Delegation and Continuity of Care Notes

Delegation and Continuity of Care

Delegation

  • Definition:
    • ANA: Transfer of responsibility.
    • NCSBN: Transfer of authority. A nurse gives a competent individual the authority to perform a selected nursing task in a selected situation while retaining accountability for the delegation.

Principles of Delegation

  • First Principle:
    • Nurses must have knowledge of the nurse practice act in the state where they are licensed.
  • Second Principle:
    • The RN cannot delegate assessment, planning, evaluation, or accountability for the assigned task.
  • Third Principle:
    • The person to whom the assignment was delegated cannot delegate that assignment to someone else.

Five Rights of Safe Delegation

  • Right Task
  • Right Person
  • Right Circumstance
  • Right Communication
  • Right Supervision

Communication of Delegation

  • Specific tasks to be done for each client.
  • When each task is to be done.
  • Expected outcome of each task.
  • Who is available to help.
  • When and what should be reported.

What Can Be Delegated

  • This section encourages brainstorming and creating a list based on the text regarding what can be delegated and to whom.

Delegation - Unlicensed Assistive Personnel (UAP)

  • Vital signs
  • I&O (including emptying foley catheters, drains, and colostomies)
  • Transfers and ambulation – stable patients
  • Postmortem care
  • Bathing/Feeding
  • Simple dressing changes
  • Attending to safety – setting up bed alarms
  • Weights
  • CPR

Delegation - Licensed Practical/Vocational Nurse (LPN/VN)

  • Medication Administration (except IV medications unless IV certified)
  • Complex dressing changes
  • Other basic nursing skills (NG tube placement; foley catheter insertion)
  • Enteral feedings (G-tube/NG)
  • Update care plans
  • Plus, everything that the UAP can do

Delegation Decision Tree

  • This section encourages describing the decision tree in delegating.

Continuity of Care

  • What is it?
  • What must nurses do in order to provide continuity of care?
  • What are the types of clients who need home care referrals?