...------------------------------------------------- Does delegation help or hurt nursing? A Research Paper April 11, 2013 Fiona Molloy Dr. McDonnell HAS 420 April 11, 2013 Fiona Molloy Dr. McDonnell HAS 420 Fiona Molloy Dr. McDonnell/Bill Miller HSA 420 Does Delegation Help or Hurt Nursing? Chapter One: The History of Nursing. The first nursing school was established in India in about 250 B.C., and only men were permitted to attend because men were viewed to be more pure than women. If you think of a woman dressed in scrubs with a stethoscope around her neck and a clipboard in her hands, you aren’t alone. An overwhelming majority of nurses in the United States today are women. However, nursing began as a practice reserved for men. It wasn’t until the 1800's that nursing became an organized practice. During the Crimean War, Florence Nightingale and 38 volunteer nurses were sent to the main British camp in Turkey. Nightingale and her staff immediately began to clean the hospital and equipment and reorganized patient care. Nightingale pushed for reform of hospital sanitation methods and invented methods of graphing statistical data. When she returned to Britain, Nightingale aided in the establishment of the Royal Commission on the Health of the Army. As a woman, Nightingale could not be appointed to the Royal Commission, but she composed the Commission’s report. (Travel Nurses of America, 2010) Completed, the report was over 1,000 pages in length and included detailed...
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...Continuing Education Effective Delegation: Understanding Responsibility, Authority, and Accountability Christine Mueller, PhD, RN, FAAN, and Amy Vogelsmeier, PhD, RN The obligation to provide safe, quality care creates challenges and concerns when registered nurses (RNs) delegate duties to unlicensed assistive personnel. These challenges and concerns are magnified in today’s health care environment of shrinking resources; patients with complex, chronic conditions; health care settings with high patient acuity rates; and the use of sophisticated technology. To make safe, effective delegation decisions, RNs must understand the responsibility, authority, and accountability related to delegation. Delegation decisions must be based on the fundamental principle of public protection. This article describes effective delegation by presenting the factors affecting delegation, explaining when and what an RN can delegate, and describing the delegation process. Learning Objectives ⦁ ⦁ ⦁ Identify three factors that affect delegation. Discuss what registered nurses can and cannot delegate. Explain the steps of the delegation process. N ursing’s Social Policy Statement (American Nurses Association [ANA], 2010), the Code of Ethics for Nurses with Interpretive Statements (ANA, 2001), and individual state nurse practice acts (NPAs) underscore the responsibility, authority, and accountability of registered nurses (RNs) for their nursing practice. The RN’s obligation...
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...1Care Delivery: Delegation Introduction The topic I have chosen to discuss in this essay is delegation, as from my experience this is one of the most complex nursing skills to develop, this claim is supported by literature (Weydt: 2010) Delegation is a suitable topic to discuss as it is a necessity for any nurse to be able to delegate effectively, especially in recent times in which nurses are stretched to their limits due to an increase in patient numbers and current government NHS cuts. The NHS is supposed to be protected from the public sector cuts, but new research shows that more than 50,000 jobs are disappearing from the NHS (Ramesh: 2011) Delegation has particular relevance to me as a third year student because knowing when, how and to whom you can delegate requires a complex understanding of the task in hand, the process of delegation, and the skills and existing workloads of the people available. It is especially important to achieve the right balance as a third year student, as delegating too much may result in a loss of control, while failing to delegate or not delegating enough can lead to duties not being completed. I will begin by discussing areas of delegation such as responsibility, accountability and authority. I will then move on to discuss aspects and principles of best practice. I will then continue to focus on managerial and organisational aspects relating to delegation, I will discuss these aspects using examples from practice. Delegation may be difficult...
