Management of Care / 07

Make sure to:

  • Delegate tasks to appropriate staff.
  • Communicate information to clients, their designees, and care team members.
  • Prioritize and efficiently manage time.

The acuity of clients in various healthcare facilities has increased within the past decades. There is a shortage of nurses, and scientific breakthroughs, as well as advanced technology, have made the healthcare environment much more complex. Nurses must delegate tasks to meet clients’ needs efficiently while ensuring that they still receive high-quality care in a safe environment.

This learning experience provides the learner with knowledge about how to delegate tasks to appropriate staff, communicate expectations, and manage their time effectively.

4.1 Delegation

According to Kaplan Nursing (2023), nurses can delegate a task or group of tasks for which they are responsible to qualified care team members, such as registered nurses (RNs), licensed practical or vocational nurses (LPN/VN), and unlicensed assistive nursing personnel, such as patient care technicians. It is important to consider the five rights of delegation, which include the right tasks, right circumstances, right persons, right instructions/communication, and right supervision.

Right Tasks

Delegate tasks for clients who are stable and ensure that the tasks are related to routine care, such as activities of daily living and client transfers. It is not advisable to delegate tasks that involve clients who are unstable or tasks that involve clients who are unpredictable and complicated (Kaplan Nursing, 2023a). Nonprofessional staff should not be tasked with performing nursing assessment, nursing diagnoses, or any activities requiring professional skill and knowledge (Kaplan Nursing, 2023a).

Some tasks that may be delegated include:

  • Measuring and recording intake and output.
  • Measuring and recording height, weight, and vital signs.
  • Assisting with client transfers, transport, and bladder function.
  • Assisting clients with activities of daily living, such as dressing, hygiene, and sitting up in bed (Burke, 2023).

Right Circumstances

Consider whether the client is stable or unstable and whether the outcome is predictable or unpredictable. Delegate only those tasks that involve stable clients and those with predictable outcomes (Kaplan Nursing, 2023a).

Right Persons

Ensure the delegatee possesses the necessary education, skill, legal authority, experience, and whether the task(s) align with their job description and the policies and procedures of the healthcare facility or organization (Burke, 2023).
When evaluating their education, take into account the number of years of educational preparation and the skills required for graduation. For instance, an RN with a Bachelor of Science in Nursing has undergone more extensive training than an RN with an Associate Degree in Nursing, and the same distinction holds true for the latter nurse when compared to an LPN. All licensed personnel must have legal authorization to perform their assigned task, meaning that it must fall within their scope of practice determined by their educational background, licensure, and, in some cases, certification. Failing to operate within one's scope of practice can lead to the revocation of one's license. Thus, it is imperative for the delegator to be well-informed, but if they are not, the delegatee should decline to perform the delegated task(s) (Burke, 2023). Finally, it is crucial to assess each individual's level of experience instead of making assumptions. For instance, a recent graduate may have gained clinical experience during their educational program and may possess a passion and aptitude for specific client conditions.

Right Supervision

Supervise the designee as appropriate or indicated, and follow up on how the task was completed, demonstrating personal accountability and responsibility for the client’s care. Continuously monitor the care being provided, offer support and guidance to the designee, and assist in prioritizing care.

According to Burke (2023), it is also important to consider the client’s needs:

  • Are the client’s needs changing or consistent?
  • Do the clients require someone who must exercise their professional judgment, or do they need routine care?
  • Does the client need an individual with a specific skill or competency?
  • Do the clients have an acute or a stable chronic healthcare need?
  • Does the client have a common or an uncommon condition?

4.2 Communication

Clearly communicate tasks to the designated personnel and ensure that all completed tasks are documented in the client’s electronic health record. Communicate all aspects of care with both clients and their families and assess the impacts of all interventions.  It is vital to document any changes in the client's status and communicate them with the client’s healthcare provider and the nursing supervisor (Burke, 2023).

4.3 Time Management

Clients should receive care in a timely manner, and every healthcare team member needs to plan to complete their tasks without accruing overtime. Prioritize tasks, clarify assignments, follow a systematic approach, when necessary, it may be required to decline requests for assistance from others if assisting them would hinder the timely completion of your tasks (Burke, 2023).

By the conclusion of this learning experience, you will have enhanced your understanding of leadership, with an emphasis on delegation, communicating information to clients, designees, and care team members, as well as prioritizing and efficiently managing your time.

The resources listed below are curated to support your knowledge and gaining proficiency in appropriately delegating tasks. These resources aim to help you excel both in the NCLEX examination and your professional career.

After reviewing the resources, assess your strengths and weaknesses. Then, identify specific areas where you can improve and channel your efforts towards enhancing those skills.

  • Burke, A. (2023a, September 23). Assignment, Delegation, and Supervision: NCLEX-RN. https://www.registerednursing.org/nclex/assignment-delegation-supervision/
  • Kaplan Nursing. (2023a). Next Generation NCLEX-RN Prep 2023-2024: Practice Test + Proven Strategies (9th ed.).  Kaplan Test Prep.
  • Kaplan Nursing. (2023b). NCLEX-RN Content Review Guide (9th ed.). Kaplan Test Prep.

The following links do not belong to Tecmilenio University, when accessing to them, you must accept their terms and conditions.

Reading

  • Baker, E.  L. and Murphy, S.  A. (2022). Delegation: A Core Leadership Skill. Journal of Public Health Management and Practice, 28(4), 430-432. DOI: 10.1097/PHH.0000000000001545

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