Posted: April 25th, 2025

Discussion 2 MIN

Discussion 2

Review Chapter 9 slide in module

Activity:

Examine the five factors to be assessed before delegating (potential for harm, etc.) for a particular task.

In making a decision to delegate a nursing task, the following five factors should be assessed:

1. Potential for harm: The nurse must determine how much risk the activity carries for an individual patient.

2. Complexity of the task: The more complex the activity, the less desirable it is to delegate.

3. Amount of problem solving and innovation required: If an uncomplicated task requires special attention, adaptation, or an innovative approach, it should not be delegated.

4. Unpredictability of outcome: When a patient’s response to the activity is unknown or unpredictable it is not advisable to delegate that activity.

5. Level of patient interaction: It is not advisable to delegate so many tasks that the amount of time the nurse spends with the patient is decreased to the point that a therapeutic relationship cannot be established between the nurse and the patient. (

AACN, 2004Links to an external site.

, p.10)

Explain why or why not a task would be delegated depending on each factor.

using an example you can share, and/or face at your current practice setting? (I work at a needle exchange program where understaff and delegation has become a big problem as more work has to be divided when staff is already burnout).

Submission Instructions:

Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.)
All replies must be constructive and use literature where possible.
Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.

Chapter 9
Delegation in Nursing

Delegation is a fundamental aspect of a nurse’s role

Florence Nightingale viewed delegation as a critical skill

Delegation issues

Overview of Delegation
Copyright © 2018, by Elsevier Inc. All rights reserved.

Accountability

Assignment

Authority

Client care activities

Delegate/delegation

Nursing activities

Scope of practice

Supervision

Unlicensed assistive personnel (UAP)

Definitions
Copyright © 2018, by Elsevier Inc. All rights reserved.

Working With Others: A Position Paper: Tools created by NCSBN relating to delegation and the roles of licensed nurses and assistive personnel

Data from NCSBN (2005).
Standards and Guidelines for Delegation
Copyright © 2018, by Elsevier Inc. All rights reserved.

Assess and plan

Communicate

Surveillance and supervision

Evaluation and feedback

Data from NCSBN (2005).
NCSBN Model for Delegation Decision Making
Copyright © 2018, by Elsevier Inc. All rights reserved.

Potential for harm
Complexity of task
Problem solving and innovation required
Unpredictability of the outcome
Level of patient interaction

Data from American Association of Critical-Care Nurses (2004).
Five Factors to Assess When Making a Decision About Delegating Nursing Tasks
Copyright © 2018, by Elsevier Inc. All rights reserved.

Right task
Right circumstance
Right person
Right direction and communication
Right supervision and evaluation
Five Rights of Delegation
Copyright © 2018, by Elsevier Inc. All rights reserved.

Prepared to receive delegation

Participate in communication/information exchange

Accept the delegated task

Seek clarification

Request additional training/supervision (if needed)

Confirm expectations/plan of care

UAP’s Role in Delegation
Copyright © 2018, by Elsevier Inc. All rights reserved.

Organizational and legal guidelines and policies

Patient safety and accountability

Knowledge and education

Three Organizational Principles of Delegation
Copyright © 2018, by Elsevier Inc. All rights reserved.

Nurses use ongoing assessment to prioritize patient needs

Prioritization is a non-sequential decision-making process that is ongoing

Prioritization
Copyright © 2018, by Elsevier Inc. All rights reserved.

Addressing imminent clinical concerns

High uncertainty activities

Significant, core clinical caregiving and managing pain

Relationship management

Documenting

Helping others and patient support

System improvement and cleaning/preparing supplies

Personal breaks and social interactions

Prioritization Hierarchy
Copyright © 2018, by Elsevier Inc. All rights reserved.

Status

Risk to patient and organization

Lack of time

Lack of trust in UAP

Compromised self-esteem

Lack of understanding of delegation

Leadership style

Delegation Barriers
Copyright © 2018, by Elsevier Inc. All rights reserved.

Copyright © 2018, by Elsevier Inc. All rights reserved.
Data from Keogh, K. (2014). Lecturer says delegation should be a part of preregistration courses. Nursing Standard, 29(1), 9. doi:10.7748/ns.29.1.9.s7)

Mutual respect

Feedback

Supervision

Communication

Solutions to Delegation Barriers
Copyright © 2018, by Elsevier Inc. All rights reserved.

Nurse must know state’s nurse practice act/organization’s policies/procedures/competencies

Practice acts defines activities only nurse can perform

Nurse monitors UAP to ensure not acting beyond scope of practice

Scope of Practice
Copyright © 2018, by Elsevier Inc. All rights reserved.

Under law, nurses are not permitted to passively observe substandard care

Safety and ethical concerns must be reported to management

Budget constraints versus safe staffing

Inadequate staffing is not a legal defense for inappropriate delegation

When UAP accepts task then they shoulder some responsibility, but nurse is still held accountable

Nurse is obligated to answer for own actions, including supervision

Direct versus indirect delegation

Communication

What to do when in doubt

Provide delegation education to staff

Coach staff in use of delegation

Use TeamSTEPPS to mitigate problems

Delegation is result of expanded nurse role versus expanded role is result of delegation

Changing health care environments: community-based and ambulatory

Escalating shortages of nurses, greater acuity of patient illnesses, technological advances, and increased complexity of therapies contribute to today’s current chaotic and multifaceted health care

The five rights of delegation include all of the following except:

Correct answer: d

Rationale: The five rights of delegation include right task (element of care), right circumstance, right person, right direction/communication, and right supervision and evaluation. The right time is not included in the five rights of delegation.

Level: Comprehension
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