Delegation

DELEGATION in the CLINICAL SETTING What is DELEGATION? “Transferring to a competent individual the authority to perform a selected nursing task in a selected situation. The nurse retains the accountability for the delegation.” Why delegate? enables one to accomplish all that is expected of them allows outcomes to be achieved in a timely, cost-effective manner contributes to employee’s personal and professional growth we delegate based on desired patient outcomes What do you need to delegate? a delegator a delegatee an activity, task, or job the transfer of responsibility/authority What will dictate what you delegate? Nurse Practice Law of a particular state Job description, policies, and procedures of the agency “Let whoever is in charge keep this simple question in her head (NOT, how can I always do the right thing myself but) how can I provide for this right thing always to be done?” SUPERVISION “The provision of guidance or direction, evaluation and follow-up by the licensed nurse for accomplishment of a nursing task delegated to unlicensed assistive personnel.” (NCSBN position paper, 1995) ACCOUNTABILITY “Being answerable for what one has done, and standing behind that decision and/or action.” (Hansten and Washburn, 1994) Delegate, Supervise, and beAccountable You are accountable for: making the decision to delegate assessing the client’s needs planning the desired outcome assessing the delegate’s competency, and giving clear directions and obtaining acceptance from the delegatee Four Rights of Delegation Right task

Right person Right communication Right feedback RIGHT TASK Determine what needs to be done and decide if tasks can be delegated Be familiar with Nurse Practice Act Know employee job descriptions, skills checklists, and demonstrated competencies Consider, what can I not delegate? (Assessment, planning, nursing diagnoses, and teaching) Match the right person with the right task RIGHT PERSON Focus on outcomes and strengths and weaknesses of team members Remember, matching the right person with the right task is the second step of the delegation process RIGHT COMMUNICATION Clearly communicate client outcomes and expectations Achievement of client outcome is dependent upon the direction you give and how it is given Do not assume others know what you need FEEDBACK FORMULA Ask for the other individual’s input first Give credit for effort Share perceptions with one another Explore different viewpoints, focusing on outcomes Determine what steps may be necessary to assure that certain desired outcomes are achieved Agree on future plan, revisit plan and results And, remember: We delegate based on patient outcomes Four C’s of Clinical Delegation Clear Concise Correct Complete