...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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...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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...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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...------------------------------------------------- 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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...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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...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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...of view on several facets of nursing today. The information provided will speak to lessons learned in the Everest College Nursing program. Topics covered shall consist of a reflection of the personal nursing philosophy, impact and concepts of the Nursing Code of Ethics and how it applies to Nursing as a profession, the concept of patient centered care, use of technology in documentation, and the leadership aspects that are considered as a new graduate. Leadership aspects entail team leading, delegation, and role transition from graduate to RN. This is the point of view of the author and information given here will be both objective and subjective. Nursing Philosophy In a previous paper written, the reflection of this student’s own nursing philosophy seemed to coincide with that of Florence Nightingale as well as Dorothy Orem. Orem’s school of thought leans toward the nurse having a large hand in aiding a patient to achieve total self-sustainability. Dorothy Orem’s theory is actually three separate theories that work synergistically. These theories are the theory of self-care, theory of self-care deficit, and the theory of Nursing systems. This works well for a patient, when achieved, due to the self-care aspect. Someone whom is actively involved in their own progress displays an inherent will to do well by oneself. This promotes compliance which can be a large barrier in healthcare. Education is an extremely important aspect in all of nursing but even more so in this philosophy...
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...& VALUES Delegation Orchid Quiton Chefalo Western Governors University Nursing Program 11/11/2011 Revised 11/30/2011 12/10/2011 SUBDOMAIN 724.7 - PROFESSIONAL ROLES & VALUES 2 Delegation It takes a team approach to manage patient-care. As a FNP, and a provider for this patient, she could collaborate with other experts and delegate care of the patient. The nursing supervisor for the clinic can aid the FNP to identify her role in the best utilization of the diverse workforce by facilitating the coordination of care by employing the experts and give an introduction of what services each specialty can offer to meet the needs of the patient. Examples of the roles of the diverse workforce are as follows: The LVN educator can give one to one instructions and education in pre-partum, intra- partum and post-partum care; The social worker can interview the patient’s life condition like the family dynamics and make appropriate recommendations for the patient to be successful at home; The community health RN, BSN can use her knowledge on what specific resources the patients needs within the facility and/or outside the community; The obstetrician can be consulted, and may expedite the care of the patient by making the recommendation to transfer to a higher level of care. As the nursing supervisor, it is a...
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...Delegation in nursing is the most evident but yet most overlooked of management skills. Integrating this ability is an essential constituent within the scope of the nursing practice. The American Nursing Association (2006) defines delegation as, “The transfer of responsibility for the performance of a task from one individual to another while retaining accountability for the outcome”. With the anticipation of the baby-boomer generation and the utilization of unlicensed nursing assistive personnel (NAP) on the rise; how will healthcare prepare for such conditions? By distinguishing the nature of communication as well as personal interaction during delegation, may better clarify how both roles work together to carry out patient care and...
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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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...Delegation and Ethical Decision Making Student’s Name Institution Date Question 1 Delegation Delegation is a process by which a task’s responsibility and authority is transferred to individual who accepts the transfer. It is based on effective up-down and down-up communication in an organization or unit. However, the delegator retains accountability for the tasks delegated (Lipe & Beasley, 2004). The five rights of delegation are the right task, circumstances, person, communication and supervision. Considering the right task, a task may only be delegated if the delegator has responsibility and authority over it and if it has not been delegated to them. From the right circumstances, a task is appropriate for delegation if it does not involve personal information or confidential issues that the person is not allowed to access. Considering the right person, tasks that require specific skills, knowledge and attitudes can only be delegated to a person who has such qualities. The right communication implies that a task will be appropriate for delegation if there are clear instructions and information concerning it. Lastly, a task that requires a certain level supervision and monitoring, cannot be delegated unless that level of monitoring and supervision is available. These rights of delegation are applied in decisions concerning what tasks a manager will delegate and to whom the tasks will be delegated (Lipe & Beasley, 2004). Question 2 Ethical Dilemmas The...