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...These changes have subsequently led to the emergence need of registered nurses having to work with personnel who will assist them in their work. Delegation of tasks is important so that the nurse can have more time to critically reason, plan and coordinate healthcare given to patients. The act of delegating is attributed to the fact that, as a registered nurse, one has greater knowledge and critical reasoning ability than the assistive personnel. As a result, the RN has the responsibility of delegating, assigning and supervising the assistive personnel. According to the NCBSN and the ANA, appropriate delegation of tasks can result in effective and safe nursing care (NCSBN & ANA, 2006). In the case study given, the recently graduated registered nurse (RN) is new in the field, thus does not have enough experience with regard to attending to six patients during the morning shift. Six patients are too many for the new RN thus, need for the UHCW. Delegation of duties as stated earlier on should be done so that the registered nurse gets enough time to complete tasks that require his or her specialized attention and knowledge. The reason why the RN has delegated the UHCW to assess the patients’ vital signs is so that he or she can do the final touches with regard to personal hygiene care. This reason is not professional enough in that the RN can use the help of the UHCW in completing the personal hygiene care process. The UHCW can gather up the dressing the used up dressing materials...
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...DECISION TREE Nurse Delegation to Nursing Assistive Personnel (NAP) Step One – Assessment and Planning Are there laws and rules/regulations in place that support the delegation? [NMAC 16.12.2] Yes Is the task within the scope of practice of the delegating nurse? [NMAC 16.12.2] Yes Has there been assessment of the client’s needs? Yes No Do not delegate. No If not in the licensed nurse’s scope of practice, he/she should not delegate to NAP. Authority to delegate varies from state-to-state; licensed nurses should check the local jurisdiction’s statutes and administrative rules/regulations. No Assess client’s needs; then proceed to a consideration of delegation. Does the delegating nurse have competencies to make the delegation decisions required? Yes No Do not delegate until evidence of competency is obtained and is documented; then reconsider delegation. Does the procedure/task meet all the following recommended criteria for delegating to NAP? • • • • • • • Task/procedure is within the range of approved functions for the NAP. Task/procedure frequently recurs in daily care of client or group of clients. Task/procedure is performed according to an established sequence of steps. Task/procedure involves little or no modification from one client-care situation to another. Task/procedure may be performed with a predictable outcome. Task/procedure does not inherently involve ongoing assessment, interpretation, or decision-making which cannot be logically separated from...
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...Application of Benner’s theory to problem of delegation Introduction A frequent problem at work is that registered nurse's (RNs) are often reluctant to delegate tasks to unlicensed assistive personnel (UAP). Many patients at the hospital suffer from strokes, spinal injuries, brain tumors, dementia/Alzhiemer’s disease, or other devastating illnesses/injuries. Also, large hospitals and hospitals in urban areas tend to have numerous patients at the hospitals at any given time. Every day hospital units are quite busy and nurses are required to turn, feed, constantly observe for patient safety, bathe, and assist with elimination. RNs need to delegate the tasks or responsibilities to unlicensed assistive personnel (UAP) or other healthcare professionals....
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...Nursing Practice Act Rules Cindy Hersey Fortis College November 05, 2013 A professional nurse who lacks the knowledge, ability to understand, and competence to delegate care appropriately not only Puts the patient at risk for injury, but also puts his or hers license in jeopardy. The practice of nursing requires specialized Knowledge, skill, and independent decision making. The purpose of delegation was put into perspective when Corazzini et al. (2010) said delegation by RNs is a primary mechanism for ensuring that professional nursing standards of care reach the Bedside. RNs must be made aware of which nursing tasks can be delegated and which cannot. Most importantly , they must know that basic delegation skills will be expected in their first nursing job (Huston, 2008). Nursing Practice Acts are set up in each state to protect individuals who are being taken care of by nurses from unprofessional or unsafe nursing practices. Although the Nursing Practice Acts vary from state to state they all include information on the board of nursing, education standards, requirements for titles and licenses and grounds for disciplinary action. Also included are the standards and scope of nursing practice, these are the sections that will be focused on here (Nurse Practice Act Rules and Regulations, 2013). In the nursing field delegation is the process of transferring a selected task to another individual who is competent to perform the selected task. It is very...
