Nursing Delegation: The 5 Rights & Key Considerations | Lecturio Nursing Leadership

Summary

This educational video emphasizes the critical skill of delegation for nurses, particularly for those new to the profession. It outlines the importance of assigning tasks to other nursing staff while maintaining accountability for the outcomes. Key considerations for effective delegation include assessing potential harm, task difficulty, required critical thinking, and patient interaction levels. The video also addresses common barriers to delegation and provides practical advice on how to delegate tasks appropriately, ensuring quality patient care and legal safety.

Takeaways

• 😀 Delegation is a crucial skill for new nurses to manage their workload effectively.
• 🔍 Delegating tasks in nursing involves transferring responsibility for a task to another staff member while retaining accountability for the outcome.
• 🤔 Before delegating, consider the potential for harm, task difficulty, required problem-solving, and predictability of the outcome.
• 👥 Understand the level of patient interaction needed for the delegated task to ensure the right person is chosen for the job.
• 📋 The '5 rights of delegation' include selecting the right staff, delegating the right task, considering the right circumstances, clear communication, and supervisory evaluation.
• 👩‍⚕️ In high-acuity situations, it's vital to choose a registered nurse for tasks involving unstable patients, like new admissions.
• 📢 Clear communication is essential when delegating tasks to ensure the staff member understands what and when to do it.
• 🚫 Barriers to delegation can include time pressures, heavy documentation, lack of education on delegation, and unfamiliarity with team members' skills.
• 📝 Effective delegation involves identifying tasks based on client needs, ensuring the right education and skills for the task, and supervising and evaluating the delegated work.
• ⏰ Organizing the workload and managing time effectively is key for both the delegator and the delegatee.
• 🛡 Accountability for the delegated task remains with the delegating nurse, emphasizing the importance of proper assignment and supervision.

Q & A

What is the definition of delegation in nursing?

Delegation in nursing is the transfer of a nurse's responsibility for the performance of a task to another nursing staff member, while ultimately holding accountability for the outcome.

What are the considerations to keep in mind before delegating a task in nursing?

Before delegating, consider the potential for harm, the difficulty of the task, the amount of problem-solving and innovation required, and the predictability of the outcome.

What are the '5 rights of delegation' in nursing?

The '5 rights of delegation' include selecting the right staff member, delegating the right task, considering the right circumstances, giving clear directions and communication, and ensuring supervision and evaluation of the task.

Why might a registered nurse be hesitant to delegate tasks?

Registered nurses might hesitate to delegate due to time pressures, feeling that tasks are easier to complete themselves, having a lot of documentation to do, lack of education on delegation, or discomfort with the skills of unlicensed or less experienced staff.

What are the barriers to effective delegation in a nursing setting?

Barriers to delegation include time pressures, heavy documentation, lack of education on delegation, and unfamiliarity with team members' skills.

How does a nurse ensure effective delegation?

A nurse ensures effective delegation by identifying tasks based on client needs, ensuring the appropriate education and skills of personnel, assigning and supervising care, communicating clearly, organizing workload, and evaluating the delegated task and staff member's performance.

Why is it important for a registered nurse to evaluate the delegated task?

Evaluating the delegated task is important for the registered nurse to ensure the correct completion of the activity and to provide opportunities for peer coaching and professional development.

What tasks can unlicensed assistive personnel (UAP) typically perform?

Unlicensed assistive personnel can typically assist patients with bathing, collect vital signs, and weigh patients, among other tasks within their scope of responsibility.

Which tasks require a licensed nurse, and why?

Tasks such as IV flushes, wound dressing changes, and applying oxygen to patients require a licensed nurse due to the complexity and potential for harm, which necessitates the higher level of training and accountability.

What is the key takeaway from the discussion on delegation in nursing?

The key takeaway is that while responsibility for tasks can be delegated, accountability cannot. The registered nurse remains accountable for client care and must ensure proper delegation to maintain quality and safety.

