Susan S. Cox is a member of the Huron School of Nursing's nursing faculty in East Cleveland, Ohio. Show
You probably count on unlicensed assistive personnel (UAPs) to help you care for your patients. As an RN or LPN, however, you're ultimately responsible for your patients, even when you've delegated some of their
care to a UAP. To delegate legally, safely, and effectively, you need to know a few rules. Before handing off duties to UAPs, check the following five points to make sure you're meeting your responsibilities.
Your judgment is always key because whether or not delegating care is appropriate isn't always obvious. A patient may appear to be independent, yet still need care from someone skilled in communication. For example, a patient with newly diagnosed diabetes will benefit from the teaching and support you can offer while performing hands-on care you might otherwise delegate. Although delegating this “bed and bath” to a UAP is legal and safe, it may not be in this patient's best interest. Although you need to maintain standards, you should also be flexible. Acknowledge that some things can be done more than one way. You'll foster cooperative attitudes if you act as a guide and teacher, rather than a dictator. Just as you need to trust the UAPs assigned to you, the UAPs need to trust you. The end result will be better patient care—the one goal shared by everyone on staff. DELEGATIONTransferring to a competent individual the authority to perform a selected nursing task in a selected situation. The nurse retains accountability for the delegation. A little praise goes a long wayHere are a few ways to motivate a UAP on your staff:
SELECTED REFERENCESCohen, S. Managers' fast track. Delegating vs. dumping: Teach the difference. Nursing Management. 35(10):14,18,52, October 2004. National Council of State Boards of Nursing: Delegation: Concepts and Decision-Making Process. National Council Position Paper, 1995. Accessed online at http://www.ncsbn.org/regulation/uap_delegation_documents_delegation.asp, April 18, 2006. National Council of State Boards of Nursing: Delegation Decision-Making Tree. 1997. Accessed online at http://www.ncsbn.org/pdfs/delegationtree.pdf, April 18, 2006. Whitman, MM. Professional development. Return and report: Establishing accountability in delegation. American Journal of Nursing. 105(3):97, March 2005. Williams JK and Cooksey MM. Navigating the difficulties of delegation. Nursing2004. 34(9):32hn12, September 2004. What activities would be appropriate to delegate to the UAP?In general, simple, routine tasks such as making unoccupied beds, supervising patient ambulation, assisting with hygiene, and feeding meals can be delegated. But if the patient is morbidly obese, recovering from surgery, or frail, work closely with the UAP or perform the care yourself.
Which nursing tasks would be appropriate for the nurse to assign to the unlicensed assistive personnel?The RN is ultimately accountable for the care provided by the UAP. *The RN can delegate routine tasks such as taking vital signs, supervising ambulation, making beds, assisting with hygiene, and activities of daily living to the experienced UAP.
What are 3 tasks an RN can delegate to AP?Initiate, administer, and titrate both routine and complex medications. Perform education with patients about the plan of care. Admit, discharge and refer patients to other providers.
Which task is most appropriate for the nurse to delegate to the unlicensed assistive personnel UAP?(Options 2 and 5) Client positioning and measurement of vital signs and pulse oximetry may be delegated to unlicensed assistive personnel (UAP). Although LPNs can carry out these tasks, their time is better spent performing more complex client care (eg, medication administration) if UAP is available.
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