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...Delegation Paper Delegation Paper The definition of delegation, according to the medical-dictionary.com, is delegation of Administrative authority responsibility transfer to a person of lower license from the person of higher license, while remaining responsible for the actions of the outcome. The RN must have trust and confidence in the team members they are delegating to be able to delegate effectively and with minimal stress for themselves (Harris, 2007). With the determining of competence and appropriateness of the task to be delegated, there are many things to consider. According to the nursing practice act, the RN is authorized to delegate to lower licensed staff with ongoing supervision to help patients receive a quality of health care. The RN has to evaluate the patient for stability, condition, and abilities of the team to perform the task (Joint Statement on Delegation). One of the difficult responsibilities for an effective delegation of responsibilities is that the RN understands the families and patients need to be able to assign the right team member with a compatible personality. This is important because the family and the patient have to be able to trust the staff member assigned to them to help with managing care and having a RN, LPN, and CNA that work well as a team will benefit any and all patients. It has been stated, many times, in different articles, that the RN delegation skills are not checked off like the other clinical skills are the...
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...Philosophy of Nursing The environment in which the patients are in plays a big role in their healing process. Florence Nightingale founded her nursing theory and philosophy on enhancing environmental factors to improve the patients overall health, healing and well-being. Nightingale's attention to environment has added significance to the role environmental conditions play in human health status (Shaner, 2006). In Nightingale’s book, Notes of Nursing, she reflects on how air and water quality, noise, light, and diet and nutrition enhance the healing process. Maslow’s Hierarchy of Needs is similar to Nightingale’s theory of nursing. They both believed that one’s basic needs must be met before they could achieve an optimal level of functioning. I believe that a noisy, uncomfortable environment, along with an unappealing diet will make the patient miserable and uncomfortable. When one is miserable and uncomfortable, it makes it very difficult to achieve a successful outcome. Nightingale believed that her nursing career was a calling from God. She utilized her attributes of love, compassion and veracity to promote quality care of the patient. Nightingale proved to be a provider of care, as she integrated holistic human needs in the provision of safe and effective nursing care. The holistic approach to medicine attempts to treat both the mind and the body. I thoroughly believe that a person’s social, mental, and physical conditions all contribute to the healing process...
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...Understaffing is one of the major problems encountered not only by the hospital administration but by the nursing staff and patients as well. An over fatigue nurse due to workload is reflected through her performance in rendering nursing care and by the way she approaches or treats her patients. Patients tend to be sensitive due to their present conditions; a stressed nurse can be easily recognized by the way she talks, acts and reacts. As a nursing leader in the future, I will ask my subordinates what they could contribute to make the nursing services better in spite of shortage of staff. I will motivate them to provide potential solutions whenever influx of patients comes. The spirit of camaraderie among nurses must be developed because each member of the team plays an important role in the care system; the absence of one may paralyze the operations and may endanger the whole performance of the unit. Through team work, working with colleagues and dedication to work and co-worker will be strengthened with an effort to provide utmost patient care. Further, organizing the work load in an equal and efficient fashion is another method to demonstrate teamwork. And, it allows staff to accomplish their goals in lieu of short staffing. Effective delegation between licensed nurse and nursing attendants also reduces the fatigue of one person, it reduces overall negativity, and it enhances morale in a fashion similar to teamwork. Moreover, ward nurses performing same routine procedures...
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...leaders are born and not made, whereas the trait theory categorizes leaders as that of certain qualities that correlate with leadership skills. The situational theory, on the other hand, gives significance to the particular situation for a leader to be effective. Contemporary type of leadership seems to be the practice of modern kinds of leaders. The contemporary theory of leadership combines the leaders, his/her followers, and the situation at hand for leadership to be effective. Our group all agree that the Kaiser Permanente Ambulatory setting practices both the contemporary and trait theories of leadership. We have seen leaders and managers appointed to their positions based on their attribute from people they know and some appointed based on support from their team members. The nurse leaders especially are selected based on how involved they are with their teams, how they manage conflicts and their performance on fiscal responsibility. The nurse leaders are recognized as followers of the mission and vision of the organization, that is, providing quality and affordable care for members and the vision for the organization as a leader in healthcare in the country. Leadership Theory of Each Key Player in KP Ambulatory Care Nursing Practice The Department Administrator (DA), Provider/Physician (MD), Registered Nurse (RN), and the Licensed Vocational Nurse (LVN) are our key players in our leadership change proposal. Being the department head, the administrator has the ultimate...
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