from a licensed nurse to a delegatee.

Assignment

The routine care, activities, and procedures that are within the authorized scope of practice of the RN, LPN or UAP.

Competence

The ability of a nurse to integrate and apply knowledge, skills, judgment and personal attitudes required to practice safely and ethically in a designated role and setting.

Delegation

Transfer of responsibility for performance of a task from one individual to another while retaining accountability for the outcome.

Unlicensed Assistive Personnel (UAP) Task Guidelines

Care activities including ambulation, basic skin care, bathing, client transport, grooming, hygiene measures, positioning, range-of-motion exercises, and some specimen collections such as urine or stool.

Licensed Practical or Vocational Nurse (LPN) Task Guidelines

Activities including administering oral, IM, subcutaneous, intradermal, topical, GI tube, and selected IV piggyback medications, changing dressings, irrigating wounds, monitoring IV flow rate, suctioning, urinary catheterization, teaching basic hygienic/nutritional measures, and data collection within the clinical problem-solving process.

Registered Nurse (RN) Task Guidelines

Activities including administering IV medications by continuous IV, piggyback, and IV push, initiating client teaching, administering blood products, and using the nursing process (assessment, analyzing data, planning, implementing, and evaluating).

Five Rights of Delegation

Right Task, Right Circumstance, Right Person, Right Communication, and Right Supervision.

Right Task

The delegation right requiring that the activity falls within the delegatee’s job description or is included as part of the established written policies and procedures of the nursing practice setting.

Right Circumstance

The delegation right requiring that the health condition of the patient is stable; if the condition changes, the delegatee must communicate this and the nurse must reassess.

Right Person

The delegation right requiring that the licensed nurse, employer, and delegatee ensure the delegatee possesses the appropriate skills and knowledge to perform the activity.

Right Directions and Communication

Clear, specific instructions provided to the delegatee regarding the task, where the delegatee understands and agrees to the terms without making independent modifications.

Four Cs of Communication

Clear, Concise, Correct, and Complete.

Clear Communication

Communication in which the receiver understands the message.

Concise Communication

Communication in which unnecessary information is omitted.

Correct Communication

Direction given according to policy, procedure, job description, and the law.

Complete Communication

Communication in which the receiver has all of the information necessary to complete the task.

Right Supervision

The responsibility of the licensed nurse to monitor delegated activities, follow up, evaluate patient outcomes, remain available to intervene, and ensure proper documentation.

Clinical Judgment

The observed outcome of critical thinking and decision making.

Nursing Clinical Judgment (WKU LPN to ASN definition)

An iterative process using nursing knowledge to observe a situation, identify a prioritized patient concern, and generate the best evidence-based solution to deliver safe care.

Clinical Problem-Solving Process

A 5-step process comprising Assessment (Recognize Cues), Analysis (Analyze Cues and Prioritize Hypothesis), Planning (Generate Solutions), Implementation (Take Action), and Evaluation (Evaluate Outcomes).

Prioritization

Deciding which needs or problems require immediate action and which ones could be delayed until a later time because they are not urgent.

The 80/20 Rule

A prioritization principle stating that out of 100% of patient tasks, a nurse should identify the 20% that must get done to keep patients safe and spend 80% of their time on that vital 20%.

First-Level Priority Problems

Immediate priorities summarized as ABCs plus V: Airway, Breathing, Cardiac and Circulation, and Vital signs concerns.

Intermediate Level Priority Problems

Problems requiring care after first-level issues, including mental status change, acute pain, acute urinary elimination problems, abnormal lab values, and risk for infection, safety, or security.

Low Priority Problems

Non-urgent health problems such as lack of knowledge, rest, activity, or family coping.