Outlines

00:00

📘 Delegation in Nursing: A Key Skill for New Nurses

This paragraph introduces the concept of delegation in nursing, emphasizing its importance for new nurses. Delegation is defined as the transfer of a nurse's responsibility for a task to another staff member while retaining accountability for the outcome. The paragraph outlines several factors to consider before delegating, such as the potential for harm, task difficulty, required critical thinking, and predictability of the outcome. It also introduces the '5 rights of delegation', starting with selecting the right staff member and considering the context and circumstances for effective task delegation. The importance of clear communication and the registered nurse's role in supervising and evaluating delegated tasks are highlighted, along with potential barriers to delegation, such as time pressures, documentation burdens, lack of education on delegation, and unfamiliarity with team members' skills.

05:01

🛠 Effective Delegation Strategies and Task Assignment

This paragraph delves deeper into the strategies for effective delegation, focusing on identifying tasks based on client needs, ensuring the personnel's education, skills, and experience match the delegated task, and the importance of assigning and supervising care provided by others. It stresses the necessity of clear communication of tasks and the expectation for delegated staff to report any client concerns immediately. The paragraph also discusses the importance of workload organization for effective time management and the evaluation of delegated tasks to ensure correct completion and provide opportunities for peer coaching and professional development. It concludes with a practical example scenario involving a busy hospital unit, where the audience is challenged to determine which tasks can be delegated to unlicensed assistive personnel, highlighting the registered nurse's ultimate accountability for the appropriateness and supervision of delegated tasks.

Keywords

💡Delegation

Delegation in the context of the video refers to the process by which a nurse assigns tasks to other nursing staff members while retaining accountability for the outcomes. It is a critical skill for new nurses to manage their workload effectively and ensure quality patient care. The video emphasizes the importance of proper delegation to prevent harm and maintain high standards of care.

💡Accountability

Accountability is the responsibility that a nurse holds for the tasks they delegate to others. Even though tasks can be delegated, the registered nurse remains ultimately responsible for the results. This concept is central to the video's message, highlighting the nurse's duty to supervise and evaluate delegated tasks to ensure they are completed correctly.

💡Nursing Staff

Nursing staff encompasses various healthcare professionals, including registered nurses, licensed practical nurses, and unlicensed assistive personnel. The video discusses the importance of selecting the appropriate staff member for delegation based on their qualifications and the nature of the task, ensuring that the right person performs the right task under the right circumstances.

💡Task Difficulty

Task difficulty is a consideration when delegating, referring to the complexity of the task and the level of expertise required to perform it. The video script mentions evaluating the potential for harm, the need for critical thinking, and the predictability of the outcome as part of assessing task difficulty before delegating.

💡Critical Thinking

Critical thinking is the ability to analyze situations and make sound judgments. In the context of the video, it is a factor to consider when delegating tasks, as some tasks may require a higher level of critical thinking and problem-solving skills, which might not be appropriate to delegate to less experienced staff.

💡Patient Interaction

Patient interaction refers to the level of communication and engagement required with patients when performing a task. The video script discusses this as a consideration for delegation, as tasks that require more patient interaction may need to be performed by staff with the appropriate skills and experience to ensure positive patient outcomes.

💡5 Rights of Delegation

The 5 Rights of Delegation are a framework to guide proper delegation in nursing. The video mentions these as ensuring the right staff member is selected, delegating the right task, considering the right circumstances, clear communication of directions, and the ability to supervise and evaluate the task. These rights are essential for effective delegation and maintaining patient safety.

💡Barriers to Delegation

Barriers to delegation are factors that may prevent a nurse from effectively delegating tasks. The video identifies time pressures, heavy documentation requirements, lack of education on delegation, and unfamiliarity with team members' skills as potential barriers that can hinder the delegation process.

💡Quality of Care

Quality of care is the standard or level of healthcare provided to patients. The video emphasizes that proper and appropriate delegation of tasks is crucial for facilitating quality care. In contrast, improper delegation can lead to poor outcomes and potentially jeopardize patient safety.

💡Legal Consequences

Legal consequences refer to the potential legal ramifications that may arise from improper delegation, such as patient harm or substandard care. The video script warns that inadequate delegation could lead to legal issues, underscoring the importance of the registered nurse's accountability in the delegation process.

