Paper Assignment FO
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Concept: Delegation
Case Study
You are working the night shift on a medical unit and have been assigned charge nurse responsibilities. You are working with four RNs, one LPN, and two UAPs. A client becomes pulseless and is not breathing, and the nurse assigned to the client’s care calls a code. The nurse is occupied at this client’s bedside for 1.5 hours until the resuscitation effort is completed, and the client is transferred to the intensive care unit. This nurse also has four other assigned clients. In addition to the nurse assigned to care for the client requiring resuscitation, two of the other nurses working on your unit are assisting in the code.
Review the case study and write an essay (suggested length of 2–3 pages, excluding title page and reference page) in which you do the following:
- Discuss what tasks could you delegate to the UAPs?
- The LPN working on the unit is a new graduate and has been employed for only 4 weeks. How would you collaborate with this nurse when delegating tasks for completion?
- Discuss how you will maintain the safety of the other clients on your unit while three nurses are occupied with the client requiring resuscitation?
Explain how might effective delegation to other team members contribute to care of the clients on the unit? (Remember, this is not a question about the patient that is coded, but how you will handle the unit while you are short staffed).
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Solution
Delegation
Delegation is the process whereby a registered nurse or delegator directs another person, the delegate, to perform nursing activities and tasks involving patient care (Barrow & Sharma, 2021). Registered nurses must decide whether to delegate and understand which tasks can be delegated, the competence of the delegate, and the level of supervision necessary (Barrow & Sharma, 2021). Delegation decisions are challenging in nursing practice and require appropriate considerations to improve patient care outcomes. Factors that necessitate delegation include increased patient care complexity and nursing shortages (Barrow & Sharma, 2021). This means that delegation in the healthcare sector is unavoidable but requires a thorough understanding by involved parties to avoid lawsuits and deliver safe and effective care. Thus paper discusses tasks that can be delegated to UAPs, how to collaborate with the LPN to delegate duties, and ensure patient safety during the delegation process.
Delegation to UAPs
Nursing tasks can be performed by other healthcare team menders, such as unlicensed assistive personnel (UAPs). UAPs provide effective care both through clinical work like vital signs monitoring, mouth care, and turning, and nonclinical work like keeping the environment orderly (Wagner, 2016). In this case, I would delegate the three clinical tasks to the UAPs to assist in providing care to the coded patient in the intensive care unit. However, I would follow the legal parameters defined by the scope of practice established by professional nursing organizations like the ANA and the state to ensure patient safety (Wagner, 2016). RNs are accountable for delegation decisions and the adequacy of nursing care provided to the client or healthcare customer. Thus, the UAPs will perform these tasks under the supervision of the RN.
Collaboration with LPN in Task Delegation
Collaboration in nursing practice is vital as it helps promote patient safety and better patient outcomes. In cases of emergencies in the facility, collaboration is crucial in meeting the patients’ complex needs (Jowsey et al., 2020). In this case, the newly graduated LPN will perform tasks as taking and monitoring vitals and administering medications under the supervision of the RN (Jowsey et al., 2020). The RN should thoroughly explain the tasks to be completed the how they should be performed while supervising the LPN to enhance patient safety and outcomes.
Patient Safety Concerns
As a charge nurse, I would do rounds and communicate with the other patients to ensure they feel safe and comfortable. I would instruct the UAPs to keep the environment orderly and the LPN to take and monitor patients’ vitals and ensure medications are taken on time under my supervision as a charge nurse (AHRQ, 2021). This will provide a safe environment for the patients, thus promoting patient outcomes.
Impact of Effective Delegation to Patient Outcomes
Effective delegation is crucial in leadership and helps create workload balance between management and staff. Delegators or nurses in charge should assign tasks with the understanding that they are responsible for the outcomes of the activities the individual the task is delegated to perform (Walker et al., 2021). Thus, the nurse in charge should critically consider individuals’ competencies, the scope of practice, and competencies before delegating tasks to provide a sense of safety to patients and promote patient outcomes. Moreover, effective communication and teamwork will promote a better work environment where all employees and staff members are committed to patient safety and outcomes by delivering high-quality and timely care (Walker et al., 2021). Patients are satisfied when they receive high-quality care from caring staff and in a caring environment.
References
AHRQ. (2021, April). Nursing and patient safety. https://psnet.ahrq.gov/primer/nursing-and-patient-safety
Barrow, J. M., & Sharma, S. (2021). Five rights of nursing delegation. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK519519/
Jowsey, T., Foster, G., Cooper-Ioelu, P., & Jacobs, S. (2020). Blended learning via distance in pre-registration nursing education: A scoping review. Nurse education in practice, 44, 102775. https://dx.doi.org/10.1155%2F2020%2F5057084
Wagner, E. A. (2018). Improving patient care outcomes through better delegation-communication between nurses and assistive personnel. Journal of nursing care quality, 33(2), 187-193. https://www.nursingrepository.org/bitstream/10755/612249/3/Wagner_Manuscript2016.pdf
Walker, F. A., Ball, M., Cleary, S., & Pisani, H. (2021). Transparent teamwork: The practice of supervision and delegation within the multi‐tiered nursing team. Nursing Inquiry, e12413. https://doi.org/10.1111/nin.12413