DELEGATION IN NURSING

By: Lindsay Johnson

OBJECTIVES

Understand the principle of delegation

Describe two relevant theories
Be able to properly delegate to different roles in the
hospital
Understand consequences in patient care for improper
delegation
Understand how delegation is vital in the nursing
profession

INTRODUCTION

What does delegation mean?

The transfer of responsibility for the
performance of an activity from one individual
to another while retaining accountability for the
outcome (AACN, 2014, p 5)

HOW TO DELEGATE

Know the five rights of delegation:

1. Right task
2. Right circumstances
3. Right person
4. Right directions and communication
5. Right supervision and evaluation

National Counsel of State Boards of Nursing

WHAT TO DELEGATE

Nursing Assistant vs Nurse Technician

Licensed Practical Nurse
https://www.youtube.com/watch?v=_YeKSuPGksc

National Counsel of State Boards of Nursing. Video retrieved from

https://www.youtube.com/watch?v=_YeKSuPGksc

NURSING THEORY: PATRICIA BENNER

From Novice to Expert

Novice
Advanced Beginner
Competent
Proficient
Expert
Nursing Theory, 2016

WILBUR SCHRAMM

Theory of Communication in 1954

Message, Sender, Decoder, Receiver
Field of Experience

Businesstopia

ROOT CAUSE ANALYSIS

Communication

Experience
Poor Patient
Outcomes
(Death, Injury,
Increased Length
of Stay, etc)

Responsibilities/Tim
e

Relationships

IMPLICATIONS ON NURSING

Many RNs never develop the skills needed to delegate patient care
appropriately to others, nor do their educational programs target the
development of leadership skills (Saccomono & Zipp, 2011, p 523)
New nurses feel uncertainty regarding delegation and describe
learning to delegate through trial and error (Standing & Anthony,
2008, p 9)
Good delegation skills can have a positive impact on teamwork and
job satisfaction, provide RNs with more time to fulfill their
professional role expectations, and reduce the turnover rate of RNs
(Kaernested & Bragadottir, 2012, p 10)

QUALITY AND SAFETY EDUCATION

FOR NURSING COMPETENCIES
Teamwork & Collaboration
Safety
Evidence Based Practice

QSEN, 2014

ANA STANDARDS

Standard 7: Ethics
Standard 8: Education
Standard 11: Communication

American Nurses Association, 2010

NCLEX

A patient with sleep apnea has a nursing diagnosis of Sleep

Deprivation related to disrupted sleep cycle. Which action
should you delegate to the nursing assistant?
A. Discuss weight-loss strategies such as diet and exercise with
the patient.
B. Teach the patient how to set up the BiPAP machine before
sleeping.
C. Remind the patient to sleep on his side instead of his back.
D. Administer modafinil (Provigil) to promote daytime
wakefulness.

NCLEX

The patient with COPD has a nursing diagnosis of Ineffective

Breathing Pattern. Which is an appropriate action to delegate
to the experienced LPN under your supervision?
A. Observe how well the patient performs pursed-lip breathing.
B. Plan a nursing care regimen that gradually increases activity
intolerance.
C. Assist the patient with basic activities of daily living.
D. Consult with the physical therapy department about
reconditioning exercises.

NCLEX

You are initiating a nursing care plan for a patient with

pneumonia. Which intervention for cough enhancement should
you delegate to a nursing assistant?
A. Teaching the patient about the importance of adequate fluid
intake and hydration.
B. Assisting the patient to a sitting position with neck flexed,
shoulders relaxed, and knees flexed.
C. Reminding the patient to use an incentive spirometer every
1 to 2 hours while awake.
D. Encouraging the patient to take a deep breath, hold it for 2
seconds, then cough two or three times in succession.

CONCLUSION

Effective delegation improves job satisfaction, responsibility,

productivity, and development (Yoon, Kim, & Shin, 2016)

REFERENCES
American Nurses Association. (2010). Scope and standards of practice: Nursing. (2 nd Ed.). Silver
Spring, MD: Nursebooks.org
Kaernested, B., & Bragadottir, H. (2012). Delegation of registered nurses revisited: Attitudes
towards delegation and preparedness to delegate effectively. Nursing Science & Research in the
Nordic Countries (32)1, 10. Retreived from Academic OneFile.
QSEN Institute. (2014). Competencies. Retrieved from http://qsen.org/competencies/
Saccomono, S., & Pinto-Zipp, G. (2011). Registered nurse leadership style and confidence in
delegation. Journal of Nursing Management, 19, 522-533. doi: 10.1111/j.1365-2834.2010.01189.x
Standing, T., & Anthony, M. (2008). Delegation: What it means to acute care nurses. Applied
Nursing Research (21)1,
8-14. doi: 10.1016/j.apnr.2006.08.010.
Yoon, J., Kim, M., & Shin, J. (2016). Confidence in delegation and leadership of registered nurses in
long-term-care hospitals. Journal of Nursing Management, 1-10. doi: 10.111/jonm.12372