💡Peer Coaching

Peer coaching is a professional development technique where colleagues provide feedback and guidance to one another. In the video, it is mentioned as a way for the delegating nurse to offer improvement opportunities to the staff member who performed the delegated task, enhancing their skills and contributing to better patient care.

Highlights

Delegation in nursing is a critical skill, especially for new nurses, involving transferring responsibility for a task to another staff member while retaining accountability for the outcome.

Considerations for delegation include potential for harm, task difficulty, required problem-solving, and predictability of the outcome.

The '5 rights of delegation' include selecting the right staff member, delegating the right task, considering the right circumstances, clear communication, and ensuring supervision and evaluation.

Selecting the right staff member involves matching the task to the individual's licensing and capabilities, especially in high-acuity situations.

Clear communication is vital when delegating tasks to ensure the staff member understands exactly what is expected of them.

Barriers to delegation may include time pressures, heavy documentation, lack of education on delegation, and unfamiliarity with team members' skills.

Effective delegation involves identifying tasks based on client needs, ensuring the right education and skills for the task, and assigning and supervising care.

Communication of tasks and immediate reporting of client concerns is essential in the delegation process.

Organizing workload and managing time effectively is crucial for both the delegator and the delegatee.

Evaluating the delegated task ensures the correct completion of the activity and provides opportunities for peer coaching and professional development.

Evaluating the staff member's ability to perform tasks and their time management skills is important for ongoing improvement.

Unlicensed assistive personnel can perform tasks such as assisting with bathing, collecting vital signs, and weighing patients.

Tasks like IV flush, wound dressing change, and applying oxygen are within the scope of responsibility for licensed personnel.

The registered nurse remains accountable for the appropriateness and supervision of delegated tasks, regardless of who performs them.

Delegation is a daily decision that impacts the quality of care, client safety, and potential legal consequences.

While responsibility can be delegated, accountability remains with the delegating registered nurse for client care.

Understanding delegation is key to facilitating quality care and avoiding negative outcomes in nursing practice.

Transcripts

Welcome back everyone. Today, we're going to be talking about an incredibly important skill

especially for the new nurse. Delegation. Imagine, a brand new nurse coming in to one of her

very first shifts at an organization and she has an incredible list that she has to accomplish.

How is she going to get it all done? Delegation. So delegation in nursing is a transfer of the

nurse's responsibility for the performance of a task to another nursing staff member. Well,

ultimately, holding accountability for the outcome. So there are several considerations to

delegation. You want to think before you delegate a skill or a task to someone else. What is the

potential for harm? Can the patient get harmed in the task that you are delegating to another

individual? How difficult is the task? What is the amount of problem solving and innovation

required? In other words, does it require critical thinking? What is the predictability of the

outcome? For example, are you going to delegate a task that could be medication to an unstable

patient? You don't know what it is or what the outcome may be for that particular client, or are you

delegating a skill such as a bad bath to a stable client? And then, what is the level of patient

interaction needed for the skill or the task that you are transferring or delegating to the other

individual? The image like we have rights of medication administration, we also have 5 rights of

delegation. First, you want to ensure that you are selecting the right staff member whether they are

licensed or unlicensed to delegate the task to. You have to make sure that you're delegating

the right task based on the circumstances. Thinking of circumstances, what are they? What is

the context around why you are delegating the task and what is going on at that particular

moment. So for example, if you have a new admission coming in and you know this patient is going to

be unstable and they need a full admit and they're probably going to be needing medications,

when you're thinking about selecting a staff member you would need to select a registered nurse

to be able to admit the new client coming in that is possibly unstable. And so those are all 3 of

these are encompassed in this one example to understand how you can select the right person

with the right task under the right circumstances for that specific situation. You also want to

be able to think about the directions and communication that you are giving the staff member

that you're delegating the task to. Communication is clear. You need to make sure that you're giving

them very clear directions on exactly what and when to do what you need to be completed.

And finally, as a registered nurse, you need to be able to ensure that you're able to supervise

and evaluate the task that was completed. Now sometimes, there are some barriers to delegation.

Now why would we have any barriers to delegation? Well first, as registered nurses, we are

incredibly busy throughout our shift. So sometimes, time pressures can actually prohibit us

from delegating a task. It seems counter intuitive but a lot of times when we're really busy we

just think it's easier for us to complete the task rather than to give it to another person.

