Delegation Tips

I don't know if there is already a post dedicated to this (if so let me know) , but I have been working a lot on delegation lately and wanted to share a list of key words I have made so far that have been helpful. (NOTE: These aren't 100% accurate ALL of the time, but combining these loose "rules" with some critical thinking has really improved my delegation results)

Nursing Assistant

- ADLs/Noninvasive

- Assist

- Remind/Reinforce: usually reminds pt. TO do something rather than HOW to do it (skills previously taught by other health care professional or precaution measures)***

** Usually in regards to ADLs (hygiene, nutrition, ambulating, skin care), turning, repositioning, cough deep breathe ROM **

- Special positioning-- requires initial education by RN -- assistant will assist not teach

- I/O , VS, Weight

- Gather (equipment)

LVN/LPN

- Auscultate/Listen

- Check(s)

- Reinforce/remind

- Administer (PO,SubQ,IM -- NO high alert meds, plasma, blood products)

- Observe

- Collect (data, specimens)

- Monitor

- Set up (basic equipment)

- Review/Teach-- Usually standard practices (hand washing/hygiene) or med administration (ie. eye drops) -- RN mostly teaches (if anyone else has example of instances when LVN/LPN teach that would be great

- Routine/Standard

- Wound care/Suction/Urinary Cath

** Don't assign LVN/LPN to do a task an nurse assistant can complete**

RN

- Assess

- Plan

- Evaluate

- Consult

- Teach/Educate

- Encourage

- Develop

- Review

- Update

- Counsel

- Suggest

- Initial/Comprehensive/Baseline (assessments)

- Frequent/Ongoing assessments (unstable pts)

Physician

-Informed Consent

-Medical diagnosis

-Prescriptions

-Order procedures

Avoid These Assignments for New/Float/LVN/LPN/Traveling

-New onset/sudden/acute

-New admission

-Transfer

-Newly diagnosed

-Discharge

-Require education/teaching (beyond basic skills -- tend to be complex and specific to patients on that particular unit)

- Unstable (ie. High risk of sudden respiratory failure, or requires frequent assessments and changes in therapy)

Give

- Chronic

- Routine meds/procedures

- Stable

ALL HEALTHCARE WORKERS

- Responsible for knowing about and implementing standard precautions + airborne/droplet/contact --> therefore all can teach about it or prepare a room for it

This is what I have so far, but plan to add to it if I find more things as I go along -- If anyone has any input or corrections I would love to hear them :-)