Question

a) What must delegation instructions include and how must they be provided?

b) What responsibilities does a Registered Nurse have when the administration of medication is delegated to another employee?

Answer 1

a) Delegation Instructions:

Delegation is the process of assigning a task to a subordinate, while taking the responsibility of the outcome of the action. Delegation is a nursing skill In nursing delegation:

- the APRN ( Advanced practice Registered nurse ) can delegate the task to RN ( registered nurse) , LPN/ VN or AP

- RN can delegate the task to LPN or LVN or to AP ( Assistive personnel)

- LPN/ LV ( Licenced practice nuse/ Vocational nurse can delegate to AP.

The delegation instructions must include:

* delegatee's name , identify the Right person

* task

* circumstances

* directions and necessary communications

The nurse leader , who delegated the task has to supervise the task and after the task , write down the evaluation and record it.

Before assigning the delegation, the nurse has to identify the right person to assign the task, and   give direct instructions on 'what to do' and ' how to do it'. Delegation Instructions should be provided in a clear and understanding manner. Make sure that the delegatee is a right person for that and ask the feedback from them to understand their agreeableness to the task. The delegatee should be competent enough to carry out the task.

2. RN responsibility, when administration of medication is delegated to another employee:

The RN has to ensure the 5 rights of delegation, such as:

* The right person

* The right task

* The right circumstances

* The right directions and communications

* The right supervision  and evaluation.

- RN has to ensure that the delegatee os competent enough to carry out the administration of medication. She has to ensure that the delegatee is following the principles of rights of medication administration.  

- RN has to take the complete accountability of the procedural outcomes.

- RN has to follow the regulatory bodies' instructions on what type of medication administration should give to a LPN or VN.

Example: Medication administration via Intravenous, intraosseous, intrathecal etc , should not be delegated to AP.

- The delegatee should not allow for making nursing judgements.

- RN should not delegate any Decision making responsibility to AP.