Similarly, when we are registered nurse, we're all registered nurses, do documentation. Sometimes

when we have a lot to document, again we feel like we don't have the time to delegate. We know that

we are going to be ultimately accountable for it so we feel comfortable completing the task

ourselves rather than to delegate it to another individual. Sometimes, depending on your

organization, there may be lack of education on delegation so even seasoned nurses and new nurses

may not know exactly who they can delegate task to or how to evaluate it. So, instead of doing

it, they just prefer not to delegate and they just do the skills themselves. And finally, depending

on the type of care model that's adopted within your organization depending on which team members

you're working with, you may or may not be comfortable with the skills of an unlicensed assistant

personnel or even another registered nurse or another licensed practical nurse because you

just haven't worked with them that long and until you've had the opportunity to work with certain

team members you may not feel comfortable delegating task until a relationship has been established.

So there are some important aspects to effective delegation. You want to make sure that you identify

the tasks for delegation based on the client needs. That's paramount. You need to be sure that

what the client needs dictates what type of tasks and to whom you delegate them to. You want to

ensure the appropriate education, skills, and experience of the personnel performing the delegated

task. You also want to assign and supervise the care provided by others. That is your responsibility

as a registered nurse. Terribly important is communicating tasks to be completed and then ensuring

that you tell the person that you're delegating to to report any client concerns to you immediately.

You also want to organize the workload to manage the time effectively and that holds true for

you as well as to the person that you're delegating the task to. Make sure that everything is

there in regard to workload. You want to evaluate the delegated task to ensure that the correct

completion of the activity occurred. This is really important because as a registered nurse you

are accountable for the activity that was delegated and this gives you an opportunity to actually

make sure that it was completed and to also possibly even give some peer coaching to the person that

you delegated the task to in case they need some opportunities for improvement in that area.

You also want to evaluate the ability of the staff member to perform the assigned tasks for

the position. And finally, you also want to evaluate the effectiveness of the staff member's

time management skills. Even though you were assessing the situation at the time and you delegated

the task and everyone felt that they had enough time to complete the task, that may not have

been the case. So this is a great opportunity to evaluate that and to evaluate those time management

skills of the staff, again so that you can help with some peer coaching and some professional

development there as well. So now we're going to do a really great example to see if you're

able to figure out what type of skills someone can do or that you can delegate as a registered

nurse. So your hospital patient care unit is full and it's busy with high acuity patients. The shift

is somewhat short staffed but Susan, an unlicensed assistive personnel and then Beth, a licensed

practical nurse, has been floated in to help the registered nurses. Which of the following tasks

might be delegated to Susan, the unlicensed assistive personnel? Can she assist the patient

with a bath, perform an IV flush, perform a wound dressing change, collect vital signs, weigh

the patient, or apply oxygen to the patient? I'm going to give you just a moment to look through

these options and select more than one if possible, select all the correct answers. So if you

selected assisting a patient with the bath, collecting the vital signs, and weighing a patient,

you are correct. All of these activities do fall under the scope of responsibility of an unlicensed

assistive personnel. An IV flush, a wound dressing change, and applying oxygen to a patient all

fall under the scope of responsibility for a licensed personnel. So it's incredibly important to

remember that the nurse, the registered nurse, is ultimately accountable for the appropriateness

and the supervision of the delegated task. So what do we learn today? We learned that the assignment

of care to others including nursing assistants, licensed practical nurses and even other registered

nurses, well it's perhaps one of the most important daily decisions that a nurse makes everyday.

Proper and appropriate assignments facilitate quality care. If they're not, if they're improper

and they're inappropriate assignments that can actually lead to poor quality of care, disappointing

outcomes, and also could possibly jeopardize client's safety leading to possible legal consequences.

So it's important to remember, responsibility can be delegated but accountability cannot be

delegated. The delegating registered nurse does remain accountable for client care despite the

fact that some of these aspects of care can and are delegated to others. So I hope you've had

a really great time understanding a little bit more about delegation. Thank you so much for

watching this video.