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...Delegation Example in a Health Care Setting Presentation * The delegation model or process * The delegation issue in your work place * The stakeholders in their different health care roles * How you choose the right stakeholder for the job At the completion of this presentation the learner will know the delegation model process, be capable of identify issues in the workplace, how to choose the appropriate stakeholder to complete the job, and the stake holders in their different health care roles. By using a possible occurrence that can happen in the work place as an example we will walk through the delegation process. * How you communicate with the stakeholders * How you resolve conflict * How you know when to give feedback * How you evaluate the problem solved * Relevant recommendations With communication being the most important aspect of delegation, we will discuss how to communicate with the stakeholders, resolving conflict, different ways to know when to give feedback, different evaluation methods to problem solve and relevant recommendations. * Know Your World * Know Yourself * Know What Needs To Be Done * Know Your Delegate * Communicate * Resolve Conflict * Feedback/Evaluate First, we will need to know what the definition of delegation is. According to Hansten and Jackson (2009), the National Council of State Boards of Nursing states that delegation is the “transferring to a competent individual...
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...Question I Assigning fault in this case is difficult because all the facts are not presented; there are so many details and questions that are left unanswered to make a justified decision as to who really is at fault in this case. That being said I would not place fault to anyone in this case, however everyone involved in this case has some shared responsibility to the patients care. During report Jane is told that the patient fell without injury around lunch time but has had an uneventful evening. At my current place of work VA Hospital there is a Fall Prevention Program with a Post Fall Management Protocol in place, these are measures that are to be implemented after a fall by nursing, and multidisciplinary team members they are; assess for injuries and determine level of injuries, assess vital signs, including sitting/standing blood pressure and pulse, If diabetic, check blood glucose, notify physician/medical provider, The provider of or on-call physician will assess patient within one hour, provide care, order any needed diagnostic tests, medications, etc., complete a Report of Fall Incident Note and document circumstances of fall in medical record, notify all team members of the patient’s fall, complete Fall Risk assessment and implement high risk fall interventions, if indicated. First 24 hours after the fall: obtain vital signs every 8 hours, observe for possible injuries not evident at the time of the fall (assess limb reflex, joint range of motion, weight bearing)...
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...Effective Delegation Erik Blashak Clarion University of PA Nurs 340: Nursing in Transition September 19, 2016 Effective Delegation as a Nurse Manager Gaudenzia, Common Ground is located in Harrisburg, Pennsylvania. The facility is a 34 bed in-patient, non hospital, drug and alcohol rehabilitation. It is also licensed for dual diagnosed clients, and has a ten bed detoxification unit. There are ten female beds and twenty four male beds, including the detoxification clients. The client turnover rate is very high, and this adds pressure to the nursing department. There are two registered nurses and four licensed practical nurses on staff. At least one nurse is on duty twenty four hours a day. There is one nurse manager who works on the floor. The average nurse ratio is 17:1. The reason it is so high is because most clients are medically stable once they are done with detoxification. There are many nursing...
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...Introduction • Delegation is the assignment of authority and responsibility to another person to carry out specific activities. • The person who delegated the work remains accountable for the outcome of the delegated work. • Delegation provides a means for increasing productivities. • Delegation empowers a subordinate to make decisions. Definitions • Delegate- “to entrust to another; to appoint as one’s representative; to assign responsibility or authority”. • Delegation- “the act of empowering to act for another”. • "Delegation is defined as the transfer of responsibility for the performance of a task from one person to another" • "Transferring to a competent individual the authority to perform a selected nursing task in a selected nursing situation . The nurse retains accountability for delegation" • "The transfer of responsibility for the performance of an activity from individual to another while retaining accountability for the outcome". (American Nurses Association) • Delegation is appointing a person to act on one's behalf 5 Rights to delegation (NCSBN) NCSBN in US presents 5 rights to delegation from the perspectives of both nursing service administrator and staff nurse. 1. Right task 2. Right circumstance 3. Right person 4. Right direction/communication 5. Right supervision/evaluation Delegation Process 1. Define the task 2. Decide on the delegate 3. Determine the task 4. Reach an agreement 5. Monitor performance and 6. provide...
