1. Delegation In The Healthcare Setting
An Essential Piece
Kristine DeBarge
HCS/350
March 01, 2013
Amy Dun
Kristine DeBarge
Clinical Educator
2. • Definition of Delegation
• Description of Stakeholders in
Delegation
• Nurses Role in Delegation
• Role of Delegatee
• Parameters of Delegation in the
Workplace
• 3 Communication Levels
• Conflict Resolution
Agenda
3. What is Delegation?
• Transferring authority to a
competent individual to perform a
selected task in a selected situation
• The nurse retains accountability for
the delegation
(National Council of State Boards of Nursing, 1995)
5. Delegation Definitions
• Delegator
– RN who has the scope of authority to delegate
– Has appropriate education, skills & experience
– Documented/demonstrated evidence of current
competency
• Delegatee
– C.N.A. with appropriate education, skills &
experience
– Documented/demonstrated evidence of current
competency
6. Delegator = Nurse
• Accountable for the act of delegation
• Supervising the performance of the
delegated task
• Assessment and follow-up evaluation
• Interventions/corrective actions required
to ensure safe and effective care
• Ultimately accountable for all tasks
delegated.
7. Delegatee= C.N.A. & RT/PT
• Accountable for His/Her own Actions
• Accepting Delegation within the Scope of
His/Her Training and Education
• Communicating the Appropriate
Information to the Delegator
• Completing the Task
8. Delegation Issues in the Workplace
•Now lets look at what
Can and Can Not Be
Delegated?
9. Parameters of Delegation in the Workplace
What Can Not Be Delegated?
The Nursing Practice Cannot be Delegated
–“Any nursing intervention that requires
independent, specialized nursing
knowledge, skill or judgment cannot be
delegated,” (ANA, 1997).
–Initial nursing Assessment &
subsequent Assessment if nursing
judgment is needed
10. Parameters of Delegation in the Workplace
What Can Not Be Delegated? Cont.
–Decisions/judgments about
Outcomes & Nursing
Diagnoses
–Interventions that require
Professional Nursing
Knowledge, Decisions, or
Skill
11. Parameters of Delegation in the Workplace
What Can Not Be Delegated? Cont.
–Interventions that require
Professional Nursing Knowledge,
Decisions, or Skill
–Determining & Approving of Plan
of Care
–Decisions/Judgments of the
Evaluation of Care
12. The Five Rights of Delegation
1. The Right Task
2. The Right Circumstances
3. The Right Person
4. The Right
Direction/Communication
5. The Right Supervision
14. Conflict Resolution
• There are four main ways to resolve a
conflict
1.Obtain factual data
2.Intervene early
3.Avoid negative comments that can affect
the self esteem of the receiver
4.Consider the other’s viewpoint
15. Action Plan Feedback
• Feedback is a message given in response
to a message received or and observed
behavior
• It should focus on the content and be
specific and directed toward behavior not
motivations
16. Action Plan Evaluation
• Evaluation is an essential tool
• It assess that factual data has
been received or observed
• That feedback has occurred
between both parties during
delegation
18. Conclusions
• Description of Delegation
• Stakeholders in Delegation
• Delegation Issues in the Workplace
• Selection of Stakeholders in Delegation
• Action Plan
19. References
• Hansten, R., & Jackson, M. (2009). Clinical
delegation skills a handbook for professional
practice (4th ed.). Retrieved from The
University of Phoenix eBook Collection
database.
• American Nurses Association. (1976, 1985).
Code for nurses with interpretive statements.
• Kansas City, MO.
Editor's Notes
The RN assesses, plans, and evaluates care and delegates selected tasks to an individual who is qualified, competent, and able to perform the tasks but the nurse remains accountable for the overall nursing care of the patient.
The is the staff member that is coordinating and or leads the care for the patients. The deletee is the staff members who is being given the assignment of care and is under the supervision of the delegator. The delegator is ultimately responsible for all care provided.
The delegator is an RN who has the scope of authority to delegate, who has the appropriate education, skills and experience as well as the documented and or demonstrated evidence of current competency.
The delegatee is an individual who has the appropriate education, skills and experience as well as the documented and or demonstrated evidence of current competency to perform a task.
The RN is accountable for the act of delegation, supervising the performance of the delegated task and performing assessment and follow-up evaluation. The RN is also held accountable for interventions and or corrective actions that are required to ensure safe and effective care.
The
Nursing Practice cannot be delegated. The American Nurses Association states, “Any nursing intervention that requires independent specialized nursing knowledge, skill or judgment cannot be delegated” (ANA, 1997).
Examples of nursing practice include initial assessments, decisions and judgments about nursing diagnosis, interventions requiring specialized knowledge, and the determination and evaluation of a plan of care.
Examples of nursing practice include initial assessments, decisions and judgments about nursing diagnosis, interventions requiring specialized knowledge, and the determination and evaluation of a plan of care.
The right task is based on whether it is within a health worker’s practice act, within his or her scope of practice or preparation, and whether the worker is competent to perform it. The right circumstances include the appropriate patient setting, availability of resources; complexity of patient care, how often does the patient's condition change, what is required to completely assess the patient's condition, and what technology involved in the patient care. There are three major criteria that will help you determine the right person and they are the level of education, training, possibly certification. The right direction or communication include clear specific directions, correct tasks these should be within that patient’s care plan, concise, complete - directions should include all the necessary information to complete the assignment or task.
Intrapersonal communication is thinking within or self-talk, it happens constantly, consciously and the goal is self-awareness. Interpersonal communication is between two people, face-to-face, or in a small group. It includes healthy problem solving, share ideas, makes decisions, and promotes personal growth.
According to Boggs, 2011, “Remember the issue is the conflict, not your
Coworker (p. 454). There are four main ways to resolve conflict. First obtain factual data before engaging in negotiation. Second you must intervene early by creating two-way communication. Structured formats like the Describe, Express, Specify, Consensus, Avoid (D.E.S.C.A.) formula to resolve conflict in the workplace.
Feedback is a message given in response to a message received or and observed behavior. It should focus on the content and be specific and directed toward behavior. Feedback should be specific and directed to the behavior not motivations. Effective feedback mirrors the problem to both side and only addresses current topics. I statements used in feedback are a powerful tool.