Delegation and Prioritization of

Client Care & Scope of Practice

Mariana Sanchez
Miami Dade College
Professional Nursing Leadership NUR2811C
Delegation

 The American Nurses Association (ANA):

“Reassigning of responsibility for the
performance of a job from one person to
another”.
 The National Council of State Boards of
Nursing (NCSBN): “Transferring of
authority”.
 The RN has the ability to request another
person to do something that this individual
may not usually be permitted to do while
maintaining accountability for supervising
those to whom tasks are delegated.

Scarborough Civitelli, J. (2019). How to Delegate.

https://www.ncsbn.org/decision-making-framework.htm
 Work Allocation

 Assignment/work allocation:
 Allocation of duties that each staff
member is responsible for during a
specific work period
 Allocation involves asking another person
to care for one or more patients or
residents on the assumption that the
specific care required is normally within
that person’s responsibility and scope of
practice.

Jacob, B. (2015). Work allocation.

http://cenexcisekochi.gov.in/work-allocation/
 Benefits of Delegation
 Development of new skills.
 Time for more complex tasks.
 Needs met/quality of care.
 Close professional relationships with patients.
 The task can be performed when it is convenient for the patient, and not just when another member
of staff can be free.
 It promotes cooperation.
 It improves job satisfaction, responsibility, productivity and development.
 It facilitates more frequent observation of patients.
 It enhances confidence and self-esteem.
 It improve safety.
 Assessment
Assessment

The Nursing
Process and
Feedback
Feedback Planning
Planning

Delegation

Evaluation Implementation
Implementation
Seven Components of the Delegation
Decision-Making Grid

 1. Level of client acuity

 2. Level of unlicensed assistive personnel capability
 3. Level of licensed nurse capability
 4. Possibility for injury
 5. Number of times the skill has been performed by the unlicensed assistive personnel
 6. Level of decision making needed for the activity
 7. Client’s ability for self-care
Five Factors for Determining If Client Care
Activity Should Be Delegated

 1. Potential for harm to the patient

 2. Complexity of the nursing activity/care
 3. Extent of problem solving and innovation required
 4. Predictability of outcome
 5. Extent of interaction
Criteria for
Delegation
 Task-related concerns:
 Abilities
 Priorities
 Efficiency
 Appropriateness
 Relationship-oriented concerns
 Fairness
 Learning opportunities
 Health concerns
 Compatibility
 Staff preferences
CFI Education Inc. (2020). Delegating. https://corporatefinanceinstitute.com/resources/careers/soft-skills/deleg
Barriers to Delegation

Experience issues
Licensure issues
Legal issues
Quality of care issues
Assigning work to others
Live And Learn Consultancy. (2020). Popular Reasons Why Managers Fail to Delegate.
https://corporatefinanceinstitute.com/resources/careers/soft-skills/delegating/
The Five Rights of Delegation

 1. Right task.
 2. Right circumstances.
 3. Right person.
 4. Right direction or communication.
 5. Right supervision or evaluation.

Sherman, R. O. (2011). Teaching Nurses to Delegate.

https://www.emergingrnleader.com/delegationnursing-leadership/
Prioritization
Other
Prioritization
Frameworks to
Consider
Scope of Practice

 Scope of practice describes the

services that a qualified health
professional is deemed competent
to perform, and permitted to
undertake – in keeping with the
terms of their professional
license.

Clipboard Health. (2020). Understanding Scope of Practice.

https://clipboardhealth.com/kb/understanding-scope-of-practice
 Scope of Practice for RNs, LPNs, PCTs, NAs
and UAPs 
 REGISTERED NURSES Section 464.003(3)(a), Florida Statutes.
 The observation, assessment, nursing diagnosis, planning, intervention,
and evaluation of care; health teaching and counseling of the ill, injured, or
infirm; and the promotion of wellness, maintenance of health, and
prevention of illness of others.
 The administration of medications and treatments as prescribed or
authorized by a duly licensed practitioner authorized by the laws of this
state to prescribe such medications and treatments.
 The supervision and teaching of other personnel in the theory and
performance of any of the above acts.
Scope of Practice for RNs, LPNs, PCTs, NAs
and UAPs (Cont.)
 LICENSED PRACTICAL NURSES Section 464.003(b), Florida
Statutes.  
 The licensed practical nurse performance includes the
administration of treatments and medications, in the care of the
ill, injured, or infirm and the promotion of wellness,
maintenance of health, and prevention of illness of others under
the direction of a registered nurse, a licensed physician, a
licensed osteopathic physician, a licensed podiatric physician, or
a licensed dentist.
Scope of Practice for RNs, LPNs, PCTs, NAs
and UAPs (Cont.)
 CERTIFIED NURSING ASSISTANT Section 464.2035 (1),
Florida Statutes.
 A certified nursing assistant may administer oral, transdermal,
ophthalmic, otic, rectal, inhaled, enteral, or topical prescription
medication to a patient of a home health agency if the certified
nursing assistant has been delegated such task by a registered
nurse licensed, has satisfactorily completed an initial 6-hour
training course approved by the board, and has been found
competent to administer medication to a patient in a safe and
sanitary manner.
 Scope of Practice for RNs, LPNs, PCTs, NAs and UAPs (Cont.)
 Unlicensed assistive personnel
(UAP).
 An umbrella term to describe a
job class of paraprofessionals
who assist individuals with
physical disabilities, mental
impairments, and other
healthcare needs with their
activities of daily living and
provide care—including basic
nursing procedures—all under
the supervision of a registered
nurse, licensed practical nurse,
or other healthcare
professionals.
 Practice Questions
 1. Allowing persons to perform a specific nursing activity, skill, or procedure that is
outside the traditional role and basic responsibilities of the delegatee's current job is
the definition for which of the following terms?
 a. Supervision
 b. Delegation
 c. Responsibility
 d. Accountability
 2. The nurse asks the unlicensed assistive personnel to measure blood pressure,
temperature, pulse, and respirations. This is an example of:
 a. Delegation
 b. Supervision
 c. Work allocation
 d. Authorization
 3. Which of the following is NOT one of the Five Rights of Delegation?
 a. Right reason
 b. Right person
 c. Right task
 d. Right communication
 4. What two factors help ensure optimal outcomes in delegation?
 a. Communication and collaboration
 b. Licensure and experience
 c. Training and authorization
 d. Certification and endorsement
 Case Discussion
 https://www.youtube.com/watch?v=1wiBfGlrdaM
References

 Assessment Technologies Institute, Nursing Education. (2019). Content Mastery Series

Review Module; Nursing Leadership and Management (7th edition) . 
 Assessment Technologies Institute, Nursing Education. (2019). The Comprehensive
NCLEX-RN Review (18th edition).
 Clipboard Health. (2020). Understanding Scope of Practice.
https://clipboardhealth.com/kb/understanding-scope-of-practice.
 National Council of State Boards of Nursing. (2016). National guidelines for nursing
delegation. Journal of Nursing Regulation, Volume 7(Issue 1 ), 5–14.
 Weiss, Tappen, Grimley (2019). Essentials of nursing leadership and management (7th
edition). F.A. Davis.