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...Delegation Example in a Healthcare Setting Abiola Edwards April22, 2010 Introduction * Definition of delegation * Delegation process * Delegation issue one faces at work * Stakeholders in their different roles * Choosing the right stakeholder * How to communicate with stakeholders * Conflict resolution * Feedback/ Evaluation * Recommendations * Summary * References My name is Sadie Edwards and I have over 10 years of nursing experience Definition of Delegation Delegation: Transferring to a competent individual the authority to perform a selected nursing task in a selected situation. The nurse retains accountability for the delegation. Concepts and Decision-Making Process National Council Position Paper, 1995 Most nurses would rather do the tasks themselves, but they can not perform all of them safely. According to Hansten & Jackson, “it is our responsibility to the patients we care for to ensure that they receive the best that we can offer by delegating wisely”. Delegation Process * Define the task * Select the individual or team * Assess ability and training needs * Explain the reasons * State required results * Consider resources required * Agree to deadline * Support and communicate * Feedback and results Alan Chapman, Delegation 1995-2009 The steps to successful delegation are: 1. To define the task, ask yourself if the task is right to be delegated. Does it meet the criteria...
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...non-licensed personnel is by professional nurses, staffing requirements are based on acuity levels and optimum staffing models, and nursing leadership and management as areas I would address as a nurse manager. As a registered nurse you are responsible for the supervision of unlicensed direct care staff in the performance of nursing tasks and activities. It is the responsibility of the nurse manager and the company to ensure that all staff is adequately trained regarding the elements of supervision and delegation of duties. As a nurse manager address the following will help improve quality of care for patients. The initial training of the task or activity, and periodic inspection of the actual act of accomplishing the task or activity are important for proper patient care. The amount and type of nursing supervision required will be determined by the registered nurse responsible for supervising the task or activity, and will depend upon the complexity of the task, the skill, experience and training of the staff, and the health conditions and health status of the patient (Potter & Kuhrik, 2010). The purpose of delegation is to gain work efficiency, which can only be achieved when registered nurses and patient care technicians work together in partnership to manage the changing priorities of care within a patient care assignment (Potter & Kuhrik, 2010). Delegation is not only key for the registered nurse it is key for the nurse manager. Delegation is the link that joins organizational...
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...Running Head: DELEGATION AND SUPERVISION Delegation and Supervision Delegation and Supervision In the area of nursing, delegation and supervision often go hand in hand. Supervising is providing guidance for a specific nursing task. A qualified nurse with the goal of making sure the task is accomplished properly and correctly does this supervision. Usually this is the job of a nurse manager and that person is liable for assigning, delegating and supervising of activities. If the manager fails to assign, delegate and supervise these activities within acceptable standards of nursing practice, she can be accused of malpractice. Delegation is assigning a task to another person who is competent and qualified to perform that task. Only the task can be delegated. The person performing the task must have the knowledge, skill, and judgment to complete it. According to Yoder-Wise (p. 65) delegation is the transfer of responsibility for the performance of an activity from one individual to another, with the delegator retaining accountability for the outcome. An example of this is when the RN delegates some of the patient ADL’s to a CNA or a tech. When the RN delegates these tasks, he/she retain the accountability and responsibility for making sure that that delegated tasks is actually completed in a competent manner. The benefits of delegating a task are that the RN has more time to complete the multitude of things on her work list. The barriers are that the...
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...2003, p. 268). Accountability is defined as, "being responsible and liable for actions or failure of actions of oneself or others in the context of delegation" (NCSBN, 2009). This is in reference to the nurse's legal liability for the actions taken and patient outcomes. Accountability and responsibility are different, as responsibility belongs to the person doing the task and accountability belongs to the person who assigned the task. The nurse is both accountable for the task being completed and is also responsible for the patients in their care. (RCN, 2010) Accountability and responsibility are two essential parts of delegation. DeWits and O’Neill (2014) define delegation as "transferring the authority to perform a selected nursing task in a selected situation to a competent individual ". When delegating, the registered nurse (RN) allocates nursing tasks to health care assistants (HCAs) while still remaining accountable for the patient and the task that was assigned. Delegating is a management technique that is used to provide more efficient care to patients. (NCSBN, 2009) Permitting HCAs to take on nursing responsibilities allows the nurse to complete other tasks that need to be completed; however, delegation is done at the nurses' discretion and is a personal choice. Nurses need to make careful decisions regarding delegation, taking into account the skill and training of the HCA, the difficulty and risk of the task, and the patient's condition. The expected outcomes, a time...
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