Prioritization and Delegation

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  1. What is Nursing?
    “Nursing is the diagnosis and treatment of human responses to actual and potential health problems.”
  2. žCues for Setting Priorities
    The RN must decide the priorities of care

    Maslow’s Heirarchy of Needs



    Acute vs Chronic

    —Patient safety is always a first priority
  3. Maslow’s Hierarchy of Needs
    Self Actualization

    Self Confidence, Achievement, Self Worth

    Love & Belonging, Friendship, Love, Social Relationships

    Safety & Security Needs

    Air, Water, Food
  4. Emergent
    those client needs with highest priority

    Basic survival needs

    Life-threatening client problems

    Safety of client and/or nurse
  5. Urgent
    focus on medium and low priorities. These are problems that do not impede medical treatment but require early resolution and have potential to impair functioning or normal growth and development.
  6. Non-urgent
    client problem does not need immediate attention
  7. Acute
    An illness with an abrupt onset and usually a short course.
  8. Chronic
    An illness that persists for a long period of time. It is a continuing disease process.
  9. Delegation according to the ANA
    According to the American Nurses’ Association (ANA):

    The reassigning of responsibility for the performance of a job from one person to another
  10. delegation
    a process that transfers to a competent individual the authority to perform a selected nursing task in a specific situation.

    žThe responsibility for the task is transferred.

    Accountability remains with the person who is delegating tasks
  11. Accountability
    means that the nurse is legally liable for her actions and is answerable for the overall nursing care of her patients.
  12. Responsibility
    žinvolves reliability, dependability, and the obligation to accomplish work. Responsibility also includes each person’s obligation to perform at an acceptable level.
  13. Who delegates
    žUsually verbal direction

    žThe registered nurse (RN) decides which staff member is capable of performing a specific task

    Lpn and assistance do not delegate

    Usually in a nursing home lpns can delegate
  14. Assigning Tasks
    žAssign staff members who have the appropriate level of expertise that is necessary to deliver the patient care and perform the activities.

    žThe RN may assign a more skilled individual to perform specific tasks.

    • žThe RN may not assign an individual to perform a task that is outside that individual’s job
    • description or scope of practice.
  15. 5 Rights of Delegation
    žRight task

    žRight circumstance/concern

    žRight person

    žRight direction/communication

    žRight supervision
  16. Directions for Delegation
    Priority of activity

    žExpected timeliness

    žReportable conditions

    žGuidelines for reporting task completion

    žUse of written and visual resources may be used to reinforce direction
  17. Delegation Red Flags
    žRefusal to accept delegation

    žIncomplete directions

    žFailure to confirm expectations

    žFailure to communicate

    ** Your delegation may be inappropriate

    Take a step back and see what is wrong did you say things correctly do they understand is there a problem and is it you before it is them for delegation
  18. The LPN/LVN can…
    Perform routine assessments and skills

    žDeliver basic care

    žPerform routine tasks with predictable outcomes

    žPerform routine wound care/dressing changes

    žPerform uncomplicated sterile procedures (wound dressing, foleys etc)

    žPerform specialized “skills” with proper training in stable situations

    žObserve & report

    žReinforce teaching
  19. LPN/LVN Cannot Administer
    Antineoplastic agents

    žAdminister Blood products

    žTotal parenteral nutrition

    žTitrate medications

    žIV push (except heparin and NSS flushes)

    LON can administer O2 and put them on it but pt getting off O2 they need to b weend down and is much difficult which means a nurse needs to do so
  20. UAP can….
    žProvide Basic care/ ADL

    žRoutine clinical tasks

    Vital signs; collecting urine & stool samples; I & O

    žRoom preparation

    žPatient ambulation & transport

    žMust be stable situations with predictable outcomes

    Must have been trained and deemed “competent” to perform these tasks

    Feed, wash, ambulate, collect vitals, stool and urine specimens can do clean catch with urine but not foley because it is sterile, make beds, transport but pt needs to be competent
  21. Can Delegate
    Stable patients

    Requirements within caregivers job description & legal constraints

    Adequate supervision available

    Within skill & competencies of individual caregiver

    Minimal potential for harm
  22. Cant Delegate
    Unstable patient with unpredictable outcome

    Condition requires complex assessment

    Problem Solving & critical thinking required

    Nursing judgment required

    Potential for harm exists
Card Set:
Prioritization and Delegation
2011-06-26 21:06:54

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