North Carolina Board of Nursing Delegation Decision Tree

In Conclusion

Successful delegation depends on the quality of RN and UAP working relationships, timely ongoing communication, initiative and a willingness to collaborate (Potter, Deshields, & Kurik, 2010).

How does delegation work effectively?

• Staff communication must be:
• open
• trusting
• (Bai, 2014)
• Delegator must have:
• Authority
• Accountability
• Responsibility
• (Bai, 2014)

Five Rights of Delegation

1. Right task

2. Right circumstance

3. Right person

4. Right directions/communication

5. Right supervision and evaluation

(Plawecki & Amrhein, 2010)

Delegation "No-no's"

• Do not delgate the nursing process itself (Plawecki & Amrhein, 2010)
• Do not use a "bossy" tone or attitude (Bai, 2014)
• Do not think that you can work by yourself
• Nurses require help from others
• You cannot do everything by yourself
• No one can!
• (Bai, 2014)

Common Delegated Duties

Nurses and Delegation

• Vital signs
• Recording intake and output
• Activities of daily living
• Nutrition
• Activity and mobility
• Respiratory care
• Cleaning
• Errands
• Clerical tasks
• Stocking and maintainance
• (Snyder et al., 2004)

Example of Delegation

• North Carolina Board of Nursing Delegation Decision Tree
• Tool to help RNs and Unlicensed Assistive Personnel (UAP)
• Help maintain patient safety

Is this a poor or good example of delegation?

Why is delegation important?

• Ensures that a team of interprofessionals are a part of a single patient's care (Bai, 2014)
• Ensures patient safety (Bai, 2014)
• Maintain efficiency (Plawecki & Amrhein, 2010)

References

(Snyder, Medina, Bell, & Wavra, 2004)

History of Delegation

Bai, H. J. (2014). Delegation in nursing

management: Common errors. Asian Journal of Nursing Education and Research, 4(2), 242-244.

NC Board of Nursing. (2012). Delegation tree for delegation to UAP. NC Board of Nursing.

Plawecki, L., & Amrhein, D. (2010). A question of delegation: Unlicensed assistive personnel and the professional nurse. Journal of Gerontological Nursing, 36(8), 18-21. doi:http://dx.doi.org/10.3928/00989134-20100712-01

Potter, P., Deshields, T., & Kurik, M. (2010). Delegation practices between registered nurses and nursing assistive personnel. Journal of Nursing Management, 18(2), 157-165. Doi: 10.1111/j.1365-2834.2010.01062.x

Snyder, D.A., Medina, J., Bell, L., & Wavra T.A. (2004).

AACN delegation handbook, 2nd edition. American Association of Critical Care Nurses.

Yoder-Wise, P.S. (2015). Leading and managing in nursing (6th ed.). St. Louis, MI: Elsevier Mosby.

• 1970s and 1980s: relatively limited knowledge

• Principles of delegation had not been a major focus in nursing schools.

• Mid 1990s: dramatic shift

• (Yoder-Wise, 2015)

Delegation & the professional Nurse