DELEGATION

ADERO D.
‘It came about that from the time he made him
overseer in his house and over all that he owned, the
LORD blessed the Egyptian's house on account of
Joseph; thus the LORD'S blessing was upon all that he
owned, in the house and in the field.’ GENESIS 39: 5
HISTORICAL PERSPECTIVE OF
DELEGATION
 Delegation in nursing has been emphasized
and deemphasized at different periods in
history.
 Delegation has not always been emphasized
in nursing education.
 Current staffing practices require a greater
amount of delegation from the nurse.
 DEFINITIONS
 Delegation is the transfer to a competent individual of the
authority to perform a selected nursing task in a selected
situation. The nurse retains accountability for the delegation.

 Accountability means that the nurse is legally liable for her

actions and is answerable for the overall nursing care of her
patients.

 Responsibility involves reliability, dependability, and the

obligation to accomplish work. Responsibility also includes each
person’s obligation to perform at an acceptable level.
 CT…
 Authority occurs when a person who has been given the right to
delegate, based on the state Nurse Practice Act, also has the
official power from an agency to delegate.

 Assignment making- is the process of delegating the duties and

all aspects of care for a patient to individual personnel.

 The assignment includes giving clear, concise directions, and

delegating the responsibility and the authority for the
performance of the care.
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 The education, skill, knowledge, and
judgment levels of the personnel being
assigned to a task must be relative to the
assignment.
 The expected outcome of the assignment,
time frame for completion, and any limitations
on the assignment should be specified when
the assignment is made.
 Components of delegation
• Care outcomes - patient care is safely provided
• Accountable and Responsible - both supervisor
and delegatee have an obligation to care for that
patient and ensure the task is completed
• Sharing activities – both the supervisor and
delegatee work together to accomplish care
• Appropriate authority – the supervisor selects
the appropriate person to delegate the task
 Responsibilities of health team
members
 Care should be used in delegating or
accepting responsibility for any action that:
 May carry the potential for harm
 May be highly complex or require advanced skill
 May require a high level of problem-solving skill
 Has a greater than average degree of
unpredictability
 Requires a complex level of patient interaction
Functions of a professional nurse
 The registered nurse is responsible and
accountable for the provision of nursing care.
 The registered nurse is always responsible
for patient assessment, diagnosis, care
planning, and evaluation.
 The registered nurse remains responsible for
the patient outcome.
 Nurses must be alert and avoid misuse of
UAPs and LPN/LVNs.
 Unlicenced auxillary personell
functions
 UAPs can deliver supportive care. They are
expected to document and report information
related to such activities.
 UAPs cannot practice nursing or provide total
patient care. They cannot be delegated to
assess or evaluate responses to treatment.
 The RN has an increased scope of liability
when delegation takes place to a UAP.
 cont’d
 since the RN is accountable for the
delegation of nursing care activities, the RN
must consider the following in determining the
appropriate use of a UAP:
 An assessment of patient condition
 The capabilities of the UAP
 The complexity of the nursing task
 The amount of supervision the RN will be able to
provide
 The available staff assigned to accomplish the unit
workload
 Licensed personnel function
 Even though LPN/LVNs are able to perform
duties and functions that UAPs are not
allowed to do, LPN/LVNs are held to a higher
standard of care and are responsible for their
actions.
 The RN is still primarily responsible for overall
patient assessment, planning, and evaluation
of the quality of care delegated
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 Common LPN/LVN duties include:
 Teaching from a standard care plan
 Reinforcing teaching
 Updating initial assessments
 Removal of sutures
 In some states, starting and or maintaining
intravenous lines, after receiving additional
education
 Direct/indirect delegation
 Direct delegation is usually verbal direction by
the RN delegator regarding an activity or task
in a specific nursing care situation.
 Indirect delegation is done using an approved
listing of activities or tasks that have been
established in the policies and procedures of
the health care institution or facility
 underdelegation
 Usually occurs when a person is in a new job
role 
 Potential causes:
 Trying to avoid resentment from “old guard” staff
 Not knowing who to delegate to
 Not knowing scope of staff duties
 Seeking approval by demonstrating competency
 Delegation barriers
 Barriers in the delegator
 Do-it-myself attitude, inability to ask others,
inability to organize/manage, uncertainty 
 Barriers in the delegatee
 Inexperience, incompetence, disorganization,
irresponsibility 
 Barriers in the situation
 Inadequate support, hurried atmosphere, hostile
management
 Rights to delegation
 The right task
 The right circumstance
 The right person
 The right direction and communication
 The right supervision and evaluation
 Transcultural delegation
 Transcultural delegation is the process of
having personnel perform duties with the
diversities of culture taken into consideration.
 Cultural phenomena (areas where cultures have
different interpretations or preferences) include:
 Communication
 Space
 Social organization
 Time
 Environmental control
 Biological variations
 Principles of delegation
 Assignment of authority.
 Parity of authority.
 Clarification of limits of authority.
 Unity of command.
Quality control
 A health agency administrator and nurse
managers at all hierarchical levels have a legal
obligation to ensure nursing care quality
 This imposes a duty to observe report and
correct the incompetence's of any patient care
provider.
 The law indicates that the head nurse/patient
care manager/nursing coordinator is generally
responsible for the quality of patient care given
by all personell within the care unit.