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Delegation Paper

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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 help in delegating appropriately. "Delegation is a complex process in professional practice requiring sophisticated clinical judgment and final accountability for patients' care (National Council of State Boards of Nursing [NCSBN], 2005).
With the different complexities and variability’s the RN needs to do, a thorough assessment of each situation to figure out the appropriateness for the delegation. The NCSBN defines delegation as "giving someone a task from the delegator's practice" (NCSBN, 1995, p.l). With this assignment, the receiving nurse has to have the skills and confidence with their skills to perform that delegated task within the practice act, policy and procedures, and knowledge base. The definition of the assignment is "giving someone else a task within his/her own practice and is based on job descriptions and policies" (NCSBN. 1995. p.l). With this knowledge, trust and confidence, each team member will help with the assignments and delegation of staff members to help understand why there cannot be a simple list of what can be delegated to staff with certain skill levels [ (Wedyt, 05) ].
In my personal work, we have an Admissions Nurse that has knowledge of each staff member and the skills list that they are able to do confidently, safely, and efficiently with the different types of patients. We have LPN's that strictly do medication set up, blood glucose and insulin administration, with minimal assessments needed. We have a couple of LPN's that are higher functioning with assessment skills, wound care, calling Doctor's with reports, and able to confidently take more complex patients. This is important when assigning staff members to new patient, in having a good experience for the patient, family and team members. It provides quality of care and good references for later business.
Knowing the skill level of each team member helps increase the confidence with coworkers and helps with the success of delegating. If an RN does not have confidence in his or her coworkers, he or she will not delegate tasks. This can be a problem for two reasons; the first is that the RN will not delegate tasks that could and should have been assigned, and second the being, tasks assigned to a UAP may be inappropriate. With the RN having knowledge, confidence and appropriate job descriptions with the skill's list of the team member, this can go against practice acts for the person. Job descriptions that are vague can make the accountability and delegation process a challenge for the RN. The RN must know what the right circumstances and right tasks are to transfer care in a downward transfer of accountability and authority of the transfer based on the team member’s skill level and knowledge of the specific task. The RN must be available for questions and guidance after the staff receiving the delegated patient has accepted the task.
With the right supervision, the lower level staff member should report back to the RN in a timely manner with all progress or the patient needed more care than lower level staff member could provide. Communication is an important part of the delegating process with the completion of each task in a timely manner. The RN should be able to complete other tasks, which can be only completed by them, in a timely manner. The lower level staff member should be held accountable for the work performed with positive and guidance with other aspects that need growth. With the constructive criticism, it provides both bases for the RN and the staff member to understand the ability of that particular person [ (Quallich, A Bond of Trust Delegation) ].
With any kind of delegation, there are still barriers. Nurses who are not confident with their own skills may feel that delegating diminishes their role as an RN and can cause burnout. This causes an ineffective environment for handling care efficiently for good health care. RN's need to have delegation teaching to ensure they are able to do the appropriate tasks that cannot be delegated. RN's should have skills that allow them to implement a mix of staff to take care of a patient effectively and efficiently for a good leadership role model. The RN should have knowledge of the state practice act and the company's policy and procedures to be able to delegate to lower level team members effectively. [ (Johnson, 1996) ]
The ANA Code of Ethics (2001) has the “Five rights to Delegation” and also “Five rights of Delegation” that was developed by the NCSBN (1995) that include: 1) the right person, 2) the right communication and direction, 3) right task, 4) the right circumstances, and 5) the right supervision. With this model, a RN should be able to delegate effectively and efficiently for the continuing care of any patient [ (Wedyt, 05) ].

References:
Joint Statement on Delegation. (). Retrieved from https://www.ncsbn.org/Delegation_joint_statement_NCSBN-ANA.pdf
Harris, L. (04/2007). Professional Boudaries and Competence. Retrieved from http://search.proquest.com.ezproxy.apollolibrary.com/docview/230431465
Quallich, S. (). A Bond of Trust Delegation. Retrieved from http://search.proquest.com.ezproxy.apollolibrary.com/docview/220154111
Johnson, S.H. (03/1996). Teaching Nursing Delegation: Anaylizing Nurse Practise Acts. Retrieved from http://search.proquest.com.ezproxy.apollolibrary.com/docview/915527430
Weydt, A. (05/2010). Developing delegation skills. Retrieved from http://search.proquest.com.ezproxy.apollolibrary.com/docview/763483864

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